The Breast:
VOLUME 55, P37-44, FEBRUARY 01,
2021
by Dong-Yun Kim, Eonju Park, Chan Yeong Heo, Ung Sik Jin,
Eun Kyu Kim, Wonshik Han, Kyung Hwan Shin, In Ah Kim
Highlights
•There was no significant difference in the occurrence of
breast complications between the two fractionation regimens.
•Hypofractionated RT may be used comparable to conventional
fractionated RT in reconstructed breast cancer patients.
•The prospective randomized trial would be necessary to
clarify this issue.
Purpose
This study investigated whether hypofractionated adjuvant
radiotherapy (RT) increased breast-related complication(s) compared to
conventional fractionated RT in reconstructed breast cancer patients.
Methods
We conducted a retrospective review including 349 breast
cancer patients who underwent immediate breast reconstruction following
mastectomy or breast-conserving surgery (BCS) between 2009 and 2018 at two
institutions. All patients were treated with adjuvant RT via either a
conventional fractionated or hypofractionated regimen. We defined a major
breast complication as a breast-related toxic event requiring re-operation or
re-hospitalization during the follow-up period after the end of RT.
Results
The median follow-up was 32.3 months (4.8–118.5 months); 126
patients had conventional fractionated RT, and 223 patients received
hypofractionated RT. In patients with mastectomy, there was no significant
difference in the occurrence of any or major breast-related complications
between the two fractionation regimens. In patients undergoing BCS, incidence
of any breast complication showed no difference between two RT groups and no
major breast complication was reported as well. Hypofractionated RT did not
increase major wound problem (infection and dehiscence) compared to
conventional RT. Incidence of major contracture was significantly lower in
hypofractionated RT.
Conclusions
There was no significant difference in the occurrence of any
or major breast-related complications between the two different fractionation
regimens, even in patients with mastectomy. Hypofractionated RT may be used
comparable to conventional fractionated RT in terms of breast-related
complications in reconstructed breast cancer patients. The prospective
randomized trial would be necessary to clarify this issue.
