Breast Cancer Patient-Reported Quality of Life Outcomes Following Radiation Therapy

  • Gan M
  • Ganju R
  • Faucheux M
  • et al.
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Purpose/Objective(s): As cure rates for breast cancer improve, there has been increasing emphasis on quality of life and cosmesis following breast cancer treatment. Breast local therapy is rapidly evolving, with new strategies for reconstruction, differences in surgical approaches to nodal assessment, and shorter radiation fractionation schemes. We recently implemented the BREAST-Q1 questionnaire as part of our routine assessment of our breast cancer patients in our clinic and sought to assess the impact of changes in local therapy on patient reported outcomes. Materials/Methods: A total of 281 patients at a single institution were prospectively enrolled for patient-reported outcomes research. This study was approved by our institutional IRB. Electronically collected data was performed using the Vision Tree platform. Patients were given BREAST-Q questionnaires prior to radiation, one month post treatment, 6 months post treatment, and then annually for up to 5 years. Patient data was collected on age, race, mastectomy vs lumpectomy, sentinel vs axillary dissection, stage, hormone status, lymphedema, smoking use, reconstruction type, BMI, chemotherapy, and radiation dose. Statistical analysis was used to assess correlation between patient and tumor characteristics with BREAST-Q scores. Emphasis was placed on the following quality of life endpoints: acceptance of body image, breast pain, arm pain, and range of motion. Result(s): Median age was 57, range 28-89. Fifty three patients underwent post mastectomy radiation and 228 were treated with breast conservation. 14% of patients were African American. In mastectomy patients, there was significantly higher unacceptable body appearance for white versus black patients (17% vs 0%, p=0.001). In lumpectomy patients, there was significantly higher breast pain in black as compared to white patients (17% vs 4%, p=0.03). There was no significant correlation between patient's perceptions of attractiveness, arm pain, breast pain, or range of motion in regards to use of hypofractionation, sentinel node biopsy vs axillary node dissection, premenopausal status, use of chemotherapy, laterality, or immediate reconstruction. Conclusion(s): Counter to our hypothesis, changes in local therapy were not significantly correlated with improved BREAST-Q scores in our patient population. Interestingly, race had a significant association with outcomes of pain and appearance. Further study is warranted to verify these findings, as racial differences in patient reported outcomes may impact choice of local treatment for these patients. 1. Pusic AL, Klassen A, Scott A, Klok J, Cordeiro PG, Cano SJ. Development of a New Patient Reported Outcome Measure for Breast Surgery: The BREAST-Q©. Plast Reconstr Surg. 2009 Aug;124(2):345-53.Copyright © 2019




Gan, M., Ganju, R. G., Faucheux, M., Tennapel, M. J., & Mitchell, M. P. (2019). Breast Cancer Patient-Reported Quality of Life Outcomes Following Radiation Therapy. International Journal of Radiation Oncology*Biology*Physics, 105(1), E54.

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