Factors Affecting Significant Breast Edema in Breast Cancer Patients

Overview

This study identifies significant predictors of breast edema in patients undergoing radiotherapy after breast-conserving surgery. Notably, the volume of the planning target volume boost (PTVboost) was found to be the only independent factor significantly associated with increased risk of significant breast edema (SBE).

Background

Breast edema is a common complication following breast-conserving surgery and radiotherapy, impacting patient quality of life and treatment outcomes. Understanding the factors that contribute to significant breast edema is crucial for optimizing radiotherapy planning and improving patient care. This study aims to fill the gap in knowledge regarding the predictors of SBE during radiotherapy.

Data Highlights

Key Findings

• Significant breast edema (SBE) was defined as a breast dimensional increase of ≥5 mm during radiotherapy.
• PTVboost volume was the only independent factor significantly associated with SBE (OR = 1.072, p = 0.022).
• Univariate analysis indicated that CTV, CTVboost, PTV, and PTVboost volumes were significant predictors of SBE.
• The optimal cutoff value of PTVboost volume for predicting SBE was determined to be 107.5 cc.
• Increased attention to SBE is recommended during radiotherapy for breast-conserving surgery patients.

Clinical Implications

Clinicians should monitor PTVboost volume closely when planning radiotherapy for breast cancer patients to mitigate the risk of significant breast edema. Proactive management strategies may enhance treatment accuracy and improve patient quality of life.

Conclusion

The findings underscore the importance of PTVboost volume in predicting significant breast edema during radiotherapy, highlighting the need for careful planning and monitoring in breast cancer treatment.

References

1. The ASCO Post, Margin Reassessment in Breast-Conservation Therapy, 2014 -- https://ascopost.com/issues/june-10-2014/margin-reassessment-in-breast-conservation-therapy/
2. The ASCO Post, Breast Shrinkage Following Breast-Conserving Therapy, 2025 -- https://ascopost.com/news/april-2025/breast-shrinkage-following-breast-conserving-therapy
3. The ASCO Post, Breast Volume Preservation Comparable After Five-Fraction Whole- or Partial-Breast Radiotherapy, 2025 -- https://ascopost.com/news/october-2025/breast-volume-preservation-comparable-after-five-fraction-whole-or-partial-breast-radiotherapy
4. NCCN 2025 Breast Cancer Congress -- https://education.nccn.org/sites/default/files/course/2025-02/3_Moran_NCCNbc25_v1.pdf?utm_source=openai
5. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial - PubMed -- https://pubmed.ncbi.nlm.nih.gov/32580883/?utm_source=openai
6. The ASCO Post — Margin Reassessment in Breast-Conservation Therapy
7. The ASCO Post — Breast Shrinkage Following Breast-Conserving Therapy
8. the asco post — Breast Volume Preservation Comparable After Five-Fraction Whole- or Partial-Breast Radiotherapy
9. The ASCO Post — Reducing the Risk of Lymphedema in Patients With Cancer
10. NCCN 2025 Breast Cancer Congress
11. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial - PubMed
12. Factors associated with breast lymphedema after adjuvant radiation therapy in women undergoing breast conservation therapy - PubMed