To evaluate patient-reported outcomes (PROs) and long-term aesthetic outcome (AO) related to radiotherapy (RT) in the breast-conserving therapy setting for breast cancer over time. To explore the agreement between PROs and AO.
Patients treated with breast-conserving therapy at one institute between April 2015 and April 2016 were prospectively included in the cohort. The AO was scored by the patient and by the BCCT.core software. Further PROs were measured with the EORTC QLQ-C30, QLQ-BR23 and the BIBCQ. Patients were evaluated at preset time points over two years. First, we assessed the evolution in time of the PROs and AO. Second, we tested the differences in mean scale scores of the PROs between patients with a favourable and an unfavourable AO.
175 patients were included in the analysis. At baseline unsatisfactory levels were already present for several global, functional, symptom and body image scales. Most unsatisfactory PROs improved significantly up to one year after RT. Fatigue showed a small deterioration at the start of RT, but improved medium thereafter up to one year after RT (mean difference (MD) 7.6, -12.3, respectively and p < 0.001). Cognitive functioning showed a small decrease from at the start of RT with no further significant decrease (MD -4.73, -0.21 and p 0.003, 0.894, respectively). Breast symptoms significantly increased during RT but decreased afterwards up to two years after RT to lower values than at baseline and were then considered satisfactory (MD 15.6, -19.7, -4.1 and p < 0.001, <0.001, 0.005, respectively). AO scored by the patient and with the BCCT.core associated well with each other and with the body image measures. There was no association between AO and global cancer-related QOL in the present cohort.
Small quality of life impairments present during RT with good recovery up to one year after RT. Body image is disturbed during RT and improves up to two years after RT. Around one third of patients score their long-term AO as unfavourable and these PROs correlate well with body image.
Clinical trial identification
Legal entity responsible for the study
Kom Op Tegen Kanker.
All authors have declared no conflicts of interest.