The effects of radiation therapy on quality of life of women with breast carcinoma - Results of a randomized trial

BACKGROUND. The purpose of this study was to evaluate the effect of breast irradiation on quality of life, including cosmetic outcome, for patients en rolled in a clinical trial. METHODS. Between 1984 and 1989, a randomized trial was conducted in Ontario , Canada, in which women with lymph node negative breast carcinoma who had undergone lumpectomy and axillary lymph node dissection were randomized to either breast irradiation or no further treatment. A modified version of th e Breast Cancer Chemotherapy Questionnaire (BCQ) was administered to women at baseline, 1 month (4 weeks), and 2 months (8 weeks) after randomization. Irritation of the skin of the breast, breast pain, and appearance of the b reast to the patient were also assessed every 3 months for the first 2 year s of the study. RESULTS. Of 837 patients, 416 were randomly allocated to radiation therapy and 421 to no further treatment. The mean change in quality of life from ba seline to 2 months was -0.05 for the radiation group and +0.30 for the cont rol group. The difference between groups was statistically significant (P = 0.0001). Longer term radiation therapy increased the proportion of patient s who were troubled by irritation of the skin of the breast and breast pain . Radiation therapy did not increase the proportion of patients at 2 years who were troubled by the appearance of the treated breast; 4.8% in irradiat ed and nonirradiated patients (P = 0.62). CONCLUSIONS. Breast irradiation therapy had an effect oil quality of life d uring treatment. After treatment, irradiated patients reported increased br east symptoms compared with controls. However, no difference was detected b etween groups at 2 years in the rates of skin irritation, breast pain, and being upset by the appearance of the breast. Cancer 2000;88:2260-6. (C) 200 0 American Cancer Society.