Breast preservation after in-breast-recurrence of breast cancer: comparison of overall survival and quality of life (QoL) between breast conserving surgery with intraoperative radiotherapy (TARGIT-IORT) versus mastectomy

Background Mastectomy is the standard treatment of in-breast-recurrence of breast cancer after breast conserving surgery (BCS) and external beam radiation therapy (EBRT). In selected cases of in-breast-recurrence it is possible to offer BCS and TARGIT-IORT. We present a comparative analysis of overall survival and QoL between BCS with TARGIT-IORT and mastectomy.

Methods Patients in our database with in-breast-recurrence and either mastectomy or BCS and TARGIT-IORT were included. Identified patients were offered participation in a prospective QoL-analysis using the BREAST-Q questionnaire. The cohorts were compared for confounding parameters, overall survival and QoL.

Results 36 patients treated for in-breast-recurrence were included, 21 had received a mastectomy and 16 patients had received BCS with TARGIT-IORT. Mean follow-up was 12.8 years since primary diagnosis and 4.2 years since recurrence. Both groups were balanced regarding prognostic parameters. Overall survival was numerically longer for BCS and TARGIT-IORT, but the numbers were too small for formal statistical analysis. No patient had further in-breast-recurrence.

Psychosocial wellbeing, sexual wellbeing and satisfaction with the surgeon did not differ between both groups. Physical wellbeing was significantly superior for those whose breast could be preserved (median score for BCS and TARGIT-IORT group was 91 (71-100) vs. 66 (14-100) for the mastectomy group, p-value = 0.021).

Conclusion Preserving the breast by use of TARGIT-IORT was safe with no re-recurrence and no detriment to overall survival in our analysis and led to a statistically significant improvement in physical wellbeing. These data should increase the confidence in offering breast preservation after in-breast-recurrence of breast cancer.

Interessenskonflikt

Ich erkläre als korrespondierender Autor, dass ich oder einer bzw. mehrere meiner Ko-Autoren während der letzten 3 Jahre wirtschaftliche oder persönliche Verbindungen im oben genannten Sinne hatten: Interessenskonflikt Details Hans-Christian Kolberg: Honorare von Carl Zeiss meditec. Cornelia Kolberg-Liedtke: Honorare von Carl Zeiss meditec. Jayant S. Vaidya: Reisekostenunterstützung von Carl Zeiss meditec. Helena Niesing, Leyla Akpolat-Basci, Abdrhman Maguz, Miltiades Stephanou, György Lövey, Oliver Hoffmann: keine Interessenskonflikte

Publication History

Article published online:
21 June 2022