ASTRO: Whole, partial breast RT yield similar cosmetic results

By Kate Madden Yee, staff writer

September 16, 2019 -- Whole- and partial-breast radiation after lumpectomy produce similar cosmetic outcomes for women diagnosed with early stages of cancer who seek to preserve their breasts, according to research presented September 15 at the American Society for Radiation Oncology (ASTRO) meeting in Chicago.

The findings offer women an option when it comes to further treatment after surgery, noted lead study author Dr. Julia White of Ohio State University Comprehensive Cancer Center in Columbus in a statement released by ASTRO.

"Partial-breast radiation is a good choice. That's what I'm going to say to certain subsets of my patients," she said.

Women diagnosed with early breast cancer who undergo lumpectomies commonly have radiation therapy afterward to reduce recurrence risk. Partial breast radiation is an appealing option, since it delivers radiation over several days to the area around the surgical site rather than over three to four weeks to the entire breast, White and colleagues noted.

The group analyzed data from a phase III trial, NRG Oncology/NSABP B-39/RTOG 0413, that included 900 women with early-stage breast cancer. Of these, 477 received partial-breast radiation and 423 underwent whole-breast radiation.

The women and their physicians were asked to rate the cosmetic outcome of the treated breast in comparison with the untreated side at three time points: baseline, 12 months after treatment, and three years after treatment. Physicians also reviewed digital patient photos of the women's breasts taken at each time point, blinded to the treatment the women received.

Women were equally satisfied with cosmetic results whether they underwent whole- or partial-breast radiation, White's team found. Three years after completing radiation therapy, 81% of patients said they were totally satisfied with partial-breast radiation and 86% were totally satisfied with whole-breast radiation.

The group also found that, on average, patients who scored their outcomes as "excellent" or "good" (compared with those who rated them as "fair" or "poor") agreed with their doctors' ratings 89% of the time and agreed with physicians making photo-based ratings 85% of the time.

"If a patient chooses breast conservation for her treatment, she generally wants the breast to feel and look as normal as possible," White said. "It is difficult to have to say to a patient that she can have a shorter, more convenient treatment but will have to accept a cosmetic outcome that is not as nice as she would get with a longer treatment. We were relieved to find out the cosmetic outcomes are equivalent."

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