Journal Article

DKFZ-2026-00081

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Trajectories and risk factors for long-term breast symptoms following breast-conserving surgery and radiotherapy: a single centre analysis.

Jones, C. ; Nurmahomed, N. ; Kaushik, M. ; Krupa, J. ; Lambert, K. V. ; Pilgrim, S. M. ; Kancherla, K. ; Sampson, K. ; Sasi, W. ; Seibold, P.DKFZ* ; Symonds, R. P. ; Valassiadou, K. ; Webb, A. J. ; West, C. ; Talbot, C. J. ; Rattay, T.

2026
Springer New York,NY

Abstract: Long-term breast symptoms (pain, sensitivity, swelling and skin problems) after breast cancer treatment can affect survivors' quality-of-life. The trajectory of breast symptoms over time and risk factors associated with their development are not well understood.This study built on the work of the international prospective REQUITE cohort study. Patients who underwent breast-conserving surgery and adjuvant radiotherapy (± chemotherapy) completed the EORTC-QLQ-BR23 questionnaire items relating to breast symptoms at four timepoints up to 24 months following radiotherapy. Patients at were re-contacted to complete additional psychometric questionnaires on different aspects of pain perception and the Hospital Anxiety & Depression Scale (HADS), with 237 respondents.Average breast symptoms peaked on completion of radiotherapy but returned to levels equal to or below baseline by 24 months. Patients with more severe breast symptoms at baseline continued to have worse symptoms long-term. In multivariable mixed models, higher breast symptom scores were associated with smoking (p = 0.036), any analgesic use at baseline (p = 0.005), and post-operative haematoseroma (p = 0.034), while older age and use of intensity modulated radiotherapy (IMRT) were protective (p = < 0.001 and p = 0.045 respectively). Psychometric questionnaire scores for life interference and pain severity perception were associated with persistently increased breast symptoms at 24 months on multivariable analysis, while anxiety (as determined by HADS) was associated on univariable analysis.This study identifies several risk factors for persistent breast symptoms including younger age, smoking, and post-operative haematoseroma. This particularly highlights the importance of smoking cessation and use of IMRT in women at higher risk of side effects.

Keyword(s): Humans (MeSH) ; Female (MeSH) ; Breast Neoplasms: radiotherapy (MeSH) ; Breast Neoplasms: therapy (MeSH) ; Breast Neoplasms: surgery (MeSH) ; Risk Factors (MeSH) ; Middle Aged (MeSH) ; Mastectomy, Segmental: adverse effects (MeSH) ; Mastectomy, Segmental: methods (MeSH) ; Prospective Studies (MeSH) ; Quality of Life (MeSH) ; Aged (MeSH) ; Surveys and Questionnaires (MeSH) ; Adult (MeSH) ; Radiotherapy, Adjuvant: adverse effects (MeSH) ; Age Factors (MeSH) ; Radiotherapy, Intensity-Modulated: adverse effects (MeSH) ; Psychometrics (MeSH) ; Time Factors (MeSH) ; Cohort Studies (MeSH) ; Breast cancer survivorship ; Breast pain ; Multivariate analysis ; Quality of life ; Radiotherapy side-effects

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Contributing Institute(s):

1. Personalisierte Früherkennung des Prostatakarzinoms (C130)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2026

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Springer ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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