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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2015

01-04-2015 | Breast Oncology

A Comparison of Complication Rates in Early-Stage Breast Cancer Patients Treated with Brachytherapy Versus Whole-Breast Irradiation

Authors: Nicolas Ajkay, MD, Abigail E. Collett, BS, Erica V. Bloomquist, MD, Edward J. Gracely, PhD, Thomas G. Frazier, MD, Andrea V. Barrio, MD

Published in: Annals of Surgical Oncology | Issue 4/2015

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Abstract

Background

The adoption of breast brachytherapy into clinical practice for early-stage breast cancer has increased over the last several years. Studies evaluating complication rates following treatment with brachytherapy have shown conflicting results. We compared local toxicity in patients treated with brachytherapy with those treated with whole-breast irradiation (WBI).

Methods

We identified 417 early-stage breast cancer patients treated with breast-conserving surgery and radiation between 2004 and 2010, and compared 271 women treated with intracavitary brachytherapy with 146 women treated with WBI. Long-term complications were assessed using Kaplan–Meier curves with the log-rank test.

Results

Median follow-up was 4.6 years, and the 5-year incidence of infectious skin complications (9.7 vs. 11.0 %, p = 0.84), abscess (1.1 vs. 0 %, p = 0.15), telangiectasia (8.0 vs. 5.3 %, p = 0.35), and breast pain (14.2 vs. 9.4 %, p = 0.2) was similar between the brachytherapy and WBI cohorts. The brachytherapy cohort had a higher 5-year rate of seroma (46.5 vs. 18.5 %, p < 0.001), and fat necrosis (39.5 vs. 24.4 %, p < 0.001). Brachytherapy patients trended towards more frequent biopsies as a result of fat necrosis to rule out a recurrence (11.2 vs. 6.7 %, p = 0.13).

Conclusions

Patients treated with intracavitary brachytherapy had more local toxicity, particularly seroma and fat necrosis. Patients should be counseled on the possible increased rate of long-term complications associated with brachytherapy treatment.
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Metadata
Title
A Comparison of Complication Rates in Early-Stage Breast Cancer Patients Treated with Brachytherapy Versus Whole-Breast Irradiation
Authors
Nicolas Ajkay, MD
Abigail E. Collett, BS
Erica V. Bloomquist, MD
Edward J. Gracely, PhD
Thomas G. Frazier, MD
Andrea V. Barrio, MD
Publication date
01-04-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 4/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4131-6

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