A Quantitative Evaluation of the Effects of Radiation Therapy on the Post-Surgical Breast.

Autor:	Becker M; University of California San Diego, School of Medicine, San Diego, CA., Reese M; University of California San Diego, School of Medicine, San Diego, CA., Yessaillian A; University of California San Diego, School of Medicine, San Diego, CA., Lopes K; University of California San Diego, School of Medicine, San Diego, CA., Harfouche C; Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, CA., Leach G; Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, CA., Blair S; Department of Surgery, University of California San Diego, San Diego, CA., Yashar C; Department of Radiation Oncology, University of California San Diego, San Diego, CA., Ojeda-Fournier H; Department of Radiology, Breast Imaging Division, University of California San Diego, San Diego, CA., Reid CM; Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, CA.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2024 Sep 04. Date of Electronic Publication: 2024 Sep 04.
DOI:	10.1097/PRS.0000000000011732
Abstrakt:	Background: Radiation (RT) effects on breast volume may impact breast-conserving therapy (BCT) outcomes, but quantitative information is lacking regarding the extent/timing of volume loss. This study aimed to quantify volume loss by assessing changes in irradiated breasts. Methods: Breast volume changes were calculated for 113 patients (115 breasts) following T1 tumor lumpectomies. From preoperative baseline to seven years post-radiation, volumes were calculated from mammograms using π/3* height*radius2. Paired t-tests assessed change over time, with subset analyses of tumor/breast volumes of ≤ 10% (n=67) and > 10% (n=48). Multivariable regression assessed volume change as a function of age, smoking history, diabetes, radiation dosage, fractions, technique, treatment length, boost dose, chemotherapy (hormonal or cytotoxic), baseline breast volume, and time since treatment. Results: Patients lost 8.3% of breast volume during surgery. One year following BCT/RT, volume loss was 19.3%. By year five, total volume loss was 26.6%.Subset analyses demonstrated that in addition to lumpectomy defects, five-year volume loss was 21.7% for tumor/ breast volume > 10% and 29.5 % for tumor/ breast volume ≤ 10%. Volume loss between subgroups was not significantly different (p=0.37). Larger breast volume was a significant predictor of greater volume loss for all five years (p<0.001), followed by diabetes and smoking history. Conclusion: Patients with T1 tumors undergoing BCT/RT may lose approximately 20% of breast volume (beyond specimens) within a year, with continued loss for five years. Volume change did not differ significantly according to baseline breast volume, although larger breasts may experience comparatively larger volume changes. Competing Interests: Financial Disclosure Statement: No authors have any relevant conflict of interest to disclose. (Copyright © 2024 by the American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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