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Year : 2021  |  Volume : 1  |  Issue : 2  |  Page : 89-94

Volumetric changes in lumpectomy cavity during whole breast irradiation after breast conserving surgery

Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India

Correspondence Address:
Rahat Hadi
Department of Radiation Oncology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/bjoc.bjoc_23_21

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Introduction: Irradiation to the conserved breast consists of whole breast radiotherapy (WBRT) followed by tumour bed boost. Seroma in the tumor bed is a commonly observed side effects after breast-preservation, which can alter the shape of breast during WBRT and also lead to tumour bed shrinkage during boost irradiation, causing larger volumes of normal tissue irradiated. The aim was to evaluate the change in the lumpectomy cavity volumes before and after WBRT. Materials and Methods: Thirty-three patients with demonstrable lumpectomy cavity after breast conservation surgery (BCS) were included in the study. CT simulation of the breast was performed twice, initially before the start of WBRT and then 2 days prior to completion of WBRT. WBRT was delivered after contouring breast and lumpectomy volumes guided by the presence of surgical clips, seroma, and other surgical changes. Change in volume of lumpectomy cavity was analysed by Students’ paired T-test. Results: The volume reduction in the lumpectomy cavity was noted in 97% of patients (32/33). The change in lumpectomy cavity volume decreased by a mean value of 34.59% (range 0 - 72%) (p < 0.0001). The mean change in breast volume was 8.44% (range, -2.44 to 10.12%) (p - 0.394). Age, weight, location of tumour, T stage, breast volume, lumpectomy cavity volume, presence of clips and pre-radiation chemotherapy were not significantly associated with volume reduction of the lumpectomy cavity. Conclusion: The results of this study have shown that a significant volume reduction of the lumpectomy cavity after WBRT.

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