Does concomitant chemoradiotherapy influence cosmetic outcome in conservative treatment of breast cancer?

To evaluate retrospectively factors influencing the cosmetic outcome after conservative treatment for breast cancer.

From 1988 until 1992, 164 patients were treated with conservative surgery (quadrantectomy) and radiotherapy with 60Co (50 Gy on the whole breast) plus 10 Gy on the surgical bed (300 kV photons) for T1-T2 breast cancers; 46 patients (28%) received concomitant adjuvant chemotherapy (CMF schedule). Cosmesis evaluation was carried out after 24 to 108 months (median, 38 months). A logistic regression analysis was performed to identify independent variables influencing the aesthetic outcome. P values of 0.05 or less were considered significant.

Univariate analysis showed that T2 versus T1 (P = 0.0102), lower quadrants site (P = 0.0002) and concomitant adjuvant chemotherapy (P = 0.0009) produced a worse aesthetic outcome. Multivariate analysis confirmed the same factors: tumor size (P = 0.0020), tumor site (P = 0.0150) and concomitant chemotherapy (P = 0.0024).

The significant negative influence on the cosmetic outcome of concomitant adjuvant chemotherapy implies questions about the timing of radiotherapy and chemotherapy in breast cancer conservative treatment.