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02.01.2017 | Original Article

Cosmetic changes following surgery and accelerated partial breast irradiation using HDR interstitial brachytherapy

Evaluation by a multidisciplinary/multigender committee

verfasst von: Tamer Soror, György Kovács, Nina Seibold, Corinna Melchert, Kristin Baumann, Eike Wenzel, Suzana Stojanovic-Rundic

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 5/2017

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Abstract

Background

Patients with early-stage breast cancer can benefit from adjuvant accelerated partial breast irradiation (APBI) following breast-conserving surgery (BCS). This work reports on cosmetic results following APBI using multicatheter high-dose-rate interstitial brachytherapy (HDR-IBT).

Patients and methods

Between 2006 and 2014, 114 patients received adjuvant APBI using multicatheter HDR-IBT. For each patient, two photographs were analyzed: the first was taken after surgery (baseline image) and the second at the last follow-up visit. Cosmesis was assessed by a multigender multidisciplinary team using the Harvard Breast Cosmesis Scale. Dose–volume histogram (DVH) parameters and the observed cosmetic results were investigated for potential correlations.

Results

The median follow-up period was 3.5 years (range 0.6–8.5 years). The final cosmetic scores were 30% excellent, 52% good, 14.5% fair, and 3.5% poor. Comparing the baseline and follow-up photographs, 59.6% of patients had the same score, 36% had a better final score, and 4.4% had a worse final score. Only lower target dose nonuniformity ratio (DNR) values (0.3 vs. 0.26; p = 0.009) were significantly associated with improved cosmetic outcome vs. same/worse cosmesis.

Conclusion

APBI using multicatheter HDR-IBT adjuvant to BCS results in favorable final cosmesis. Deterioration in breast cosmesis occurs in less than 5% of patients. The final breast cosmetic outcome in patients treated with BCS and APBI using multicatheter HDR-IBT is influenced primarily by the cosmetic result of the surgery. A lower DNR value is significantly associated with a better cosmetic outcome.

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Titel: Cosmetic changes following surgery and accelerated partial breast irradiation using HDR interstitial brachytherapy
Evaluation by a multidisciplinary/multigender committee
verfasst von: Tamer Soror
György Kovács
Nina Seibold
Corinna Melchert
Kristin Baumann
Eike Wenzel
Suzana Stojanovic-Rundic
Publikationsdatum: 02.01.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 5/2017
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-016-1093-6

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Cosmetic changes following surgery and accelerated partial breast irradiation using HDR interstitial brachytherapy

Evaluation by a multidisciplinary/multigender committee

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Patients and methods

Results

Conclusion

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Conclusion

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