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Predictive factors for late normal tissue complications following radiotherapy for breast cancer

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Background and purpose

Radiotherapy after breast-conserving surgery is commonly applied to reduce recurrence of breast cancer but may cause acute and late side effects. To identify prognostic factors for the development of late toxicity after radiotherapy, we conducted a prospective study of breast cancer patients.

Patients and methods

We assessed late complications of radiotherapy and collected information on epidemiologic factors in a cohort of breast cancer patients who had received radiotherapy after breast-conserving surgery. Among 416 patients with complete follow-up data, the association between possible risk factors and development of late complications was evaluated using multivariate logistic regression analysis.

Results

After a median follow-up time of 51 months, 131 (31.4%) patients presented with telangiectasia and 28 (6.7%) patients with fibrosis. We observed a strong association between development of telangiectasia and fibrosis (p < 0.01). Increasing age of the patient was a risk factor for both telangiectasia and fibrosis (p-value for trend <0.01 and 0.03, respectively). Patients with acute skin toxicity (odds ratio (OR) 1.8, 95% confidence interval (CI) 1.0–3.1) were at higher risk to develop telangiectasia. Long-term smoking was associated with a significant increase in risk of telangiectasia compared to non-smokers (OR 2.3, 95% CI 1.2–4.6).

Conclusions

Our study revealed several factors other than radiation dose that may predispose to late complications following radiotherapy. Further understanding of differences in response to irradiation may advance individualized treatment and improve cosmetic outcome.

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Acknowledgments

We thank all women who participated in the study; the staff of the participating clinics for their contribution to data collection; and K. Smit for excellent technical assistance. This study was supported by the Federal Office for Radiation Protection (projects St.Sch. 4116 and 4233), and USAMRMC BCRP DAMD17-02-10500.

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Authors and Affiliations

  1. Division of Cancer Epidemiology, C020, German Cancer Research Center, im Neuenheimer Feld 280, 69120 , Heidelberg, Germany

    Carmen Lilla, Silke Kropp, Irmgard Helmbold & Jenny Chang-Claude

  2. Department of Epidemiology, Roswell Park Cancer Institute, Buffalo, NY, USA

    Christine B. Ambrosone

  3. Division of Toxicology and Cancer Risk Factors, German Cancer Research Center, Heidelberg, Germany

    Peter Schmezer

  4. Department of Gynecological Radiology, University Hospital Heidelberg, Heidelberg, Germany

    Dietrich von Fournier

  5. Clinic for Radiotherapy and Radiooncology, St. Vincentius-Clinics, Karlsruhe, Germany

    Wulf Haase

  6. Clinic for Radiotherapy, Municipal Hospital Karlsruhe, Karlsruhe, Germany

    Marie-Luise Sautter-Bihl

  7. Department of Radiation Oncology, University Hospital Mannheim, Mannheim, Germany

    Frederik Wenz

Authors
  1. Carmen Lilla
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  2. Christine B. Ambrosone
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  7. Wulf Haase
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  8. Marie-Luise Sautter-Bihl
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  9. Frederik Wenz
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  10. Jenny Chang-Claude
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Corresponding author

Correspondence to Jenny Chang-Claude.

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Lilla, C., Ambrosone, C.B., Kropp, S. et al. Predictive factors for late normal tissue complications following radiotherapy for breast cancer. Breast Cancer Res Treat 106, 143–150 (2007). https://doi.org/10.1007/s10549-006-9480-9

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  • DOI: https://doi.org/10.1007/s10549-006-9480-9

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