For women with early -stage breast cancer, the therapy that preserves the breast (BCT), including radiotherapy (RT), leads to a progressive reduction in the size of the breasts over time, reports a study in the April edition of Plastic and reconstructive surgery®, the official medical magazine of the American Society of Plastic Surgeons (ASP). The magazine is published in the Lippincott portfolio by Wolters Kluwer.
“Our findings suggest that women undergoing BCT/RT can lose approximately 20% of breast volume within a year, with continuous reductions for five years,” says Chris Reid, MD, from California San Diego. “Anticipating these changes can help guide patient expectations and help surgical planning to restore women after breast cancer treatment.”
New data on changes in breast size after BCT for early breast cancer …
The therapy that preserves the breast consists of limited surgery (lumpectomy) and RT is the preferred treatment for many women with early breast cancer. Survival rates similar to those of mastectomy, with more favorable physical, psychological and quality results.
However, RT has advertising effects on breast tissue, including breast contraction due to tissue atrophy induced by radiation and fibrosis. While this long -term side effect is well recognized, there are few data on the extension or time course of breast volume after BCT.
Dr. Reid and his colleagues measured the changes in the volume of the breasts in 113 patients who underwent BCT/RT for breast cancer at the early stage (T1) between 2005 and 2023. The measurements were made using mammograms obtained before and up to five later. The researchers also examined the impact of the initial size of the breast and other factors on the loss of volume.
Reflecting the size of the tumor, the volume of the breasts decreased by an average or 9.2% after the lumpectomy. The volume of the breasts continued to decrease over time, also after the immediate side effects of radiation were resolved. After a year, the average decrease in breast volume was 19.3%, in addition to the tissue eliminated in surgery.
… With implications for patient expectations and treatment planning
“An additional volume change was observed annually for five years,” the researchers write. At that time, the average decrease in breast size was 26.6%. According to previous studies of breast contraction after BCT, “Loss of progressive volume in all patients was observed.”
Women with larger breasts (based on tumors that measure less than 10% of breast volume) had a greater contraction of the total breasts, 29.5%, compared to 21.7% for those with smaller breasts. Other factors associated with a greater loss of volume included smoking, diabetes and receiving cytotoxic chemotherapy in addition to RT.
The study provides new evidence on breast contraction after BCT. The expected breast contraction is approximately 20% in the first year, which progresses at approximately 26% in five years. Special with the growing emphasis on patient satisfaction in the evaluation of breast cancer treatment results, findings highlight the need to discuss long -term changes in breast volume in patients undergoing BCT/RT.
The greatest loss of volume in patients with larger breasts increases conerns on breast asymmetry, which is a common group after BCT. “Anticipating these changes can help guide patient expectations and help surgeons plan reconstructive procedures to achieve symmetry after treatment,” says Dr. Reid. The authors discuss the key areas for future research, including the effects of the different treatment techniques on the changes in breast volume and the need for more objective approaches to measure breast volume.
Plastic and reconstructive surgery® is published by Wolters Kluwer.
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