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Quality of Life Outcomes Associated With Optimization of Treatment by Omitting Radiotherapy in Early Breast Cancer.
- Source :
-
Clinical breast cancer [Clin Breast Cancer] 2024 Jul; Vol. 24 (5), pp. 447-456.e2. Date of Electronic Publication: 2024 Mar 06. - Publication Year :
- 2024
-
Abstract
- Purpose: Improved prognosis of early breast cancer (EBC) has created opportunities for treatment optimization but reducing morbidity should not inadvertently compromise quality of life (QoL). PROSPECT <superscript>1</superscript> used pre-operative MRI and pathology findings to identify women suitable for radiotherapy (RT) omission following breast conserving surgery. We retrospectively explored the association between de-escalation by omission of RT and QoL in women with EBC.<br />Materials and Methods: Three groups were recruited: PROSPECT participants who omitted RT following preoperative MRI (A); participants who received RT following preoperative MRI (B); and women who received usual care - No MRI, received RT (C). Measures included the EORTC QLQ-C30 and BR23, BCTOS, DASS-21 and a measure of decision regret. Between group differences were assessed using ANOVA or nonparametric equivalents. Semi-structured interviews were analyzed with qualitative description (n = 44).<br />Results: Data from 400 women were analyzed (125A, 102B, 173C). Group A had fewer symptoms and better body image (breast symptoms: A-B P = .003, A-C P = <.001; arm symptoms: A-B P = .004, A-C P = .011; body image: A-C P = .041) and fewer differences between the treated and untreated breasts (cosmetic: A-B P < .001, A-C P < .001; functional: A-C P = .011; breast specific pain: A-B P < .001, A-C P < .001). Two qualitative themes were found: Treatment with the biggest impact on QoL, and Specific impact of RT on QoL.<br />Conclusions: Omission of RT was associated with better QoL and functional and cosmetic outcomes. It was highly acceptable to patients. Clinicians should consider the potential for preserved QoL associated with treatment optimization via omission of RT in treatment planning for patients with EBC.<br />Competing Interests: Disclosure The authors have no competing interests to declare. The authors have no relevant financial or non-financial interests to disclose.<br /> (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Female
Middle Aged
Retrospective Studies
Aged
Adult
Prognosis
Radiotherapy, Adjuvant methods
Body Image psychology
Breast Neoplasms radiotherapy
Breast Neoplasms psychology
Breast Neoplasms pathology
Breast Neoplasms surgery
Quality of Life
Magnetic Resonance Imaging
Mastectomy, Segmental psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1938-0666
- Volume :
- 24
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Clinical breast cancer
- Publication Type :
- Academic Journal
- Accession number :
- 38548516
- Full Text :
- https://doi.org/10.1016/j.clbc.2024.03.002