Breast-conserving surgery with intraoperative radiotherapy in recurrent breast cancer: the patient's perspective.
Aged
Breast Neoplasms
/ mortality
Disease-Free Survival
Female
Humans
Mammaplasty
/ adverse effects
Mastectomy
/ adverse effects
Mastectomy, Segmental
/ adverse effects
Middle Aged
Neoplasm Recurrence, Local
/ mortality
Patient Preference
/ statistics & numerical data
Patient Satisfaction
/ statistics & numerical data
Postoperative Complications
/ epidemiology
Prognosis
Radiotherapy, Adjuvant
/ psychology
Retrospective Studies
Breast cancer
Breast conserving surgery
IORT
Intraoperative radiotherapy
Quality-of-life
Recurrent breast cancer
Journal
Breast cancer (Tokyo, Japan)
ISSN: 1880-4233
Titre abrégé: Breast Cancer
Pays: Japan
ID NLM: 100888201
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
13
02
2020
accepted:
20
05
2020
pubmed:
4
6
2020
medline:
22
6
2021
entrez:
4
6
2020
Statut:
ppublish
Résumé
When ipsilateral breast-tumor recurrence (IBTR) following breast-conserving surgery (BCS) occurs, the cure of a potentially life-threatening disease is the main goal. If, however, this is diagnosed early, prognosis is still good and patient-reported outcomes become more important. Despite the fact that many patients would prefer a further BCS, international breast cancer guidelines still recommend mastectomy, mainly because previous radiation implies limited options. Our comparative study evaluates the long-term quality-of-life and outcome in patients with IBTR who received BCS plus intraoperative radiotherapy (IORT) versus mastectomy. Patients with IBTR were retrospectively divided into three groups according to the local treatment: group 1 (n = 26) was treated with BCS + IORT; group 2 (n = 35) received a standard mastectomy; group 3 (n = 52) had a mastectomy with subsequent reconstruction. Outcomes were analyzed after a mean follow-up of 5 years after IBTR. Quality-of-life was evaluated by the validated questionnaire BREAST-Q in 50 patients who fulfilled the inclusion criteria. Quality-of-life scores varied within the groups, ranging from 51.4 to 91.3 (out of 100 points). We observed satisfactory scores in all items, with no statistical difference within the groups. Disease-free survival of all groups did not statistically differ, and overall mortality was very low (0.9%). The postinterventional complication rate was lower after BCS (19.2% versus 34.3% after mastectomy and 30.8% after mastectomy with reconstruction). For patients with previous surgery and radiation who demand a second BCS in the recurrent situation, this surgical technique can be offered in combination with IORT. Our long-term results imply oncological safety, lower complication rate, and good patient satisfaction.
Identifiants
pubmed: 32488732
doi: 10.1007/s12282-020-01114-y
pii: 10.1007/s12282-020-01114-y
pmc: PMC7567708
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1107-1113Commentaires et corrections
Type : CommentIn
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