Skin Sparing Mastectomy and Immediate Reconstruction in Locally Advanced Breast Cancer Patients Treated With Neoadjuvant Chemotherapy and Postmastectomy Radiation Therapy: Long-Term Oncologic and Patient-Reported Quality of Life Outcomes

Abstract

combination in terms of rates of local control, distant recurrence, and overall survival. Materials/Methods: Women with stage I II (pT1-T2, pN0) TNBC are eligible after segmental mastectomy and axillary lymph node assessment. Weekly carboplatin (AUC Z 2.0) is delivered x 6 weeks with RT to the whole breast, delivered during weeks 2-4 via a 3D-CRT or an IMRT technique in the prone position. The whole breast receives 40.5 Gy in 15 fractions (Monday-Friday). The tumor bed receives an additional 3 Gy boost, delivered on 2 consecutive Sundays (beginning on the 2nd and 3rd weeks of RT). Consequently, a total of 46.5 Gy is delivered to the tumor bed in 17 fractions over 19 days. Adverse effects of treatment are assessed weekly during treatment, and once at 45-60 days, thereafter, using the Common Terminology Criteria for Adverse Events (CTCAE) v3.0. Results: A total of 27 patients have accrued so far. The median age was 56 years (range: 27-82). Reported acute skin toxicities are displayed (see Table). With a median follow-up of 26 months all of the women remain alive and without recurrent disease. Conclusions: Adjuvant concurrent carboplatin and prone accelerated radiation therapy appears to be a safe and effective treatment for women diagnosed with early stage TNBC. Since approximately 50% of TNBC carriers recur within 2 years from treatment, it is encouraging that none of the patients in the trial have experience a recurrence. The trial remains open for patient accrual. Author Disclosure: E.B. Golden: None. R.E. Vatner: None. M. FentonKerimian: None. Y. Novik: None. R. Oratz: None. J. Speyer: None. S.C. Formenti: None.