Breast Lymphoedema Incidence with Different Radiotherapy Schedules
Research type
Research Study
Full title
Real World Incidence of Breast Lymphoedema following Breast Conserving Surgery and Different Radiotherapy Schedules.
IRAS ID
335380
Contact name
Siobhan Laws
Contact email
Sponsor organisation
Hampshire Hospitals Foundation Trust
Duration of Study in the UK
0 years, 2 months, 0 days
Research summary
Background:
Lymphoedema of the breast is a known side effect of breast conserving surgery (BCS) and adjuvant radiotherapy. There is significant variability in reported incidence of breast lymphoedema following breast cancer treatment with even less following the newly introduced 26 Gray (Gy) in 5 fractions (#) external beam radiotherapy (EBRT) regimen following the FAST-Forward Study in 2020. However, data from FAST-Forward indicates a possible increase in clinician reported breast oedema and patient reported breast swelling, as well as increased breast lymphoedema specialist referrals from the shorter course of EBRT. There is anecdotal evidence of increased lymphoedema with the shortened coure and the Association for Breast Surgery in 2023 updated their guidance reflecting this, recommending the longer course for those more at risk of breast lymphoedema. At our district general hospital, we also offer intra-operative radiotherapy (IORT) to a subsect of patients, which showed fewer side effects than EBRT as shown in the TARGIT A trial.
We are conducting a retrospective cohort study comparing prevalence of breast lymphoedema in breast cancer patients who received BCS and either IORT, longer-course EBRT or short-course EBRT.
Materials and Methods:
We will identify eligible patient from breast surgery theatre records from 2019, 2021 and early 2022. We will match age, BMI, type of breast and axillary surgery in patients in the IORT and EBRT groups to reduce the variability these breast lymphoedema risk factors will create. From these, we will assess lymphoedema both radiologically through analysis of 1 year post-treatment mammograms for presence of lymphoedema and measurement of skin thickening, and symptomatically through attendances at breast care nurse clinics in the first year for breast lymphoedema management. There are two secondary outcome measures, which are to determine if there is correlation between radiologically assessed and patient reported breast lymphoedema, and also between type of BCS and breast lymphoedema.REC name
South Central - Hampshire A Research Ethics Committee
REC reference
23/SC/0398
Date of REC Opinion
16 Nov 2023
REC opinion
Favourable Opinion