{"title":"放射治疗对术后乳房影响的定量评估。","authors":"Miriam Becker,McKay Reese,Andrea Yessaillian,Kelli Lopes,Cyril Harfouche,Garrison Leach,Sarah Blair,Catheryn Yashar,Haydee Ojeda-Fournier,Chris M Reid","doi":"10.1097/prs.0000000000011732","DOIUrl":null,"url":null,"abstract":"BACKGROUND\r\nRadiation (RT) effects on breast volume may impact breast-conserving therapy (BCT) outcomes, but quantitative information is lacking regarding the extent/timing of volume loss. This study aimed to quantify volume loss by assessing changes in irradiated breasts.\r\n\r\nMETHODS\r\nBreast volume changes were calculated for 113 patients (115 breasts) following T1 tumor lumpectomies. From preoperative baseline to seven years post-radiation, volumes were calculated from mammograms using π/3* height*radius2. Paired t-tests assessed change over time, with subset analyses of tumor/breast volumes of ≤ 10% (n=67) and > 10% (n=48). Multivariable regression assessed volume change as a function of age, smoking history, diabetes, radiation dosage, fractions, technique, treatment length, boost dose, chemotherapy (hormonal or cytotoxic), baseline breast volume, and time since treatment.\r\n\r\nRESULTS\r\nPatients lost 8.3% of breast volume during surgery. One year following BCT/RT, volume loss was 19.3%. By year five, total volume loss was 26.6%.Subset analyses demonstrated that in addition to lumpectomy defects, five-year volume loss was 21.7% for tumor/ breast volume > 10% and 29.5 % for tumor/ breast volume ≤ 10%. Volume loss between subgroups was not significantly different (p=0.37). Larger breast volume was a significant predictor of greater volume loss for all five years (p<0.001), followed by diabetes and smoking history.\r\n\r\nCONCLUSION\r\nPatients with T1 tumors undergoing BCT/RT may lose approximately 20% of breast volume (beyond specimens) within a year, with continued loss for five years. Volume change did not differ significantly according to baseline breast volume, although larger breasts may experience comparatively larger volume changes.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Quantitative Evaluation of the Effects of Radiation Therapy on the Post-Surgical Breast.\",\"authors\":\"Miriam Becker,McKay Reese,Andrea Yessaillian,Kelli Lopes,Cyril Harfouche,Garrison Leach,Sarah Blair,Catheryn Yashar,Haydee Ojeda-Fournier,Chris M Reid\",\"doi\":\"10.1097/prs.0000000000011732\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\r\\nRadiation (RT) effects on breast volume may impact breast-conserving therapy (BCT) outcomes, but quantitative information is lacking regarding the extent/timing of volume loss. This study aimed to quantify volume loss by assessing changes in irradiated breasts.\\r\\n\\r\\nMETHODS\\r\\nBreast volume changes were calculated for 113 patients (115 breasts) following T1 tumor lumpectomies. From preoperative baseline to seven years post-radiation, volumes were calculated from mammograms using π/3* height*radius2. Paired t-tests assessed change over time, with subset analyses of tumor/breast volumes of ≤ 10% (n=67) and > 10% (n=48). Multivariable regression assessed volume change as a function of age, smoking history, diabetes, radiation dosage, fractions, technique, treatment length, boost dose, chemotherapy (hormonal or cytotoxic), baseline breast volume, and time since treatment.\\r\\n\\r\\nRESULTS\\r\\nPatients lost 8.3% of breast volume during surgery. One year following BCT/RT, volume loss was 19.3%. By year five, total volume loss was 26.6%.Subset analyses demonstrated that in addition to lumpectomy defects, five-year volume loss was 21.7% for tumor/ breast volume > 10% and 29.5 % for tumor/ breast volume ≤ 10%. Volume loss between subgroups was not significantly different (p=0.37). Larger breast volume was a significant predictor of greater volume loss for all five years (p<0.001), followed by diabetes and smoking history.\\r\\n\\r\\nCONCLUSION\\r\\nPatients with T1 tumors undergoing BCT/RT may lose approximately 20% of breast volume (beyond specimens) within a year, with continued loss for five years. 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引用次数: 0
摘要
背景放射治疗(RT)对乳房体积的影响可能会影响保乳治疗(BCT)的效果,但目前还缺乏有关体积损失程度/时间的定量信息。本研究旨在通过评估受照射乳房的变化来量化乳房体积的损失。方法计算了113例T1肿瘤肿块切除术后患者(115个乳房)的乳房体积变化。从术前基线到放疗后 7 年,乳房体积是通过乳房 X 线照片用 π/3* 高度*半径2 计算得出的。通过配对t检验评估随时间的变化,并对肿瘤/乳房体积≤10%(n=67)和>10%(n=48)进行子集分析。多变量回归评估了体积变化与年龄、吸烟史、糖尿病、放射剂量、分数、技术、治疗长度、增强剂量、化疗(激素或细胞毒性)、基线乳房体积和治疗后时间的关系。BCT/RT 一年后,乳房体积减少了 19.3%。亚组分析表明,除肿块切除缺陷外,肿瘤/乳房体积>10%的患者五年内体积损失为21.7%,肿瘤/乳房体积≤10%的患者五年内体积损失为29.5%。亚组之间的体积损失无明显差异(P=0.37)。乳房体积较大是预测五年内乳房体积损失较大的重要因素(p<0.001),其次是糖尿病和吸烟史。乳房体积的变化与基线乳房体积无明显差异,但较大的乳房可能会经历相对较大的体积变化。
A Quantitative Evaluation of the Effects of Radiation Therapy on the Post-Surgical Breast.
BACKGROUND
Radiation (RT) effects on breast volume may impact breast-conserving therapy (BCT) outcomes, but quantitative information is lacking regarding the extent/timing of volume loss. This study aimed to quantify volume loss by assessing changes in irradiated breasts.
METHODS
Breast volume changes were calculated for 113 patients (115 breasts) following T1 tumor lumpectomies. From preoperative baseline to seven years post-radiation, volumes were calculated from mammograms using π/3* height*radius2. Paired t-tests assessed change over time, with subset analyses of tumor/breast volumes of ≤ 10% (n=67) and > 10% (n=48). Multivariable regression assessed volume change as a function of age, smoking history, diabetes, radiation dosage, fractions, technique, treatment length, boost dose, chemotherapy (hormonal or cytotoxic), baseline breast volume, and time since treatment.
RESULTS
Patients lost 8.3% of breast volume during surgery. One year following BCT/RT, volume loss was 19.3%. By year five, total volume loss was 26.6%.Subset analyses demonstrated that in addition to lumpectomy defects, five-year volume loss was 21.7% for tumor/ breast volume > 10% and 29.5 % for tumor/ breast volume ≤ 10%. Volume loss between subgroups was not significantly different (p=0.37). Larger breast volume was a significant predictor of greater volume loss for all five years (p<0.001), followed by diabetes and smoking history.
CONCLUSION
Patients with T1 tumors undergoing BCT/RT may lose approximately 20% of breast volume (beyond specimens) within a year, with continued loss for five years. Volume change did not differ significantly according to baseline breast volume, although larger breasts may experience comparatively larger volume changes.
期刊介绍:
For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis.
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