Effect of Tumor Size and Tumor Location in the Breast on Late Cosmetic Outcomes in Patients with Early-Stage Breast Cancer Who Underwent Breast-Conserving Surgery and Intraoperative Boost Radiotherapy

This study aimed to investigate whether tumor size and tumor location in the breast affected cosmetic outcomes and late radiation toxicity in early-stage breast cancer patients who underwent breast conserving surgery and intraoperative radiotherapy as boost. This case series analysis study was based on records in the patient files and included 103 patients with breast cancer. Patients were scored using the Late Effects Normal Tissue Task Force (LENT)-Subjective, Objective, Management, Analytic (SOMA) scale. The effect of tumor size and tumor location on cosmetic outcomes was analyzed using one-way analysis of variance. The median duration of follow-up was 51 (24–78) months. Based on the LENT-SOMA scale, 40 (38.8%) women were grade 0, 42 (40.7%) grade 1, 18 (17.5%) grade 2, and 3 (2.9%) grade 3. The median tumor diameter of the patients was 16 for grade 0, 19 for grade 1, 23, for grade 2, and 25 for grade 3, respectively. Tumor locations in patients scored as grades 2 and 3 were mostly in inner quadrants, whereas those scored as grades 0 and 1 were similar in all quadrants. The effect of tumor size on cosmetic outcomes was statistically significant (p = 0.0001), whereas that of tumor location was no effect on result (p > 0.05). Radiotoxicity and cosmetic outcome in the late period may be related to tumor size and applicator diameter. Although patients with tumors located in the upper outer quadrant had better cosmetic outcomes, tumor location in the breast on the cosmesis was insignificant.