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A comparison of complication rates in early-stage breast cancer patients treated with brachytherapy versus whole-breast irradiation
Journal article   Peer reviewed

A comparison of complication rates in early-stage breast cancer patients treated with brachytherapy versus whole-breast irradiation

Nicolas Ajkay, Abigail E Collett, Erica V Bloomquist, Edward J Gracely, Thomas G Frazier and Andrea V Barrio
Annals of surgical oncology, v 22(4), pp 1140-1145
Apr 2015
DOI: https://doi.org/10.1245/s10434-014-4131-6
PMID: 25319575
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Carcinoma, Lobular - pathology Prognosis Follow-Up Studies Humans Middle Aged Seroma - etiology Carcinoma, Lobular - complications Aged, 80 and over Adult Carcinoma, Ductal, Breast - pathology Female Retrospective Studies Carcinoma, Intraductal, Noninfiltrating - radiotherapy Neoplasm Invasiveness Fat Necrosis - etiology Carcinoma, Intraductal, Noninfiltrating - complications Radiation Injuries - etiology Breast Neoplasms - complications Breast Neoplasms - radiotherapy Carcinoma, Intraductal, Noninfiltrating - pathology Carcinoma, Lobular - radiotherapy Breast Neoplasms - pathology Carcinoma, Ductal, Breast - radiotherapy Carcinoma, Ductal, Breast - complications Aged Neoplasm Staging Brachytherapy - adverse effects
The adoption of breast brachytherapy into clinical practice for early-stage breast cancer has increased over the last several years. Studies evaluating complication rates following treatment with brachytherapy have shown conflicting results. We compared local toxicity in patients treated with brachytherapy with those treated with whole-breast irradiation (WBI). We identified 417 early-stage breast cancer patients treated with breast-conserving surgery and radiation between 2004 and 2010, and compared 271 women treated with intracavitary brachytherapy with 146 women treated with WBI. Long-term complications were assessed using Kaplan-Meier curves with the log-rank test. Median follow-up was 4.6 years, and the 5-year incidence of infectious skin complications (9.7 vs. 11.0 %, p = 0.84), abscess (1.1 vs. 0 %, p = 0.15), telangiectasia (8.0 vs. 5.3 %, p = 0.35), and breast pain (14.2 vs. 9.4 %, p = 0.2) was similar between the brachytherapy and WBI cohorts. The brachytherapy cohort had a higher 5-year rate of seroma (46.5 vs. 18.5 %, p < 0.001), and fat necrosis (39.5 vs. 24.4 %, p < 0.001). Brachytherapy patients trended towards more frequent biopsies as a result of fat necrosis to rule out a recurrence (11.2 vs. 6.7 %, p = 0.13). Patients treated with intracavitary brachytherapy had more local toxicity, particularly seroma and fat necrosis. Patients should be counseled on the possible increased rate of long-term complications associated with brachytherapy treatment.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Web of Science research areas
Oncology
Surgery
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