Key result
Radiotherapy receipt was not associated with differences in fear of recurrence or progression or health-related quality of life, although women receiving RT had more breast symptoms (P=0.015).
Why the study?
Local recurrence is a recognized risk after breast-conserving surgery for DCIS that radiotherapy reduces without impacting overall survival, but little is known about the impact of radiotherapy on patient-reported outcomes.
Does radiotherapy impact health-related quality of life or fear of recurrence/progression in women with DCIS undergoing breast conserving surgery?
Observational (n=160)
No
Does radiotherapy impact health-related quality of life or fear of recurrence/progression in women with DCIS undergoing breast conserving surgery?
Answers are grounded in this paper and cite their sources.
Radiotherapy after breast conserving surgery for DCIS does not significantly impact long-term health-related quality of life or fear of recurrence compared to no radiotherapy.
Background Ductal carcinoma in situ (DCIS) is frequently identified during mammographic screening and treated to minimize the risk of development of invasive cancer. Local recurrence is a recognised risk after breast conserving surgery (BCS), and radiotherapy (RT) is frequently used to reduce this, despite having no impact on overall survival. Little is known about the impact of RT on patient-reported outcomes. We conducted a retrospective study to assess differences in health-related quality of life (HRQoL), fear of recurrence or progression (FRP), risk perceptions, and illness beliefs in women with DCIS, based on RT status. Patients and Methods Women with DCIS diagnosed or treated at a tertiary hospital in Melbourne from 2010-2022 who underwent BCS were eligible. HRQoL (QLQ-C30; BR45), FRP (FCRI-SF), illness perceptions (BIPQ) and perceptions of risk of DCIS recurrence or progression were assessed by self-report. Results Questionnaires from 160 women (RT n=80, no RT n=80) were analysed. Median age was 65 and median time since diagnosis was 7.7 years. Overall impact on HRQoL of treatment was low irrespective of treatment. There was no difference in FRP according to RT status. Women who received RT had larger tumours ( p <.001), more breast symptoms ( p =.015) and stronger beliefs in the effectiveness of treatment ( p=. 034). In multivariate analysis, neuroticism, perceived likelihood of DCIS progression to invasive disease and emotional impact of DCIS predicted FRP. Conclusion DCIS treatment was associated with minimal long-term HRQoL impact and low FRP, irrespective of RT. Improving understanding of recurrence/progression risk may protect against persistent FRP in these women. MicroAbstract Radiotherapy (RT) reduces recurrence but may impact quality of life (QoL). We compared QoL in women with DCIS who did (n=80) and did not (n=80) receive RT. Fears of recurrence/progression were elevated 8 years after treatment. Fears and QoL were not associated with RT receipt. Improving patient understanding of recurrence risks may be protective of long-term fear of recurrence/progression.
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Mann et al. (2025) conducted an observational in Ductal carcinoma in situ (DCIS) (n=160). Radiotherapy vs. No radiotherapy was evaluated on Health-related quality of life (HRQoL) and fear of recurrence or progression (FRP). Radiotherapy receipt was not associated with differences in fear of recurrence or progression or health-related quality of life, although women receiving RT had more breast symptoms (P=0.015).
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