Main Session
Sep 30
QP 11 - Breast Cancer 4: Quick Pitch: Radiation-Related Toxicity in Breast Cancer: Emerging Predictors, Modalities, and Metrics

1065 - Patient Reported Outcomes following Accelerated Partial Breast vs. Ultrahypofractionated/Hypofractionated Whole Breast: A Single Institution Comparison Study

04:30pm - 04:35pm PT
Room 24

Presenter(s)

Allison Rau, MD, MS Headshot
Allison Rau, MD, MS - Arthur JE Child Comprehensive Cancer Centre, Calgary, AB

A. Rau1,2, T. Phan1,2, P. Grendarova1, N. Samson2, R. Dhoot1,2, S. Quirk3, D. Yannitsos1,2, M. B. Roumeliotis4, and N. Logie1,5; 1Department of Radiation Oncology, University of Calgary, Calgary, AB, Canada, 2Arthur J. E. Child Comprehensive Cancer Centre, Calgary, AB, Canada, 3Department of Radiation Oncology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, 4Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 5Arthur J.E. Child Comprehensive Cancer Centre, Calgary, AB, Canada

Purpose/Objective(s): Patient reported outcomes (PROs) inform how patients view and perceive their own health. Women with early-stage breast cancer (ESBC) undergoing breast conserving surgery (BCS) receive adjuvant radiotherapy (RT) as the standard of care. Patients have treatment options that may include accelerated partial breast irradiation (PBI) or whole breast radiation (WB) including a variety of fractionation schemes. We aim to understand patient quality of life and satisfaction of RT choice using PROs.

Materials/Methods: A single-institution prospective REB approved study was conducted in women diagnosed with ESBC undergoing BCS and adjuvant RT. At consultation, patients selected their preferred RT regimen (5 fraction APBI , 5 fraction WB (5WB), or 16 fraction WB (16WB)). Patients completed the Breast Appearance and Symptom Score (BASS), EORTC QLQ - BR23 at baseline, 6 mos, and 1-yr. Descriptive statistics were reported using statistical software, Version 30.0.0.0 (172).

Results: Sixty-one patients were enrolled. The 1-year BASS PROM found that 36.5% of patients had pain in the treated breast compared to 31.7% at baseline. Over half (56.6%) of patients noticed a small-moderate difference in breast size at baseline compared to 75.8% at 1-yr. Nearly 80% of patients at baseline and 1-yr rated their treated breast appearance as good-to-excellent.

All 61 patients completed the EORTC QLQ BR 23 at baseline and 35 at 1-yr. There were more difficulties raising the arm at 1-yr (34.2% VS 18.1% baseline) and more pain in the treated breast (60.0% 1-yr VS 39.4% baseline). More women felt it difficult to look at themselves naked at 1-yr (42.8% VS 21.3%), and 45.7% felt dissatisfied with their body (VS 29.5%).

When comparing treatment groups, a higher proportion of women receiving WB reported worse shoulder pain at 6 mos (38.5%-5WB, 50%-16 WB) compared to APBI (18.5%) (p=0.07). At 6 mos, a higher proportion of women receiving 5WB reported worsening arm range of motion and breast pain (46.2%, 61.5%) compared to ABPI (14.8%, 44.4%) and 16WB (16.7%,33.3%) (p=0.009,p=0.005). No patients were diagnosed with a recurrence in the treated breast at 1-yr.

Conclusion: PROs provide important details on patient satisfaction. Nearly double felt it difficult to look at themselves naked and were more dissatisfied with their body post RT. Patients receiving 5WB were more likely to report shoulder dysfunction and breast pain post RT. This study reveals that women continue to physically and psychologically cope with the treatment effects and supporting recovery is of importance.