Moody A M, Mayles W P, Bliss J M, A'Hern R P, Owen J R, Regan J, Broad B, Yarnold J R
Department of Radiotherapy and Oncology, Royal Marsden Hospital, Sutton, Surrey, UK.
Radiother Oncol. 1994 Nov;33(2):106-12. doi: 10.1016/0167-8140(94)90063-9.
A prospective assessment of late changes in breast appearance in 559 patients after tumour excision and radiotherapy for early breast cancer noted a strong association with breast size. Only 3/48 (6%) patients with small breasts developed moderate or severe late changes compared with 94/423 (22%) with medium sized breasts and 34/88 (39%) patients with large breasts (p < 0.001). One possibility is that greater radiation changes are related to greater dose inhomogeneity in women with large breasts. To explore this hypothesis, radiation dose distributions were assessed in a separate group of 37 women in whom three-level transverse computer tomographic images of the breast in the treatment position were available. A significant correlation was found between breast size and dose inhomogeneity which may account for the marked changes in breast appearance reported in women with large breasts.
