Breast induration and irradiated volume in the DBCG HYPO trial: The impact of age, smoking, and boost

Mette S. Thomsen; Jan Alsner; Christina M. Lutz; Martin Berg; Ingelise Jensen; Ebbe L. Lorenzen; Hanne M. Nielsen; Erik H. Jakobsen; Lars Stenbygaard; Mette H. Nielsen; Maj Britt Jensen; Jens Overgaard; Birgitte V. Offersen

doi:10.1016/j.radonc.2024.110574

Breast induration and irradiated volume in the DBCG HYPO trial: The impact of age, smoking, and boost

Mette S. Thomsen^*, Jan Alsner, Christina M. Lutz, Martin Berg, Ingelise Jensen, Ebbe L. Lorenzen, Hanne M. Nielsen, Erik H. Jakobsen, Lars Stenbygaard, Mette H. Nielsen, Maj Britt Jensen, Jens Overgaard, Birgitte V. Offersen

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

1 Citationer (Scopus)

Abstract

Purpose: To investigate the association between irradiated breast volume and grade 2–3 breast induration three years after radiotherapy in the phase III Danish Breast Cancer Group HYPO trial randomizing patients ≥ 41 years to whole breast irradiation (WBI) with 40 Gy/15fr versus 50 Gy/25fr. Methods: Treatment plans were available for all Danish patients. Associations between frequency of induration and irradiated volume, age, smoking status, and boost were assessed by logistic regression. A sequential boost was given to patients < 50 years or in case of a narrow (<2 mm) resection margin. Results: RT plans from 1,333 patients were analyzed with 178 (13 %) having grade 2–3 induration. 1135 patients had only WBI. For this group, induration was correlated with irradiated breast volume for patients ≥ 65 years (n = 343, 10 %/22 % for small/large irradiated volumes, p = 0.005) but not for patients aged 50–64 years (n = 792, 11 % for both small and large volumes, p = 0.82). Smoking doubled the frequency irrespective of irradiated volume and age. All patients < 50 years (n = 156) had a boost. A volume effect was found for this group (5 %/21 % induration for small/large volume, p = 0.002). 42 patients ≥ 50 years had a boost and 14 (33 %) had grade 2–3 induration, however, with a p-value > 0.05 due to the few numbers of patients. Conclusion: A relationship between irradiated breast volume and 3-year frequency of breast induration was found for patients ≥ 65 years, whilst not for patients aged 50–64 years. Smoking doubled the risk of induration irrespective of volume and age. A dose-induration relationship was seen for boost patients < 50 years.

Originalsprog	Engelsk
Artikelnummer	110574
Tidsskrift	Radiotherapy and Oncology
Vol/bind	201
ISSN	0167-8140
DOI	https://doi.org/10.1016/j.radonc.2024.110574
Status	Udgivet - dec. 2024

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10.1016/j.radonc.2024.110574Licens: CC BY

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Thomsen, M. S., Alsner, J., Lutz, C. M., Berg, M., Jensen, I., Lorenzen, E. L., Nielsen, H. M., Jakobsen, E. H., Stenbygaard, L., Nielsen, M. H., Jensen, M. B., Overgaard, J., & Offersen, B. V. (2024). Breast induration and irradiated volume in the DBCG HYPO trial: The impact of age, smoking, and boost. Radiotherapy and Oncology, 201, Artikel 110574. https://doi.org/10.1016/j.radonc.2024.110574

@article{99ba7e2d8e79451083cb8716311ac2c5,

title = "Breast induration and irradiated volume in the DBCG HYPO trial: The impact of age, smoking, and boost",

abstract = "Purpose: To investigate the association between irradiated breast volume and grade 2–3 breast induration three years after radiotherapy in the phase III Danish Breast Cancer Group HYPO trial randomizing patients ≥ 41 years to whole breast irradiation (WBI) with 40 Gy/15fr versus 50 Gy/25fr. Methods: Treatment plans were available for all Danish patients. Associations between frequency of induration and irradiated volume, age, smoking status, and boost were assessed by logistic regression. A sequential boost was given to patients < 50 years or in case of a narrow (<2 mm) resection margin. Results: RT plans from 1,333 patients were analyzed with 178 (13 %) having grade 2–3 induration. 1135 patients had only WBI. For this group, induration was correlated with irradiated breast volume for patients ≥ 65 years (n = 343, 10 %/22 % for small/large irradiated volumes, p = 0.005) but not for patients aged 50–64 years (n = 792, 11 % for both small and large volumes, p = 0.82). Smoking doubled the frequency irrespective of irradiated volume and age. All patients < 50 years (n = 156) had a boost. A volume effect was found for this group (5 %/21 % induration for small/large volume, p = 0.002). 42 patients ≥ 50 years had a boost and 14 (33 %) had grade 2–3 induration, however, with a p-value > 0.05 due to the few numbers of patients. Conclusion: A relationship between irradiated breast volume and 3-year frequency of breast induration was found for patients ≥ 65 years, whilst not for patients aged 50–64 years. Smoking doubled the risk of induration irrespective of volume and age. A dose-induration relationship was seen for boost patients < 50 years.",

keywords = "Dose-volume relationship, Randomised trial, Smoking, Whole breast irradiation",

author = "Thomsen, {Mette S.} and Jan Alsner and Lutz, {Christina M.} and Martin Berg and Ingelise Jensen and Lorenzen, {Ebbe L.} and Nielsen, {Hanne M.} and Jakobsen, {Erik H.} and Lars Stenbygaard and Nielsen, {Mette H.} and Jensen, {Maj Britt} and Jens Overgaard and Offersen, {Birgitte V.}",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s)",

year = "2024",

month = dec,

doi = "10.1016/j.radonc.2024.110574",

language = "English",

volume = "201",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Breast induration and irradiated volume in the DBCG HYPO trial

T2 - The impact of age, smoking, and boost

AU - Thomsen, Mette S.

AU - Alsner, Jan

AU - Lutz, Christina M.

AU - Berg, Martin

AU - Jensen, Ingelise

AU - Lorenzen, Ebbe L.

AU - Nielsen, Hanne M.

AU - Jakobsen, Erik H.

AU - Stenbygaard, Lars

AU - Nielsen, Mette H.

AU - Jensen, Maj Britt

AU - Overgaard, Jens

AU - Offersen, Birgitte V.

PY - 2024/12

Y1 - 2024/12

N2 - Purpose: To investigate the association between irradiated breast volume and grade 2–3 breast induration three years after radiotherapy in the phase III Danish Breast Cancer Group HYPO trial randomizing patients ≥ 41 years to whole breast irradiation (WBI) with 40 Gy/15fr versus 50 Gy/25fr. Methods: Treatment plans were available for all Danish patients. Associations between frequency of induration and irradiated volume, age, smoking status, and boost were assessed by logistic regression. A sequential boost was given to patients < 50 years or in case of a narrow (<2 mm) resection margin. Results: RT plans from 1,333 patients were analyzed with 178 (13 %) having grade 2–3 induration. 1135 patients had only WBI. For this group, induration was correlated with irradiated breast volume for patients ≥ 65 years (n = 343, 10 %/22 % for small/large irradiated volumes, p = 0.005) but not for patients aged 50–64 years (n = 792, 11 % for both small and large volumes, p = 0.82). Smoking doubled the frequency irrespective of irradiated volume and age. All patients < 50 years (n = 156) had a boost. A volume effect was found for this group (5 %/21 % induration for small/large volume, p = 0.002). 42 patients ≥ 50 years had a boost and 14 (33 %) had grade 2–3 induration, however, with a p-value > 0.05 due to the few numbers of patients. Conclusion: A relationship between irradiated breast volume and 3-year frequency of breast induration was found for patients ≥ 65 years, whilst not for patients aged 50–64 years. Smoking doubled the risk of induration irrespective of volume and age. A dose-induration relationship was seen for boost patients < 50 years.

AB - Purpose: To investigate the association between irradiated breast volume and grade 2–3 breast induration three years after radiotherapy in the phase III Danish Breast Cancer Group HYPO trial randomizing patients ≥ 41 years to whole breast irradiation (WBI) with 40 Gy/15fr versus 50 Gy/25fr. Methods: Treatment plans were available for all Danish patients. Associations between frequency of induration and irradiated volume, age, smoking status, and boost were assessed by logistic regression. A sequential boost was given to patients < 50 years or in case of a narrow (<2 mm) resection margin. Results: RT plans from 1,333 patients were analyzed with 178 (13 %) having grade 2–3 induration. 1135 patients had only WBI. For this group, induration was correlated with irradiated breast volume for patients ≥ 65 years (n = 343, 10 %/22 % for small/large irradiated volumes, p = 0.005) but not for patients aged 50–64 years (n = 792, 11 % for both small and large volumes, p = 0.82). Smoking doubled the frequency irrespective of irradiated volume and age. All patients < 50 years (n = 156) had a boost. A volume effect was found for this group (5 %/21 % induration for small/large volume, p = 0.002). 42 patients ≥ 50 years had a boost and 14 (33 %) had grade 2–3 induration, however, with a p-value > 0.05 due to the few numbers of patients. Conclusion: A relationship between irradiated breast volume and 3-year frequency of breast induration was found for patients ≥ 65 years, whilst not for patients aged 50–64 years. Smoking doubled the risk of induration irrespective of volume and age. A dose-induration relationship was seen for boost patients < 50 years.

KW - Dose-volume relationship

KW - Randomised trial

KW - Smoking

KW - Whole breast irradiation

UR - http://www.scopus.com/inward/record.url?scp=85206480833&partnerID=8YFLogxK

U2 - 10.1016/j.radonc.2024.110574

DO - 10.1016/j.radonc.2024.110574

M3 - Journal article

C2 - 39395667

AN - SCOPUS:85206480833

SN - 0167-8140

VL - 201

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

M1 - 110574

ER -

Breast induration and irradiated volume in the DBCG HYPO trial: The impact of age, smoking, and boost

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