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Quantitative Evaluation of Breast Volume Changes Following Lumpectomy Combined with Oncoplastic Reduction Mammoplasty and Radiation Therapy
Cyril J. Harfouche
*, McKay D. Reese, Miriam C. Becker, Michael W. Hornacek, Chrristopher Reid
Division of Plastic Surgery, University Of California San Diego, San Diego, CA
Background:
Results of breast conserving therapy (BCT) with adjuvant radiation therapy (RT) may be impacted by RT effects on breast symmetry, ptosis and volume. This investigation sought to quantify these effects on breast volume in the setting of oncoplastic reduction mammoplasty performed at time of lumpectomy.
Methods:
A single center, retrospective review included women who underwent bilateral oncoplastic reduction mammoplasty simultaneous with lumpectomy (2017-2021). Breast volumes were calculated using mammograms one, two, and three years following RT. Paired t-tests compared volumes of radiated/ non-irradiated breasts each year. Multivariate regression explored effects of other variables on volume changes.
Results:
32 patients completed two years of mammograms, 28 completed three. By year one, a radiated breast comprised approximately 93% the volume of its non-irradiated counterpart, decreasing about 5% (p = 0.04, 95% CI [0.4% 11%]) to 88% of volume at year two. Comparing years one and three, a radiated breast comprised 84% the volume of its non-irradiated counterpart, a 9% volume loss (p = 0.008, 95% CI [2.5%, 15%]). Comparing baseline to year three, multivariate regression demonstrated increasing age was protective against greater volume differences, with 0.70% increase in volume retained per year of age (p = 0.02; 95% CI [0.12% to 1.28%]).
Conclusion:
Findings demonstrate significant volume discrepancies between radiated and contralateral non-irradiated breasts over a three-year period following oncoplastic reduction and RT. Volume change difference increases over time, highlighting the long-term impact of RT and need for continuing interventions to address asymmetry. These results may guide pre-operative planning and patient counseling regarding long-term results.
Figure 1. Longitudinal Volume Changes (Mean ± SE) of Radiated vs Non-Radiated Breasts
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