A prospective comparison of subjective and objective assessments of cosmetic outcomes following breast brachytherapy.
A prospective comparison of subjective and objective assessments of cosmetic outcomes following breast brachytherapy. J Contemp Brachytherapy. 2019 Jun;11(3):207-214 Authors: Wadasadawala T, Sinha S, Verma S, Parmar V, Kannan S, Pathak R, Sarin R, Gaikar M Abstract Purpose: We evaluated agreement between subjective and objective methods of cosmesis scoring in an accelerated partial breast irradiation (APBI) cohort. Material and methods: Consecutive women treated with APBI using interstitial brachytherapy reported for clinical follow-up every 6 months. Single cross-sectional assessment of the breast cosmesis was done by a radiation oncologist (subjective method) using Harvard scale and by photographic assessment using BCCT.core (Breast Cancer Conservative Treatment. Cosmetic results, version 3.1) software (objective method) at 18-36 months post-APBI. The agreement between subjective and objective methods for the overall score as well as individual subjective/objective subdomains was computed using kappa statistics. ANOVA was used to test the correlation between objective indices and subjective subdomains. Results: The agreement between the subjective (physician) and objective assessment was good with a kappa of 0.673. Overall, 77 (98.7%) patients were satisfied with the overall outcomes of breast conservation therapy. The kappa agreement between physician and patient scoring was 0.457 (95% CI: 0.240-0.674). Among the subjective subdomains, location...
ConclusionPRT/PCRT is associated with low grades of fibrosis and a good to excellent long-term cosmetic outcome.
This report details our experience using accelerated partial breast irradiation (APBI) as a component of salvage breast conserving treatment.
We present Results of quality of life assessment comparison between APBI and WBI in early breast cancer.
ConclusionsThe local recurrence risk reduction of the tumour bed boost in breast-conserving therapy is not influenced by the applied boost technique.
In this study, the effect of a subcutaneous spacer injection on the skin dose, late skin toxicity, and cosmetic outcome is tested in patients treated with PBSI in the setting of breast-conserving therapy. Our results will be relevant for most forms of breast brachytherapy as well as robotic radiosurgery, as skin spacers could protect the skin with these other techniques.Trial registrationNetherlands Trial Register,NTR6549. Registered on 27 June 2017.
This study aimed to estimate the probability of an unfavourable aesthetic outcome (AO) 2 years after breast-conserving therapy (BCT) and evaluate the possible influence of brachytherapy (BT) and external beam radiotherapy (EBRT) boost on patient-reported outcomes (PROs) and AO.Patients and methodsPatients treated with BCT starting April 2015 were prospectively included. Selection of the boost technique followed an in-house flowchart based on the depth of the tumour bed. An electron boost was performed for a superficial clinical target volume (maximum 28 mm under the epidermis), a BT boost was proposed in...
This report reviews our available data to provide an analysis of patient outcomes over 12 years of use at a single institution. A retrospective review was conducted of records of 150 patients who underwent APBI or attempted APBI after breast-sparing surgeries between 2006 and 2017. These charts were analyzed for documentation of patient age, cancer stage, incidence of recurrence, and posttreatment complications. Of the patients evaluated, 99 per cent (149/150) completed treatment. The median time since treatment completion is now 8.9 years. One hundred eleven patients (74% ) are now greater than five years posttreatment. I...
A series of clinical trials and prospective studies investigating intraoperative radiation therapy as a safe modality following breast conserving surgery has led to single institution studies of electronic brachytherapy for low risk breast cancer patients. Despite minimal data on the clinical effectiveness of electronic brachytherapy as a safe modality or alternative to whole breast radiation following breast conserving surgery, the adoption of this technology appears to account for the rise in intraoperative radiation therapy in the 21st century.
Breast conserving therapy is frequently used to treat early stage breast cancer but the protracted length of whole breast irradiation has made it an unattractive option for some patients. Accelerated partial breast irradiation (APBI) is used to treat the lumpectomy cavity alone in a shorter amount of time, conventionally in 10 fractions twice daily over 5 days. The SenoRx study opened by Contura, was a multi-site prospective phase II non-randomized dose-escalation trial for APBI using a multi-lumen balloon 3 or 4 fractions over 2 days.
The composite therapy concept consisting of breast-conserving surgery (BCS) followed by whole-breast irradiation (WBI) is an appropriate and established therapy for UICC (Union International Cancer Centre) Stage I and II breast cancer (BC) according to several mature randomized trials: Protocol B-06, the Milan trial, and EORTC 10801 trial. In addition, the recently published randomized GEC-ESTRO trial demonstrated equivalence between the established WBI and the concept of accelerated partial breast irradiation (APBI) by interstitial multicatheter brachytherapy (mBT) in low-risk early breast cancer.