Does breast composition influence late adverse effects in breast radiotherapy?
Abstract
BACKGROUND: Large breast size is associated with increased risk of late adverse effects after surgery and radiotherapy for early breast cancer. It is hypothesised that effects of radiotherapy on adipose tissue are responsible for some of the effects seen. In this study, the association of breast composition with late effects was investigated along with other breast features such as fibroglandular tissue distribution, seroma and scar. METHODS: The patient dataset comprised of 18 cases with changes in breast appearance at 2 years follow-up post-radiotherapy and 36 controls with no changes, from patients entered into the FAST-Pilot and UK FAST trials at The Royal Marsden. Breast composition, fibroglandular tissue distribution, seroma and scar were assessed on planning CT scan images and compared using univariate analysis. The association of all features with late-adverse effect was tested using logistic regression (adjusting for confounding factors) and matched analysis was performed using conditional logistic regression. RESULTS: In univariate analyses, no statistically significant differences were found between cases and controls in terms of breast features studied. A statistically significant association (p < 0.05) between amount of seroma and change in photographic breast appearance was found in unmatched and matched logistic regression analyses with odds ratio (95% CI) of 3.44 (1.28-9.21) and 2.57 (1.05-6.25), respectively. CONCLUSIONS: A significant association was found between seroma and late-adverse effects after radiotherapy although no significant associations were noted with breast composition in this study. Therefore, the cause for large breast size as a risk factor for late effects after surgery and optimally planned radiotherapy remains unresolved.
Collections
Subject
Breast
Humans
Breast Neoplasms
Seroma
Tomography, X-Ray Computed
Organ Size
Radiotherapy
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Logistic Models
Risk Factors
Case-Control Studies
Aged
Middle Aged
Female
Long Term Adverse Effects
Research team
Clinical Trials & Statistics Unit
Imaging for Radiotherapy Adaptation
Translational Breast Radiobiology
Language
eng
Date accepted
2015-12-12
License start date
2016-04
Citation
Breast (Edinburgh, Scotland), 2016, 26 pp. 25 - 30
Publisher
CHURCHILL LIVINGSTONE