Effect of the Order of Adjuvant Treatment on the Cosmetic Results of Patients with Breast Cancer Treated with Breast- Conserving Surgery and Intraoperative Boost Radiotherapy

Abstract

OBJECTIVEThe aim of this study was to investigate the cosmetic outcome of adjuvant treatment after breast conservingsurgery (BCS) and intraoperative boost radiotherapy (IOBRT) performed at the clinic over a4-year period.METHODSA total of 65 patients who underwent at least 1 year of treatment for a diagnosis of early stage breastcancer were included in the study. Whole breast irradiation cases were included in Group A (n=34), andpatients who underwent chemotherapy followed by WBI comprised Group B (n=31). Various details,including cosmetic outcome and score according to Johansen’s scoring system were evaluated at postoperativemonth 1, after first treatment, and at the conclusion of 1 year of treatment.RESULTSThe mean age of the patients was 53.5 years (range: 38-74 years), and the mean follow-up period was 23months (range: 12-39 months). The mean tumor diameter was 16.95 mm (range: 4-30 mm). The tumorwas located in the upper outer quadrant in 36 patients. It was determined that 14 patients had a comorbiddisease, 7 were premenopausal, 7 were cigarette smokers, 7 had a tumor of >2 cm and 11 had innerquadrant localization. In 15 cases, the score was 9 or greater, indicating a poor cosmetic result. There were7 patients with a poor cosmetic result in Group A, with a mean score of 10, and 8 patients from groupB, with a mean score of 10.3. An independent t-test did not reveal a statistically significant differencebetween the groups (p>0.1).CONCLUSIONThe effects of radiotherapy and chemotherapy in addition to BCS and IOBRT in early breast cancer caseswere similar with respect to cosmetic results. Smoking, comorbid disease, the size of the tumor and quadrantof localization may contribute to poor cosmetic outcome.