The following article is part of conference coverage from the 17th St. Gallen International Breast Cancer Symposium, which is being held virtually from March 7-21, 2021. The team at Cancer Therapy Advisor will be reporting on the latest research conducted by leading experts in breast cancer. Check back for more from the 17th St. Gallen International Breast Cancer Symposium.

Results of a study out of the University of Medicine of Tunis, Tunisia, indicated that hypofractionated whole-breast radiotherapy (HF-WBR) was found to be safe and effective in young women with breast cancer.  However, the study researchers cautioned that longer follow-up is needed in order to better define late toxicity and oncologic outcome.

According to the poster presentation at the St. Gallen International Breast Cancer Conference, HF-WBR has proved equivalent to conventionally fractionated radiotherapy in randomized trials. However, young women were often only a fraction of the patients included in these trials.

This retrospective study was designed to assess toxicity and efficacy of HF-WBR after breast-conserving surgery in women aged younger than 50 years.

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The study included 78 women who underwent 3-dimensional HF-WBR from March 2018 to October 2020. Treatment consisted of 40.05 Gy in 15 fractions to the whole breast with or without regional lymph nodes, plus a tumor boost (13.35 Gy in 5 fractions). Patients underwent weekly assessment for toxic effects during irradiation.

The median age of patients was 44, with 21 patients younger than 40.

Only 8% of patients experienced no skin toxicity. Grade 1 acute radiodermatitis occurred in the majority of patients (68%), with grade 2 occurring in approximately one-fifth (22%), and grade 3 occurring in only a minority (2%) of patients.

Radiodermatitis was not found to be correlated with the age of the patient, diabetes status, or systemic therapy.

Upper extremity lymphedema and impaired shoulder mobility were not worsened by radiotherapy, the researchers noted. Additionally, no cardiac or respiratory symptoms were reported.

After a mean follow-up of 1 year, no locoregional recurrence had occurred. One patient experienced liver metastatic progression 6 months after completing treatment with HF-WBR.

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Aissaoui D, Bohli M, Ben Amor R, et al. Tolerance and outcome of hypofractionated whole breast irradiation in young women: from controversies to evidence. Poster presentation at: 17th St. Gallen International Breast Cancer Conference; March 17-21, 2021. Abstract P012.