Longitudinal Patient-Reported Outcomes and Early Provider-Rated Cosmetic Associations Following Intraoperative...

Area of Science:

• Oncology
• Radiation Oncology
• Surgical Oncology

Background:

• Intraoperative radiation therapy (IORT) is a recognized alternative to whole-breast irradiation for select breast-conserving surgery patients.
• While oncologic and cosmetic outcomes are documented, longitudinal psychosocial outcomes and their link to cosmetic recovery require further investigation.

Purpose of the Study:

• To prospectively evaluate longitudinal psychosocial outcomes in early-stage breast cancer patients undergoing lumpectomy with IORT.
• To explore the relationship between cosmetic outcomes and patient well-being over 24 months post-surgery.

Main Methods:

• A prospective single-center cohort study involving 94 women with early-stage invasive ductal carcinoma treated with IORT.
• Validated Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaires were administered preoperatively and at 6, 12, and 24 months postoperatively.
• Independent patient and surgeon assessments of cosmetic outcomes were correlated with psychosocial well-being domains.

Main Results:

• Overall quality of life remained stable, with a modest improvement in emotional well-being at 12 months.
• Patient-reported scar appearance worsened transiently at 6 months, returning to baseline by 12 months; surgeon-rated scars improved over time.
• Worse surgeon-rated scars at 6 months were associated with lower physical and social well-being (P=0.050 and P=0.033, respectively).

Conclusions:

• Patient-reported quality of life is stable post-IORT, with a notable increase in emotional well-being.
• Early surgeon-assessed cosmetic appearance is linked to physical and social well-being, offering insights beyond self-assessment.
• Findings are descriptive and warrant further investigation in comparative studies.