Evaluation of Cosmetic outcome in a randomized trial of Hypofractionated Radiotherapy for Early Breast Cancer

Researchers: Principal Investigator: I.Dayes
Co-Investigators: V. Theberge, T.Whelan


Ian Dayes

Status: Completed.

Women who undergo lumpectomy receive breast radiation after surgery to lower the risk of recurrent cancer in the breast. Sometimes radiation can cause excessive fibrosis (scarring and thickening) of the skin of the breast which leads to a poor cosmetic result. Usually breast radiation is administered daily over about 4 weeks. Shorter courses of radiation in which a larger dose is delivered each day are being evaluated in clinical trials. However, it is possible that such radiation regimens can lead to excessive fibrosis.

There are various methods used in clinical trials to assess cosmetic outcome in women who had radiation after lumpectomy. All of them have limitations including validity and reproducibility. The breast cancer radiation oncology research team has obtained software from researchers in Portugal that can measure the cosmetic result following radiation using a digitized photograph of the breast. Drs. Dayes, Whelan, and Theberge from Quebec City conducted a pilot study to compare the cosmetic outcome using this software with the usual physician assessment.

The ability to measure the cosmetic outcome in clinical trials of breast irradiation following lumpectomy is important in order to be able to weigh the advantages and disadvantages of different radiation regimens. However measuring the cosmetic outcome is a labor intensive and expensive process, particularly as large numbers of patients are usually required. It is hoped that this project will add efficiency and standardization to cosmetic assessment in breast cancer radiotherapy trials. Unfortunately the results to date have been disappointing.