Aesthetic outcome after breast conserving surgery and either intraoperative radiotherapy or whole breast external beam radiotherapy for early breast cancer: objective assessment of patients in a randomized controlled trial in Lublin, Poland

The international randomized controlled TARGeted Intraoperative radiotherapy (TARGIT) trial demonstrated non-inferiority between the technique of TARGET (Intra-Operative RadioTherapy (IORT) with Intrabeam) and whole-breast external beam radiotherapy (EBRT) as part of the treatment for women with early breast cancer. Objective: The aim of this sub-study was to see if the single high dose of IORT leads to impaired aesthetic outcome in a group of patients participating in the trial at a single site. Materials and Methods: Frontal digital photographs were taken of women and analyzed, blinded to treatment received, by Breast Cancer Conservative Treatment cosmetic results (BCCT.core) software. This produced scores for various measures of color. Twenty-nine women (16 EBRT and 13 IORT) between 49 to 79 years of age had photographs taken at baseline (up to two days prior to surgery), and again at 12 months (median 364 days). Results: At 12 months there was a significant difference in cEMDL (p = 0.002, Wilcoxon Two-Sample test, two-sided) and other measures, indicating more "redness" in the breasts of the women in the EBRT group compared with the IORT group. This difference persisted after adjusting for tumor size, body mass index. and age (p = 0.0198, multiple regression analysis). Conclusion: This study provides further evidence for the early beneficial effect of TARGET on aesthetic outcome.