University of Twente Student Theses
Late, treatment associated morbidity after breast-conserving therapy in breast cancer patients
Oonk, R.C. (2023) Late, treatment associated morbidity after breast-conserving therapy in breast cancer patients.
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| Abstract: | Background: Breast cancer is 1 of the most common types of cancer in the Netherlands. There are several treatment options that depend on different factors. There are two types of surgery: mastectomy and breast conserving surgery. Breast conserving surgery is generally combined with radiotherapy. Mastectomy is combined with radiotherapy if necessary. Both forms of surgical treatments are combined with systemic therapy if indicated. Systemic treatment may include chemotherapy with or without immunotherapy and/or hormonal therapy. Several studies have been conducted on short-term side effects. However, little to no data is known about long-term side effects of these different treatment methods. The aim of this study is to investigate effects more than ten years after treatment of different breast cancer treatments. Method: A retrospective cohort study was conducted with 4 cohorts. These cohorts consist of 1) women who underwent mastectomy without any adjuvant treatment, 2) breast conserving surgery with whole breast radiotherapy, 3) breast conserving surgery with whole breast radiotherapy and adjuvant systemic treatment and 4) breast conserving surgery with whole breast radiotherapy and regional radiotherapy and adjuvant systemic treatment. The data were collected from the databases (EPD’s) of Ziekenhuisgroep Twente (ZGT), Medisch Spectrum Twente (MST) and Nederlandse Kanker Registratie (IKNL) and consists of women treated between 2000 and 2009. The data are divided into t0 (the moment of surgery), t1 (up to 10 years after surgery) and t2 (≥ 10 years after surgery). Results: Cohort 4 is 1.5 times more likely to develop general adverse effects compared with cohort 1 and 2.5 times more likely to develop pulmonary adverse effects. Lymphedema of the arm (p=<.001) and pulmonary fibrosis were also most common among women in cohort 4. Breast/thoracic wall pain (p=.002) was most common among women in cohort 2. Myocardial infarction and conduction disorders were most common among women in cohort 3. Survival data show for pulmonary effects much lower for cohort 4 compared to the other cohorts. This is also true for osteopenia. Regarding myocardial infarction, cohort 3 shows lower values compared to the other cohorts. Conclusion: This study shows evidence of significant differences in late adverse events. The most significant differences belong to the category of general adverse effects and these are most common in women who have had breast-conserving therapy followed by whole breast irradiation and regional irradiation, adjuvant chemotherapy with or without immunotherapy and/or hormonal treatment. Through the results, women can make considerations regarding the shared decision-making process. |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/96198 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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