2744 - Study on Short-Term Complications and Quality of Life for Breast Cancer Patients Who Underwent Breast-Conserving Surgery Combined with Intraoperative Radiotherapy

J. Wang¹, X. Liu², J. Liu³, B. Zhang⁴, J. You⁴, and Q. Pang²; ¹Department of Radiation oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention Therapy, Tiajin, China, ²Department of Radiation oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention Therapy, Tianjin, Tianjin, China, ³3rd Department of Breast Cancer, China Tianjin Breast Cancer Prevention, Treatment and Research Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China; 2 Key Laboratory of Breast Cancer Prevention and Therapy of Ministry of Educa, Tianjin, Tianjin, China, ⁴Department of Radiation oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention Therapy, Tianjin, China

Purpose/Objective(s): To evaluate scores of short-term complications and quality of life related to surgical and radiation in patients who underwent breast-conserving surgery combined with intraoperative radiation therapy (IORT), and explore influencing factors. Materials/

Methods: Clinical data of female patients who underwent breast-conserving surgery and IORT at Tianjin Medical University Cancer Institute and Hospital from March 2021 to June 2023 were collected, including age, tumor location, maximum tumor diameter, breast volume, duration of intraoperative radiation therapy, immunohistochemistry results, tumor staging, subtype, positive rate of axillary lymph nodes, and diameter of the applicator used in the surgery. The telephone follow-up was conducted to statistically analyze surgical and radiation-related complications occurring within 3 months after surgery. The breast-conserving treatment module of BREAST-Q scale and EORTC QLQ-C30 were used to record patients quality of life within 3 months after surgery and perform correlation analysis. Statistical analysis was performed using statistical software. The measurement data were tested by independent sample t-test, while the enumeration data were tested by ?² test. Logistic regression analysis and multiple linear regression analysis were utilized to investigate the risk factors for the occurrence of complications.
Results: A total of 102 patients were included in the study. Among them, 86 patients (84.3%) experienced sclerosis of the surgical incision, 60 patients (58.8%) had mild pain in the operative area within 1 month after surgery, 8 patients (7.8%) had postoperative infections, 12 patients (11.8%) developed fat necrosis in the operative area, 45 patients (44.1%) experienced indentation at the operative area, and 13 patients (12.8%) had delayed incision healing. 40 events (39.6%) of hemorrhagic or serous effusion in the breast were reported in 23 patients (22.8%) during the re-examination. And first- or second-grade radioactive skin injury was reported in 75 patients (74.3%). Correlation analysis showed a positive correlation (P < 0.01) between applicator size and the grade of radioactive skin injury, severity of indentation at the surgical site and skin irritation; Age was a risk factor for postoperative incision infection and delayed healing (P < 0.05); Tumor volume was a factor influencing Breast-Q score, particularly in satisfaction with breast and chest physical well-being scores (P < 0.01).
Conclusion: The incidence of radiotherapy and surgery-related complications was relatively high in patients who underwent breast-conserving surgery and IORT for early-stage breast cancer. Applicator size, tumor volume, and age were influencing factors for the occurrence of recent complications and patient satisfaction. Further exploration is required for the long-term quality of life.