Abstract
Purpose
The present study aimed to determine the prevalence of subjective symptoms of late complications mainly caused by radiotherapy in breast-conserving therapy (BCT), and to identify patients and treatment factors that may predict such complications.
Materials and Methods
A cross-sectional survey was conducted on 247 patients who had had early breast cancer and who were free of recurrence after BCT. Self-administered questionnaires were mailed to the 247 patients. Patient and treatment factors were analyzed.
Results
Responses were received from 193 of the 247 patients. Common perceptions of late complications included shrinking in size (85%), pain (73%), firmness (65%), thickening of the arm (34%), and changes in skin color (19%). However, high-grade toxicity (above Grade 2) was perceived in only 0.52–7.8% of patients. In multivariate models, shrinking in size was associated with age (P=0.020), pain was associated with additional boost irradiation (P=0.015), and firmness was associated with time after surgery (P-0.004).
Conclusions
Late complications as perceived by the patient herself after BCT are common, but tend to be of minimal severity. Most predictive factors are inevitably associated with late complications. However, the boost irradiation may not be indicated for every patient from a QOL perspective.
Similar content being viewed by others
References
Fujishiro S, Mitsumori M, Kokubo M et al: Cosmetic results and complications after breast conserving therapy for early breast cancer. Breast Cancer 7:57–63, 2000.
Wazer DE, DiPetrillo T, Schmi dt-Ullrich R et al: Factors influencing cosmetic outcome and complication risk after conservative surgery and radiotherapy for early-stage breast carcinoma. J Clin Oncol 10:356–363, 1992.
Early breast cancer trialists’ collaborative group: Effects of radiotherapy and surgery in early breast cancer. N Engl J Med 333:1444–1455, 1995.
Fisher B, Anderson S, Redmond CK et al: Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 333:1456–1461, 1995.
Stanton AL, Krishnan L, Collins CA: Form or function? Part 1. Subjective cosmetic and functional correlates of quality of life in women treated with breast-conserving surgical procedures and radiotherapy. Cancer 91:2273–2281, 2001.
Krishnan L, Stanton AL, Collins CA et al: Form or function? Part 2. Objective cosmetic and functional correlates of quality of life in women treated with breast-conserving surgical procedures and radiotherapy. Cancer 91:2282–2287, 2001.
Pavy JJ, Denekamp J, Letschert J et al: EORTC Late Effects Working Group. Late Effects toxicity scoring: the SOMA scale. Int J Radiat Oncol Biol Phys 31:1043–1047. 1995
Fehlauer F, Tribius S, Holler U et al: Long-term radiation sequelae after breast-conserving therapy in women with early-stage breast cancer: an observational study using the LENT-SOMA scoring system. Int J Radiat Oncol Biol Phys 55:651–658, 2003.
Hoeller U, Tribius S, Kuhlmey A et al: Increasing the rate of late toxicity by changing the score? A comparison of RTOG/EORTC and LENT/SOMA scores. Int J Radiat Oncol Biol Phys 55:1013–1018, 2003.
Whelan TJ, Levine M, Julian J et al: The effects of radiation therapy on quality of life of women with breast carcinoma. Cancer 88:2260–2266, 2000.
Bartelink H, Horiot JC, Poortmans P et al: Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N Engl J Med 345:1378–1387, 2001.
Borger JH, Kemperman H, Smitt HS et al: Dose and volume effects on fibrosis after breast conservation therapy. Int J Radiat Oncol Biol Phys 30:1073–1081, 1994.
Johansson S, Svensson H, Denekamp J: Dose response and latency for radiation-induced fibrosis, edema, and neuropathy in breast cancer patients. Int J Radiat Oncol Biol Phys 52:1207–1219, 2002.
Pierquin B, Mazeron JJ, Glaubiger D: Conservative treatment of breast cancer in Europe: report of the Groupe Europeen de Curietherapie. Radiother Oncol 6:187–198, 1986.
Johansen J, Overgaard J, Blichert-Toft M et al: Treatment of morbidity associated with the management of the axilla in breast-conserving therapy. Acta Oncol 39:349–354, 2000.
Markiewicz DA, Schultz DJ, Haas JA et al: The effects of sequence and type of chemotherapy and radiation therapy on cosmesis and complications after breast conservation therapy. Int J Radiat Oncol Biol Phys 35:661–668, 1996.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Ishiyama, H., Niino, K., Hosoya, T. et al. Results of a questionnaire survey for symptom of late complications caused by radiotherapy in breast conserving therapy. Breast Cancer 13, 197–201 (2006). https://doi.org/10.2325/jbcs.13.197
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.2325/jbcs.13.197