• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1131-1135
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• 2012

Objective: To evaluate interoperative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications, cosmetic outcome and recurrence events. Methods: From June 2007 to Dec 2011, 143 early breast cancer patients received breast conservative surgery. Seventy-two (study group) received interoperative radiotherapy, compared with 71 patients (control group) given routine radiotherapy. Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up. Results: The average wound healing time was 13~22 d in the study group and 9~14 d in the control group. In the study group, 2 patients developed lyponecrosis, 16 patients showed wound edema while no such side effects were found in the control group. No infection or hematomas were found in either group. In the study group (59 cases), overall cosmetic outcome in 53 patients was graded as excellent or good, and in 6 as fair or poor. Meanwhile in the control group (56 cases), 42 patients were graded as excellent or good, and 14 as fair or poor (P=0.032). After a follow-up from 3 to 54 months (median: 32 months), two patients (2.78%) in study group developed local relapses, one of them (1.39%) died, 2 patients (2.78%) developed bone metastases. In control group, one patient (1.41%) developed local relapse, 2 patients (2.82%) developed bone metastases, and no one died. Conclusion: Intraoperative radiotherapy is safe and reliable with good cosmetic outcome.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.2939-2943
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• 2014

Background: While many studies have shown that hormones can influence background parenchymal enhancement (BPE) in breast magnetic resonance imaging (MRI), only few have directly address the effect of radiotherapy. The purpose of this study was to evaluate the impact of radiotherapy on BPE in breast MRI. Materials and Methods: A retrospective search identified 62 women with unilateral breast cancer who had a breast MRI both before and after radiotherapy following breast-conserving surgery. In our study, we assumed that systemic therapy affected both breasts equivalently. We rated the level of BPE of both breasts using a four-point categorical scale. A change in the level of BPE prior to and after treatment was compared in the diseased and contralateral breasts. Results: All patients received a 4256 to 6480 cGy dose of whole breast radiotherapy over 3-7 weeks. The mean timing of the follow-up study was 6.6 months after completion of radiotherapy. Although the BPE showed a decrease in both breasts after treatment, there was a significant reduction of BPE in the irradiated breast compared with the contralateral breast (1.18 versus 0.98 average reduction in BPE level, p=0.042). Conclusions: Radiotherapy is associated with decrease in BPE with MRI.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4819-4823
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• 2016

Bckground: Adjuvant radiation therapy is commonly administered following breast-conserving surgery for breast cancer patients. Hypofractionated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material/Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy in two arms (hypofractionated radiotherapy arm with 30 patients, dose 42.5 Gy in 16 fractions; and conventional radiotherapy arm with 22 patients, dose 50 Gy in 25 fractions). W compared these two groups in terms of overall survival, locoregional control, late skin complications and cosmetic results. Results: At a median follow-up of 52.4 months (range: 0-64 months), the follow-up rate was 82.6%. Overall, after 60 months, there was no detectable significant differences between groups regarding cosmetic results (p = 0.857), locoregional control or survival. Conclusions: The results confirm that hypofractionated radiotherapy with a subsequent boost is as effective as conventional radiotherapy, is well-tolerated and can be used as an alternative treatment method following breast conservation surgery.

• Journal of Medicine and Life Science
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• v.20 no.2
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• pp.89-93
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• 2023

We present three cases of patients with breast cancer and psoriasis who received radiotherapy following breast-conserving surgery. One patient developed an extensive flare-up of psoriasis during chemotherapy. After discontinuing chemotherapy, she received conventional radiotherapy to the ipsilateral whole breast, axillary, and supraclavicular lymph nodes with 50.4 Gy in 28 fractions and boosted with 10 Gy in five fractions to the tumor bed. Two patients received hypofractionated whole-breast radiotherapy at a total dose of 40.05-42.4 Gy in 15-16 fractions. In all three cases, there was no flare-up of psoriatic events at least 6 months after the completion of radiotherapy. We hypothesized that there is a close relationship between psoriatic events and the extent of trauma rather than the daily dose of the fraction. Therefore, we confirmed that the effect of radiotherapy on psoriatic events is minimal if the radiation field size does not exceed that of the whole breast.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.11
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• pp.4727-4732
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• 2014

Background: Breast cancers are becoming more frequently diagnosed at early stages with improved long term outcomes. Late normal tissue complications induced by radiotherapy must be avoided with new breast radiotherapy techniques being developed. The aim of the study was to compare dosimetric parameters of planning target volume (PTV) and organs at risk between conformal (CRT) and intensity-modulated radiation therapy (IMRT) after breast-conserving surgery. Materials and Methods: A total of 20 patients with early stage left breast cancer received adjuvant radiotherapy after conservative surgery, 10 by 3D-CRT and 10 by IMRT, with a dose of 50 Gy in 25 sessions. Plans were compared according to dose-volume histogram analyses in terms of PTV homogeneity and conformity indices as well as organs at risk dose and volume parameters. Results: The HI and CI of PTV showed no difference between 3D-CRT and IMRT, V95 gave 9.8% coverage for 3D-CRT versus 99% for IMRT, V107 volumes were recorded 11% and 1.3%, respectively. Tangential beam IMRT increased volume of ipsilateral lung V5 average of 90%, ipsilateral V20 lung volume was 13%, 19% with IMRT and 3D-CRT respectively. Patients treated with IMRT, heart volume encompassed by 60% isodose (30 Gy) reduced by average 42% (4% versus 7% with 3D-CRT), mean heart dose by average 35% (495cGy versus 1400 cGy with 3D-CRT). In IMRT minimal heart dose average is 356 cGy versus 90cGy in 3D-CRT. Conclusions: IMRT reduces irradiated volumes of heart and ipsilateral lung in high-dose areas but increases irradiated volumes in low-dose areas in breast cancer patients treated on the left side.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2109-2114
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• 2014

Background: The aim of this planned research was to determine the comfort and anxiety levels of women with breast cancer receiving radiotherapy. Materials and Methods: This descriptive type study covered patients that applied to the radiation oncology breast polyclinic of our university hospital between January and May 2011. Patient Identification Form, Radiation Therapy Comfort Questionnaire (RTCQ), Spielberger State Trait Anxiety Inventory (STAI) were completed and analysed. Results: The mean age of the women who participated in the study was $51.6{\pm}10.4$ years. Mean scores of women were $3.73{\pm}0.31$ for RTCQ, $29.1{\pm}5.88$ for SAI and $37.8{\pm}6.91$ for TAI. While the comfort levels of the women with breast cancer receiving radiotherapy were moderate, they experienced only low levels of anxiety. Conclusions: By determining the comfort level of the patient before radiotherapy, besides providing comfort in this direction, eliminating/minimizing anxiety and stress will positively affect radiotherapy application. More attention of nurses to this issue is to be recommended.

• Asian Oncology Nursing
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• v.5 no.2
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• pp.97-106
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• 2005

Purpose: This descriptive correlation study was to identify the influencing factors on fatigue of patients undergoing radiotherapy for breast cancer. Method: One hundred twenty-six breast cancer patients were recruited from a radiotherapy clinic of two university hospitals. Data were collected using a package of questionnaires consisting of the Symptom Experience Scale, mood disturbance scale, and Social Support Scale. Results: The mean score of the fatigue, physical status, emotional status, and social support was 4.18, 21.96, 100.95, and 3.70, respectively. Family support and health profession support were 3.94 and 3.47, respectively. Fatigue and physical status, fatigue and emotional status, physical status and emotional status were found to have statistically positive correlations. But emotional status and social support were found to have statistically negative correlation. Stepwise multiple regression analysis showed that the influencing factors on fatigue were emotional status, marital status, and physical status which explained 64.4% fatigue of breast cancer patients.

• Korean Journal of Adult Nursing
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• v.15 no.1
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• pp.33-44
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• 2003

Purpose: The purpose of this study was to identify the patterns and related factors of fatigue in patients with breast cancer undergoing radiotherapy. Method: 31 women with breast cancer receiving radiotherapy were recruited from the out-patient radiologic clinic of the university hospital in Seoul, Korea over a period of 3 months. Data was collected prospectively concerning three points for $5\frac{1}{2}\;-\;6\frac{1}{2}$ weeks : before radiotherapy(T1), 2 weeks after starting radiotherapy(T2) and the completion of radiotherapy(T3). Data were analysed by repeated measure ANOVA, Pearson correlaton, and multiple regression. Result: 1. Score of fatigue increased significantly over the course of radiotherapy. 2. Score of symptom distress and emotional distress increased and functional status scores decreased significantly over time. 3. Fatigue was positively related with symptom distress and emotional distress and negatively related with functional status over the course of radiotherapy. 4. At T2, emotional distress explained 24.7% of the variation in fatigue. At T3, symptom distress(41.9%) and emotional distress(7.2%) explained the variance in fatigue. Conclusion: The results of this study provided evidence that fatigue increased over the course of radiotherapy and symptom distress and emotional distress were influencing factors of fatigue in this group. The results of this study suggest that comprehensive intervention strategy for fatigue should be developed to maintain quality of life during and following radiotherapy considering these factors.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.222-226
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• 2012

Background : Immediate breast reconstruction after mastectomy and delayed breast reconstruction with post-supplementary treatment are the two types of breast reconstruction currently performed when treating breast cancer. Post-mastectomy radiation therapy (PMRT) not only reduces local recurrence but also improves overall survival. However, the complications and survival rates associated with PMRT need to be clear when determining the timing of breast reconstruction. Accordingly, we investigated the optimal timing of breast reconstruction by observing patients who underwent mastectomy followed by PMRT, based on their overall health and aesthetic satisfaction. Methods : We retrospectively reviewed 21 patients who underwent breast reconstruction with PMRT between November 2004 and November 2010. We collected data regarding the various methods of mastectomy, and the modality of adjuvant therapy, such as chemotherapy, hormone therapy, and radiotherapy. Telephone interviews were conducted to study the general and aesthetic satisfaction. Results : Patients who received PMRT after breast reconstruction showed a greater complication rate than those undergoing breast reconstruction after PMRT (P=0.02). Aesthetic satisfaction was significantly higher in the groups undergoing breast reconstruction after PMRT (P=0.03). Patients who underwent breast reconstruction before PMRT developed complications more frequently, but they expressed greater aesthetic satisfaction with the treatment. Conclusions : It is recommended that the complication rates and aesthetic satisfaction after breast reconstruction be carefully considered when determining the optimal timing for radiotherapy.

• Asian Oncology Nursing
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• v.11 no.2
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• pp.136-146
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• 2011

Purpose: The purpose of this study was to examine the effects of self-efficacy promotion programs on self-efficacy, self-care behavior, and quality of life in breast cancer patients receiving radiation therapy. Methods: This study was conducted from November 1, 2009 to December 10, 2010. A total of 39 breast cancer patients, who received radiotherapy in a University hospital located in city B, participated in the study and were divided into two groups (experimental group 17 and control group 22). The data were analyzed with the ${\chi}^2$-test and ANCOVA using the SPSS/Win 17.0 program. Results: Self-efficacy promotion programs aimed at self-management were effective in enhancing concrete self-efficacy but not effective in promoting general self-efficacy, self-care behavior, and quality of life among breast cancer patients who have received radiotherapy. Conclusion: Organizing a support group for the breast cancer patients seems to be highly necessary to help themselves obtain higher level of specific self-efficacy, self-care behavior, and quality of life in general. It will also be beneficial for the breast cancer patients to understand their unique situations and improve their health problems for themselves.