An integrated optimization of Surgery and radioTherApy techniques to impRove cosmetic outcome and quaLity of life In breast conserviNG therapy for breaSt cancer patient

One in seven women will be diagnosed with breast cancer at some point during life. The majority of patients (60-70%) can be treated with breast conserving therapy consisting of lumpectomy (instead of mastectomy) combined with a sentinel node procedure or axillary lymph node dissection, followed by irradiation of the breast. A lot of patients also receive chemotherapy.
As life expectancy after breast cancer treatment has become substantially longer due to improved multimodality treatment, late adverse effects of the treatment affecting quality of life (QoL) have become increasingly important. Unfortunately, breast fibrosis occurs as a late adverse event in a substantial subset of patients (10-30%) after breast conserving therapy for DCIS or breast cancer. Fibrosis can be painful and may result in poor cosmetic outcome. Fibrosis as well as poor cosmetic outcome can negatively affect QoL. Besides patient and tumor related factors, both surgery and radiotherapy play a role in the risk of developing fibrosis.
Both surgical and radiation oncologists aim for the best cosmetic outcome and QoL of each patient, without compromising oncological safety. However, especially in the light of current oncoplastic reconstructive surgery techniques, it has not yet been properly investigated how the different surgery and radiotherapy techniques interact.
The primary focus of this project will be to determine which different combinations of (oncoplastic reconstructive) surgery and radiotherapy techniques, in the context of breast conserving therapy for (pre-invasive) breast cancer, contribute the most to the development of fibrosis. Second, to assess the relation between the presence and severity of fibrosis, cosmetic outcome and different QoL domains and symptoms.

Surgical and radiation oncologists aim for the best cosmetic outcome and QoL of each patient, without compromising oncological safety. However, especially in the light of current oncoplastic reconstructive surgery techniques, it has not yet been properly investigated how the different surgery and radiotherapy techniques interact.

4-6 years after treatment (1 time point)