S2667
RTT - Patient experience and quality of life
ESTRO 2026
Data from the South West Radiotherapy Late Effects Service (SWRLES)[1] showed 79% (264/335) of breast radiotherapy patients reported pain post-treatment, though type and location of pain were unclear. A recent study reported 14% of patients had moderate/severe chest wall pain after breast radiation [2], suggesting this may be under-recognized. This study explored chest wall pain in irradiated tissues using Patient Reported Outcome Measures (PROMs) combined with clinical records from patients reviewed in a late effects service. Material/Methods: Women referred to SWRLES completed EORTC QLQ- C30 and breast-specific PROMs (BR23, BR45 or BR42). Data from 50 consecutive breast cancer radiotherapy patients, ≥ 3 months post-treatment, were analysed; one was excluded due to subsequent lung radiotherapy. Responses were rated on a 4-point scale: ‘none’ = no pain; ‘a little’, ‘quite a bit’, ‘very much’ = pain. Clinical records were retrospectively reviewed by a therapeutic radiographer (RTT), scoring chest wall pain as ‘yes’, ‘no’, or ‘unknown’ for subgroup analysis. Results: QLQ-C30 showed 90% reported pain; breast-specific PROMs indicated 90% had pain in the affected breast, 76% reported oversensitivity, 86% arm/shoulder pain, 59% restricted arm movement, 31% arm lymphoedema, and 57% breast lymphoedema. Chest wall pain could not be identified from PROMs but clinical records confirmed breast lymphoedema in 59% and reported chest wall pain in 51% (25/49). Those with chest wall pain had higher QLQ-C30 pain scores and a lower quality of life. The differences between those with and without pain were not statistically significant but clinically meaningful (see table 1). No correlation was found between age, surgery type, or radiotherapy regime and the presence of chest wall pain.
NPMs were 10 (IQR 8-10) for both groups and remained high at 2W (10; IQR9- 10) and 3M (9.5; IQR 8-10). Patients in both groups reported mark visibility and maintenance as concerns during RT. Patients withNPM-Coverreported more skin irritation (18.5% vs 0%, p=0.052), though no discontinuations occurred.Meanmarking time was longer for NPM-Inkcompared to NPM-Cover (5.69 vs.4.05mins, p<0.001)and reapplications rates were significantly higher (83% vs. 42%, p=0.002).NPM-Ink patients more often agreed that their marks requiredadditionalradiation therapistattention ( p=0.054).At 2W and 3M, ≥ 85% of patients in both groups indicated they would not have chosen a permanent tattoo option instead of NPMs. Free- text patient responses at 3M described a sense of closure from cancer treatment with NPM removal and relief from no lasting skin markings, with many patients expressing appreciation for tattoo-
free options. Conclusion:
Both NPM approacheswere well toleratedwith high patient satisfaction and patientsvalued tattoo-free options.Semi-permanentink marks requiredmore time and reapplications, whereastemporary protective cove rs hadmore patient reported skin irritation.Our findings support integrating NPMs in clinical practice with the recommendation that departments balance clinical workflow, resources, and patient preference prior to implementation. Keywords: breast cancer, radiotherapy, non- permanent marks Proffered Paper 2495 Chest wall pain after breast cancer radiotherapy – an underrecognized problem that impacts women’s quality of life. Lisa A Durrant 1,2 , Vicki L Hands 1 , Rachel Harris 3 , Sara Faithfull 4 1 Beacon Radiotherapy Department, Somerset NHS Foundation Trust, Taunton, United Kingdom. 2 Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom. 3 Patient Experience Partner, Somerset NHS Foundation Trust, Taunton, United Kingdom. 4 Discipline of Radiation Therapy, Trinity College, Dublin, Ireland Purpose/Objective: The chest wall comprises bone, muscle, and fascia, distinct from the breast containing glandular/fatty tissue, lymphatics, and skin. The chest wall can receive significant radiation during breast cancer radiotherapy, potentially causing late adverse effects.
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