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PubMed · 42664707

Association of Therapeutic Mammoplasty and Radiotherapy Side-effects.

Arjuna Brodie·Ahmed Gaber·Monika Kaushik·Jaroslaw Krupa·Kelly V Lambert·Simon M Pilgrim·Walid Sasi·Kalliope Valassiadou·Kiran Kancherla·Kufre Sampson·Christopher J Talbot·Tim Rattay
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Abstract

INTRODUCTION: Patients with larger breast size and volume are at increased risk of side-effects (toxicity) from radiotherapy. Therapeutic mammoplasty (TM) extends breast-conserving surgery by combining wide local excision of the cancer with breast reduction and mastopexy techniques. The aim of this study was to determine the effect of TM using level 2 oncoplastic techniques on the incidence of early and long-term radiotherapy side-effects. PATIENTS AND METHODS: Breast cancer patients recruited prospectively into the multicenter REQUITE cohort study (www.requite.eu) at a single institution (n = 346) were included. Radiotherapy side-effects (CTCAE v4.0) were scored at baseline, following radiotherapy, and at 2-year follow-up. The association of TM and specimen resection weight were investigated in multivariable regression models. RESULTS: At 2 years, 20.1 % of patients had grade &#x2265; 2 atrophy, 23.2% grade &#x2265; 1 tumor bed induration (fibrosis), 12.6% grade &#x2265; 1 breast induration, and 12.1% grade &#x2265; 1 telangiectasia. 22.5 % of patients (n = 78) underwent TM. TM patients had larger tumors (P = .006) and specimen resection weights (P < .001). TM but not specimen resection weight was associated with reduced tumor bed induration (Odds ratio = 0.12, 95% confidence interval [CI] 0.035-0.395, P = .001), breast induration (OR 0.19, CI 0.043-0.852, P = .03) and telangiectasia (OR 0.12, CI 0.020-0.736, P = .02). Neither TM nor specimen weight had any effect on atrophy or early radiotherapy side-effects. CONCLUSION: TM but not resected specimen weight was associated with fewer long-term radiotherapy side-effects. This implies that the incidence of side-effects is affected not by reducing the overall radiotherapy target volume but by re-shaping the breast, which is likely to reduce dose inhomogeneity.

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HumansFemaleBreast NeoplasmsMammaplastyMiddle AgedMastectomy, SegmentalProspective StudiesAgedRadiotherapy, AdjuvantRadiation InjuriesAdultFollow-Up StudiesBreastAdverse treatment effectsBreast cancerBreast surgeryOncoplastic breast surgeryRadiotherapyJournal ArticleMulticenter Study

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Arjuna Brodie, Ahmed Gaber, Monika Kaushik, Jaroslaw Krupa, Kelly V Lambert, Simon M Pilgrim, Walid Sasi, Kalliope Valassiadou, Kiran Kancherla, Kufre Sampson, Christopher J Talbot, Tim Rattay. 2026-08-06. Association of Therapeutic Mammoplasty and Radiotherapy Side-effects.. https://doi.org/10.1016/j.clbc.2026.08.001

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