Table 2.
Subsequent mastectomy, postoperative complications, and local toxicities by radiation treatment
| Outcome | % (95% CI)
|
P value*
|
||||
|---|---|---|---|---|---|---|
| Lump | Brachy | EBRT | Lump vs Brachy | Lump vs EBRT | Brachy vs EBRT | |
| Subsequent mastectomy† | ||||||
| All patients (N=35,947) | .12 | <.001 | <.001 | |||
| 3 y | 2.6 (2.2–3.0) | 1.7 (1.1–2.7) | 0.7 (0.6–0.8) | |||
| 5 y | 4.2 (3.7–4.7) | 3.0 (2.0–4.4) | 1.4 (1.2–1.5) | |||
| Invasive patients (n=28,718) | .02 | <.001 | <.001 | |||
| 3 y | 2.9 (2.5–3.5) | 1.5 (0.9–2.5) | 0.6 (0.5–0.7) | |||
| 5 y | 4.7 (4.1–5.4) | 2.8 (1.8–4.3) | 1.3 (1.1–1.5) | |||
| DCIS patients (n=7229) | .39 | <.001 | .004 | |||
| 3 y | 1.9 (1.4–2.5) | 3.2 (1.3–7.7) | 0.8 (0.6–1.1) | |||
| 5 y | 3.2 (2.5–4.1) | 4.6 (2.0–10.5) | 1.6 (1.3–2.2) | |||
| Subsequent mastectomy† stratified by ASTRO risk group (invasive patients only) | ||||||
| Suitable (n=9966) | .20 | <.001 | .002 | |||
| 3 y | 2.6 (1.8–3.8) | 0.7 (0.3–1.9) | 0.3 (0.2–0.5) | |||
| 5 y | 3.7 (2.6–5.2) | 1.6 (0.7–3.5) | 0.8 (0.6–1.1) | |||
| Younger suitable (n=2516) | .91 | <.001 | <.001 | |||
| 3 y | 4.4 (1.7–11.5) | 1.2 (0.3–4.8) | 0.3 (0.2–0.7) | |||
| 5 y | 5.8 (2.4–13.6) | 3.1 (1.1–8.1) | 0.8 (0.5–1.4) | |||
| Older suitable (n=7450) | .07 | <.001 | .23 | |||
| 3 y | 2.4 (1.6–3.6) | 0.5 (0.1–2.1) | 0.3 (0.2–0.5) | |||
| 5 y | 3.5 (2.4–5.0) | 1.0 (0.3–3.4) | 0.8 (0.6–1.1) | |||
| Cautionary (n=5509) | .38 | <.001 | .006 | |||
| 3 y | 4.5 (2.8–7.0) | 3.0 (1.3–7.2) | 0.8 (0.6–1.2) | |||
| 5 y | 6.7 (4.4–10.2) | 5.4 (2.5–11.6) | 2.2 (1.7–2.8) | |||
| Unsuitable (n=10,119) | .43 | <.001 | .14 | |||
| 3 y | 3.2 (2.6–3.9) | 2.4 (0.8–7.2) | 1.0 (0.8–1.3) | |||
| 5 y | 5.0 (4.1–6.0) | 3.6 (1.3–9.4) | 1.6 (1.3–2.0) | |||
| Unclassified (n=3574) | .97 | <.001 | .02 | |||
| 3 y | 1.0 (0.4–2.4) | 2.0 (0.6–6.3) | 0.3 (0.1–0.6) | |||
| 5 y | 3.6 (2.0–6.4) | 3.5 (1.2–9.6) | 0.7 (0.4–1.1) | |||
| Postoperative complications in all patients (N=35,947)‡ | ||||||
| Infectious complication | ||||||
| 1 y | 9.9 (9.2–10.5) | 16.5 (14.5–18.5) | 11.4 (11.0–11.8) | <.001 | <.001 | <.001 |
| Noninfectious complication§ | ||||||
| 1 y | 6.0 (5.5–6.5) | 18.7 (16.6–20.8) | 9.5 (9.1–9.8) | <.001 | <.001 | <.001 |
| Local toxicities in all patients (N=35,947)|| | ||||||
| Rib fracture | .07 | <.001 | .93 | |||
| 1 y | 1.2 (1.0–1.5) | 0.7 (0.4–1.3) | 0.8 (0.7–0.9) | |||
| 3 y | 3.4 (3.0–3.8) | 2.3 (1.6–3.3) | 2.4 (2.2–2.6) | |||
| 5 y | 5.2 (4.6–5.8) | 4.2 (3.0–5.9) | 4.0 (3.7–4.3) | |||
| Fat necrosis | <.001 | <.001 | <.001 | |||
| 1 y | 4.2 (3.8–4.7) | 6.8 (5.6–8.3) | 4.4 (4.2–4.7) | |||
| 3 y | 4.9 (4.5–5.4) | 11.2 (9.5–13.0) | 6.3 (6.0–6.6) | |||
| 5 y | 5.3 (4.8–5.8) | 15.3 (13.0–17.9) | 7.7 (7.3–8.0) | |||
| Breast pain | <.001 | <.001 | <.001 | |||
| 1 y | 4.9 (4.5–5.4) | 11.0 (9.4–12.8) | 7.1 (6.8–7.4) | |||
| 3 y | 8.9 (8.3–9.5) | 18.2 (16.2–20.5) | 13.3 (12.9–13.7) | |||
| 5 y | 11.2 (10.5–12.0) | 22.9 (20.2–25.7) | 16.7 (16.2–17.2) | |||
| Radiation pneumonitis | .07 | <.001 | .08 | |||
| 1 y | 0.0 (0.00–0.1) | 0.2 (0.01–0.7) | 0.5 (0.4–0.6) | |||
| 3 y | 0.2 (0.01–0.3) | 0.4 (0.2–0.9) | 0.8 (0.7–0.9) | |||
| 5 y | 0.2 (0.1–0.4) | 0.4 (0.2–0.9) | 0.9 (0.8–1.0) | |||
Abbreviations: ASTRO = American Society for Radiation Oncology; Brachy = brachytherapy; DCIS = ductal carcinoma in situ; Lump = lumpectomy alone.
P value from log-rank test for all outcomes except postoperative complications, where P value is from Pearson χ2 test.
The time interval for this outcome begins 1 year after diagnosis (because treatment rendered within the first year of diagnosis is considered initial treatment and not an outcome).
These outcomes include any event that occurred within 1 year of diagnosis.
This outcome includes codes for postoperative shock, hematoma, hemorrhage, seroma, fistula, non-healing surgical wound, other specified postoperative complication, and postoperative complication not otherwise specified.
The time interval for these outcomes begins at diagnosis and continues through the time points specified.