S342
Clinical - Breast
ESTRO 2026
Purpose/Objective: Breast reconstruction following mastectomy plays a crucial role in restoring body image and psychological well-being. However, adjuvant radiation therapy may adversely affect reconstructive outcomes, leading to complications such as fibrosis, capsular contracture, or suboptimal cosmetic results. With improved survival rates among breast cancer patients, increasing attention is directed toward survivorship issues and quality of life outcomes. This study aims to assess quality of life, cosmetic outcomes, and late radiation- induced toxicities among breast cancer patients who underwent reconstruction and adjuvant radiation therapy. Material/Methods: This retroprospective study included breast cancer patients who underwent mastectomy with breast reconstruction followed by adjuvant radiation therapy at the National Cancer Institute, Egypt. Quality of life was assessed using the EORTC QLQ-BRECON23 questionnaire, cosmetic outcomes were evaluated using BCCT.core 3.1 software, and late radiation- induced toxicities were graded according to the RTOG scoring system. Most patients received hypofractionated radiotherapy (40.05 Gy in 15 fractions). Reconstruction was either autologous or implant-based. The relationship between clinical variables (age, type of surgery, and reconstruction technique) and both quality of life and cosmetic outcomes was analyzed. Results: Our study included 75 female patients (mean age 41 years) ;T2/T3 disease represented 87% of cases. Modified radical mastectomy was performed in 40% and skin-sparing mastectomy in 60%, nipple preservation in 37%. Autologous reconstruction was performed in 85% of patients (81% LD flap,19% TRAM or LICAP flaps), 15% underwent implant-based reconstruction. Radiotherapy was delivered to 90% of patients using 40 Gy/15 fractions; 10% received 45 Gy/25 fractions. At a median followup 18 months; late radiation-induced toxicities were limited: mild to moderate skin fibrosis occurred in 30% (25% mild, 5% moderate). Hyperpigmentation was absent in 74.3%, mild in 23%, and moderate to marked in 2.8%. Cosmetic outcomes were excellent in 12%, good in 69%, and fair to poor in 19%. Quality of life scores were poor (0–40) in 5.4%, good (41–60) in 48.7%, very good (61–80) in 27.0%, and excellent (>80) in 18.9%. The type of reconstruction (autologous vs. implant-) did not significantly affect quality of life (p = 0.19). Capsular contracture was observed in 3 out of 11 patients with silicon implant , no fat necorsis was observed among patients with muscle flap. Conclusion: Hypofractionated radiation therapy following breast reconstruction did not significantly impact quality of
Conclusion: In complex left-sided breast irradiation, HT achieved superior cardiac sparing and better dose homogeneity compared with VMAT, without compromising target coverage. Substructure analysis revealed intra-cardiac dose variations not captured by global metrics, supporting the need for more refined cardiac evaluation in breast treatment planning and toxicity risk assessment. Keywords: Heart-sparing Cardiac-substructure Tomotherapy Digital Poster 4901 Quality of life and Cosmetic Outcomes among breast cancer patients with mastectomy, reconstruction and adjuvant radiotherapy: data from NCI, Egypt. Marwa M Rostom 1 , Nagwan ibrahim anter 1 , Esraa gamal 1 , Ahmed Orabi 2 , Medhat El Sebaie 1 1 radiation oncology and nuclear medicine, national cancer institute, cairo, Egypt. 2 surgical oncology, national cancer institute, cairo, Egypt
Made with FlippingBook - Share PDF online