Quantitative 3-Dimensional Photographic Assessment of Breast Cosmesis After Whole Breast Irradiation for Early Stage Breast Cancer: A Secondary Analysis of a Randomized Clinical Trial

Bhavana V. Chapman, MD; Xiudong Lei, PhD; Prithvi Patil, MS; Shikha Tripathi, MS; Krista M. Nicklaus, MS; Aaron J. Grossberg, MD, PhD; Simona F. Shaitelman, MD, EdM; Alastair M. Thompson, MD; Kelly K. Hunt, MD; Thomas A. Buchholz, MD, FASTRO; Fatima Merchant, PhD; Mia K. Markey, PhD; Benjamin D. Smith, MD, FASTRO; Jay P. Reddy, MD, PhD

Advances in Radiation Oncology (Sep 2020)

Quantitative 3-Dimensional Photographic Assessment of Breast Cosmesis After Whole Breast Irradiation for Early Stage Breast Cancer: A Secondary Analysis of a Randomized Clinical Trial

Bhavana V. Chapman, MD,
Xiudong Lei, PhD,
Prithvi Patil, MS,
Shikha Tripathi, MS,
Krista M. Nicklaus, MS,
Aaron J. Grossberg, MD, PhD,
Simona F. Shaitelman, MD, EdM,
Alastair M. Thompson, MD,
Kelly K. Hunt, MD,
Thomas A. Buchholz, MD, FASTRO,
Fatima Merchant, PhD,
Mia K. Markey, PhD,
Benjamin D. Smith, MD, FASTRO,
Jay P. Reddy, MD, PhD

Affiliations

Bhavana V. Chapman, MD: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Xiudong Lei, PhD: Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
Prithvi Patil, MS: Department of Engineering Technology, University of Houston, Houston, Texas; The University of Texas Health Science Center at Houston, Houston, Texas
Shikha Tripathi, MS: Department of Engineering Technology, University of Houston, Houston, Texas
Krista M. Nicklaus, MS: Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas
Aaron J. Grossberg, MD, PhD: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
Simona F. Shaitelman, MD, EdM: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Alastair M. Thompson, MD: Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Surgery, Division of Surgical Oncology, Baylor College of Medicine, Houston, Texas
Kelly K. Hunt, MD: Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Thomas A. Buchholz, MD, FASTRO: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Scripps MD Anderson Cancer Center, La Jolla, California
Fatima Merchant, PhD: Department of Engineering Technology, University of Houston, Houston, Texas; Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas; Department of Computer Science, University of Houston, Houston, Texas
Mia K. Markey, PhD: Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas; Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
Benjamin D. Smith, MD, FASTRO: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
Jay P. Reddy, MD, PhD: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Corresponding author: Jay P. Reddy, MD, PhD

Journal volume & issue: Vol. 5, no. 5
pp. 824 – 833

Abstract

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Purpose: Our purpose was to use 3-dimensional (3D) surface photography to quantitatively measure breast cosmesis within the framework of a randomized clinical trial of conventionally fractionated (CF) and hypofractionated (HF) whole breast irradiation (WBI); to identify how 3D measurements are associated with patient- and physician-reported cosmesis; and to determine whether objective measures of breast symmetry varied by WBI treatment arm or transforming growth factor β 1 (TGFβ1) status. Methods and Materials: From 2011 to 2014, 287 women age ≥40 with ductal carcinoma in situ or early-stage invasive breast cancer were enrolled in a multicenter trial and randomized to HF-WBI or CF-WBI with a boost. Three-dimensional surface photography was performed at 3 years posttreatment. Patient-reported cosmetic outcomes were recorded with the Breast Cancer Treatment Outcome Scale. Physician-reported cosmetic outcomes were assessed by the Radiation Therapy Oncology Group scale. Volume ratios and 6 quantitative measures of breast symmetry, termed F1-6C, were calculated using the breast contour and fiducial points assessed on 3D surface images. Associations between all metrics, patient- and physician-reported cosmesis, treatment arm, and TGFβ1 genotype were performed using the Kruskal-Wallis test and multivariable logistic regression models. Results: Among 77 (39 CF-WBI and 38 HF-WBI) evaluable patients, both patient- and physician-reported cosmetic outcomes were significantly associated with the F1C vertical symmetry measure (both P < .05). Higher dichotomized F1C and volumetric symmetry measures were associated with improved patient- and physician-reported cosmesis on multivariable logistic regression (both P ≤ .05). There were no statistically significant differences in vertical symmetry or volume measures between treatment arms. Increased F6C horizontal symmetry was observed in the CF-WBI arm (P = .05). Patients with the TGFβ1 C-509T variant allele had lower F2C vertical symmetry measures (P = .02). Conclusions: Quantitative 3D image-derived measures revealed comparable cosmetic outcomes with HF-WBI compared with CF-WBI. Our findings suggest that 3D surface imaging may be a more sensitive method for measuring subtle cosmetic changes than global patient- or physician-reported assessments.

Published in Advances in Radiation Oncology

ISSN: 2452-1094 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: http://www.journals.elsevier.com/advances-in-radiation-oncology/

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