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Breast Cancer Research and Treatment

, Volume 169, Issue 1, pp 189–196 | Cite as

Patient-reported outcomes of catheter-based accelerated partial breast brachytherapy and whole breast irradiation, a single institution experience

  • Krishan R. Jethwa
  • Mohamed M. Kahila
  • Kristin C. Mara
  • William S. Harmsen
  • David M. Routman
  • Geralyn M. Pumper
  • Kimberly S. Corbin
  • Jeff A. Sloan
  • Kathryn J. Ruddy
  • Tina J. Hieken
  • Sean S. Park
  • Robert W. Mutter
Brief Report

Abstract

Purpose

Accelerated partial breast irradiation (APBI) and whole breast irradiation (WBI) are treatment options for early-stage breast cancer. The purpose of this study was to compare patient-reported-outcomes (PRO) between patients receiving multi-channel intra-cavitary brachytherapy APBI or WBI.

Methods

Between 2012 and 2015, 131 patients with ductal carcinoma in situ (DCIS) or early stage invasive breast cancer were treated with adjuvant APBI (64) or WBI (67) and participated in a PRO questionnaire. The linear analog scale assessment (LASA), harvard breast cosmesis scale (HBCS), PRO-common terminology criteria for adverse events- PRO (PRO-CTCAE), and breast cancer treatment outcome scale (BCTOS) were used to assess quality of life (QoL), pain, fatigue, aesthetic and functional status, and breast cosmesis. Comparisons of PROs were performed using t-tests, Wilcoxon rank-sum, Chi square, Fisher exact test, and regression methods.

Results

Median follow-up from completion of radiotherapy and questionnaire completion was 13.3 months. There was no significant difference in QoL, pain, or fatigue severity, as assessed by the LASA, between treatment groups (p > 0.05). No factors were found to be predictive of overall QoL on regression analysis. BCTOS health-related QoL scores were similar between treatment groups (p = 0.52).The majority of APBI and WBI patients reported excellent/good breast cosmesis, 88.5% versus 93.7% (p = 0.37). Skin color change (p = 0.011) and breast elevation (p = 0.01) relative to baseline were more common in the group receiving WBI.

Conclusions

APBI and WBI were both associated with favorable patient-reported outcomes in early follow-up. APBI resulted in a lesser degree of patient-reported skin color change and breast elevation relative to baseline.

Keywords

Breast Cancer Radiotherapy PROs APBI 

Abbreviations

APBI

Accelerated partial breast irradiation

WBI

Whole breast irradiation

PRO

Patient-reported outcomes

DCIS

Ductal carcinoma in situ

LASA

Linear analog scale assessment

HBCS

Harvard breast cosmesis scale

PRO-CTCAE

Patient-reported outcomes version of the common terminology criteria for adverse events

BCTOS

Breast cancer treatment outcome scale

QoL

Quality of life

BCT

Breast conserving therapy

IMRT

Intensity modulated radiation therapy

ER

Estrogen receptor

CT

Computed tomography

PTV

Planning target volume

HDR

High-dose rate

CTV

Clinical target volume

IRB

Institutional review board

HR-QoL

Health-related quality of life

IQR

Interquartile range

GEC-ESTRO

Groupe européen de curiethérapie of european society for radiotherapy and oncology

NSABP

National surgical adjuvant breast and bowel project

Notes

Funding

This project was supported by the Mayo Clinic CTSA through Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH).

Supplementary material

10549_2018_4665_MOESM1_ESM.pdf (1.4 mb)
Supplementary material 1 (PDF 1465 kb)
10549_2018_4665_MOESM2_ESM.docx (14 kb)
Supplementary material 2 (DOCX 14 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Krishan R. Jethwa
    • 1
  • Mohamed M. Kahila
    • 1
  • Kristin C. Mara
    • 2
  • William S. Harmsen
    • 2
  • David M. Routman
    • 1
  • Geralyn M. Pumper
    • 1
  • Kimberly S. Corbin
    • 1
  • Jeff A. Sloan
    • 2
  • Kathryn J. Ruddy
    • 3
  • Tina J. Hieken
    • 4
  • Sean S. Park
    • 1
  • Robert W. Mutter
    • 1
  1. 1.Department of Radiation OncologyMayo ClinicRochesterUSA
  2. 2.Division of Biomedical Statistics and Informatics, Department of Health Sciences ResearchMayo ClinicRochesterUSA
  3. 3.Division of Medical OncologyMayo ClinicRochesterUSA
  4. 4.Department of SurgeryMayo ClinicRochesterUSA

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