University of Twente Student Theses


Late pulmonary effects of different treatments after breast conserving surgery

Koers, Martijn (2019) Late pulmonary effects of different treatments after breast conserving surgery.

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Abstract:Background: Breast cancer is a disease with many victims that is closely watched by the national breast cancer screening. There are multiple ways of treating breast cancer. In most cases patients undergo surgery and receive additional treatment in the form of radiotherapy, hormonal- or chemotherapy, or regional radiotherapy. These treatments often lead to side effects, on the short or long term. Considering the high survival rate, long term effects can be identified. This study focuses on the pulmonary late effects of different breast cancer treatments. Patients and method: This study’s design is a retrospective cohort study, with data from the Netherlands Cancer Registry (NKR) and patient files in Medisch Spectrum Twente, where the patients were treated. These patients underwent breast cancer treatment between 1986 and 2007 and were followed for at least 10 years to be able to determine late effects. Three groups were made, where patients were included based on the treatment they received. This was breast conserving surgery combined with radiotherapy, with radiotherapy and hormonal- or chemotherapy and with radiotherapy, regional radiotherapy and possible hormonal- or chemotherapy. One-way ANOVA was used to compare baseline patient characteristics. Chi-squared tests were used to identify differences in comorbidities and late effects. Kaplan-Meier and Cox proportional hazard survival analyses were used to compare the groups’ occurrence of late effects and to correct for factors that could influence outcomes. Results: There were significant differences between the groups in prevalence of comorbidities and age of the patients at the date of surgery. Late pulmonary effects differed significantly between groups (p=0.001). For individual pulmonary late effects, only COPD differed significantly. Cox proportional hazard method showed that regional radiotherapy and smoking more than doubles the risk of late pulmonary events occurring Conclusion: Pulmonary late effects differed significantly between groups and regional radiotherapy and smoking were found to substantially increase risk of pulmonary late events during follow-up.
Item Type:Essay (Bachelor)
Medisch Spectrum Twente, Enschede, Nederland
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Health Sciences BSc (56553)
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