Trends in patient-reported outcomes after breast-conserving surgery and partial-breast versus whole-breast irradiation Journal Article
| Authors: | Chandler, J. M.; Kim, M.; Sevilimedu, V.; Le, T. V.; Nelson, J. A.; Braunstein, L. Z.; Morrow, M.; Lee, M. K.; Tadros, A. B. |
| Article Title: | Trends in patient-reported outcomes after breast-conserving surgery and partial-breast versus whole-breast irradiation |
| Abstract: | <p>Background Although several trials have demonstrated the oncologic safety of partial-breast irradiation (PBI) compared with whole-breast irradiation (WBI), data on patient-reported outcomes are mixed. Here we compare breast satisfaction and chest well-being using the BREAST-Q questionnaire among patients undergoing PBI versus WBI. Patients and Methods We identified patients undergoing lumpectomy and radiation, and analyzed their BREAST-Q scores preoperatively and postoperatively at 6 months, 1 year, 2 years, and 3 years. We stratified patients by type of radiation, and compared breast satisfaction and chest well-being scores over time, and with univariate and multivariate analyses (MVA). Results From 2017 to 2022, 6374 patients underwent lumpectomy and radiation, and responded to the BREAST-Q at >= 1 time point. For both breast satisfaction and chest well-being, patients undergoing PBI had higher preoperative scores. For breast satisfaction, scores increased for both groups postoperatively and remained above baseline through 3 years of follow-up; for chest well-being, scores decreased postoperatively and gradually increased. On MVA, radiation type was not significantly associated with either breast satisfaction or chest well-being at any postoperative time point. At the 2-year postoperative time point, receipt of adjuvant chemotherapy was associated with worse breast satisfaction, and BMI < 20 was associated with improved chest well-being. Conclusions Patients undergoing PBI and WBI had similar breast satisfaction and chest well-being at all postoperative time points. Other patient- and treatment-related variables such as body mass index (BMI), axillary surgery, and need for chemotherapy were significantly associated with long-term breast satisfaction and chest well-being. These findings support the use of PBI as an alternative to WBI in terms of patient-reported outcomes in eligible patients.</p> |
| Keywords: | radiotherapy; morbidity; biopsy; carcinoma; patient-reported outcomes; toxicity; quality-of-life; randomized-trial; lymph-node dissection; breast-conserving therapy; axillary dissection; cancer patients; partial-breast irradiation; whole-breast irradiation |
| Journal Title: | Annals of Surgical Oncology |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Publication status: | Online ahead of print |
| Date Published: | 2025-09-10 |
| Online Publication Date: | 2025-09-10 |
| Language: | English |
| ACCESSION: | WOS:001569250200001 |
| DOI: | 10.1245/s10434-025-18095-x |
| PROVIDER: | wos |
| PUBMED: | 40928574 |
| Notes: | Article; Early Access -- Source: Wos |
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