Trends in Patient-Reported Outcomes After Breast-Conserving Surgery and Partial-Breast Versus Whole-Breast Irradiation.

BACKGROUND

Although several trials have demonstrated the oncologic safety of partial-breast irradiation (PBI) compared with whole-breast irradiation (WBI), data on patient-reported outcomes are mixed. Here we compare breast satisfaction and chest well-being using the BREAST-Q questionnaire among patients undergoing PBI versus WBI.

PATIENTS AND METHODS

We identified patients undergoing lumpectomy and radiation, and analyzed their BREAST-Q scores preoperatively and postoperatively at 6 months, 1 year, 2 years, and 3 years. We stratified patients by type of radiation, and compared breast satisfaction and chest well-being scores over time, and with univariate and multivariate analyses (MVA).

RESULTS

From 2017 to 2022, 6374 patients underwent lumpectomy and radiation, and responded to the BREAST-Q at ≥ 1 time point. For both breast satisfaction and chest well-being, patients undergoing PBI had higher preoperative scores. For breast satisfaction, scores increased for both groups postoperatively and remained above baseline through 3 years of follow-up; for chest well-being, scores decreased postoperatively and gradually increased. On MVA, radiation type was not significantly associated with either breast satisfaction or chest well-being at any postoperative time point. At the 2-year postoperative time point, receipt of adjuvant chemotherapy was associated with worse breast satisfaction, and BMI < 20 was associated with improved chest well-being.

CONCLUSIONS

Patients undergoing PBI and WBI had similar breast satisfaction and chest well-being at all postoperative time points. Other patient- and treatment-related variables such as body mass index (BMI), axillary surgery, and need for chemotherapy were significantly associated with long-term breast satisfaction and chest well-being. These findings support the use of PBI as an alternative to WBI in terms of patient-reported outcomes in eligible patients.