Details

Autor(en) / Beteiligte

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

Titel

Cosmetic changes following surgery and accelerated partial breast irradiation using HDR interstitial brachytherapy: Evaluation by a multidisciplinary/multigender committee

Ist Teil von

• Strahlentherapie und Onkologie, 2017-05, Vol.193 (5), p.367-374

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• 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.