Late radiation side effects, cosmetic outcomes and pain in breast cancer patients after breast-conserving surgery and three-dimensional conformal radiotherapy

Abstract

Chronic arm and breast oedema were significantly influenced by the extent of surgery (AC). Ptotic and large breasts were significantly associated with unfavourable COs and chronic breast oedema. Late toxicities exclusive breast pain were not associated with radiotherapy parameters.

A new approach for modeling patient overall radiosensitivity and predicting multiple toxicity endpoints for breast cancer patients

“…These associations have been reported before. The correlation between breast volume and late toxicity has been seen in different publications [3,[22][23][24][25]. Since no correlation was found between breast volume and hot spots in this dataset, the effect cannot only be attributed to dose inhomogeneity, as already reported by Goldsmith et al [22].…”

Kinesiology taping for breast lymphoedema after breast cancer treatment: A feasibility randomised controlled trial

“…Increased body mass index (BMI) and upper outer quadrant tumour site were found to correlate with BLE in a study by Goffman and colleagues [13]. A bra cup size of 'C' or more was reported to be a further risk factor [10,14]. Radiotherapy dose of ≥40 Gy has also been stated to increase breast volume [15].…”

“…Certain risk factors for the development of BLE have been identified in the literature. Recently, axillary surgery is noted as a primary risk factor for BLE [9,10] and incidences of 70% and 79% have been reported in those who have had axillary node clearance (ANC) surgery and radiotherapy to the affected breast [11,12]. Increased body mass index (BMI) and upper outer quadrant tumour site were found to correlate with BLE in a study by Goffman and colleagues [13].…”

Progressive breast fibrosis caused by extreme radiosensitivity: Oncocytogenetic diagnosis and treatment by reconstructive flap surgery

“…The principal long‐term side effect of breast radiotherapy is fibrosis, a serious cosmetic and psychological problem that might be a painful condition for the patient. Besides fibrosis telangiectasis, lymphoedema in the arm and breast oedema occur, and patients often experience moderate or severe pain in the breast, arm, or shoulder . Radiotherapy of breast cancer can also induce late complications in pulmonary and cardiac tissue leading to pulmonary apical fibrosis, pericardial disease, myocardial fibrosis, coronary artery disease, and valvular lesions .…”

“…Fibrosis represents a proliferative response of the surviving fibrocytes due to growth factors released after tissue injury caused by ionizing radiation. Histological and immunological signs of radiation‐induced fibrosis include the presence of inflammatory infiltrate, macrophages, fibroblasts, matrix proteins, collagen, and growth factor beta 1 (transforming growth factor), which regulates epidermal growth factor, fibroblast growth factor, tumour necrosis factor, and interleukin‐1 production . While healing of a simple tissue injury might seem a prospective process in time, fractionated radiation therapy produces a series of repeated trauma for tissues.…”