ESTRO 2020 Abstract book

S368 ESTRO 2020

practice and better implement breast hypofractionated radiotherapy in routine

Poorer body image was independently associated with lower age (OR 0.97, 95%CI 0.95-0.99), mastectomy without direct reconstruction (OR 2.39 95%CI 1.17-4.62), chemotherapy (OR 2.05, 95%CI 1.16-3.64), and higher levels of anxiety at baseline as measured with the HADS questionnaire (OR 1.08, 95%CI 1.00-1.17).

PH-0599 Body image after breast cancer treatment and determinants associated with impaired body image M. Batenburg 1 , L.E. Van Stam 1 , R. Gal 2 , I. Van Dam 1 , A. Doeksen 3 , T. Van Dalen 4 , E.J.P. Schoenmaeckers 5 , R.M. Bijlsma 6 , A. Witkamp 7 , M. Sier 3,8 , D.H.J.G. Van den Bongard 9 , H.M. Verkooijen 2 1 UMC Utrecht- Utrecht University, Radiation Oncology, Utrecht, The Netherlands ; 2 UMC Utrecht- Utrecht University, Imaging Division, Utrecht, The Netherlands ; 3 St. Antonius Ziekenhuis, Surgery, Nieuwegein, The Netherlands ; 4 Diakonessenhuis, Surgery, Utrecht, The Netherlands ; 5 Meander Medisch Centrum, Surgery, Amersfoort, The Netherlands ; 6 UMC Utrecht- Utrecht University, Medical Oncology, Utrecht, The Netherlands ; 7 UMC Utrecht- Utrecht University, Surgery, Utrecht, The Netherlands ; 8 Ziekenhuis Rivierenland, Surgery, Nieuwegein, The Netherlands ; 9 Amsterdam University Medical Centre, Radiation Oncology, Amsterdam, The Netherlands Purpose or Objective The purpose of this study was to assess to what extent irradiated breast cancer patients are dissatisfied with their body image in the first three years after diagnosis and which determinants were associated with an impaired body image. Material and Methods Patients enrolled between October 2013 and January 2019 in the prospective UMBRELLA cohort, consisting of breast cancer patients referred to the radiotherapy department at the University Medical Centre Utrecht, were selected. Female patients with >1 year follow-up and response to >2 questionnaires (including baseline) were selected. Different aspects of body image (i.e. body dissatisfaction, loss of femininity, feeling less attractive, difficulty to see yourself naked) were assessed by means of the EORTC QLQ-BR23 questionnaire on a 4-point Likert scale upon cohort inclusion, at 3, 6, 12, 18, and 24 months. Multivariable logistic regression was performed to identify which determinants were independently associated with poor body image at two years. This cut-off value was chosen, since body image scores stabilized after two years. Results Information from 1314 patients was available. The mean age was 58 years (SD 11). The majority of the patients was treated with breast conserving surgery (86.1%), 8.5% of the patients was treated with mastectomy and 5.2% of the patients underwent mastectomy followed by immediate breast reconstruction. Sentinel node procedure was performed in 84.0% of the patients. Twenty-five percent received chemotherapy and 47.5% received endocrine therapy. Before the start of radiotherapy 10.9% (143/1312) patients felt (much) less attractive as a result of their treatment or disease. This proportion gradually decreased to 4.0% (20/503) after 36 months follow-up. Eight percent (109/1308) of the patients felt (much) less feminine due to their treatment or disease at baseline. During 36 months follow-up this proportion decreased to 2.4% (12/502). The proportion of patients who found it (very) difficult to see themselves naked was 6.3% (83/1308) at baseline and this decreased gradually to 3.0% (15/504) during 36 months follow-up. Prior to radiotherapy, 8.0% (104/1292) was (very) dissatisfied with their body. After 36 months follow- up, this proportion was 5.2% (26/492).

Conclusion Breast cancer patients experience poorer body image during and after breast cancer treatment in contrast to 3 years after treatment. However, the proportion of patients reporting poor body image is low. Lower age, systemic treatment and higher anxiety levels were associated with impaired body image. PH-0600 Distribution patterns of lymphatic metastases: influence of axillary lymph node dissection C.A.M. Schleibinger 1 , K.J. Borm 1 , J. Voppichler 1 , M. Düsberg 1 , M. Oechsner 1 , S.E. Combs 1 , M. Duma 1,2 1 Klinikum rechts der Isar, Department of Radiation Oncology- Technical University of Munich TUM- Ismaninger Str. 22, Munich, Germany ; 2 University Hospital of the Friedrich-Schiller University, Department of Radiotherapy and Radiation Oncology- Bachstraße 18, Jena, Germany Purpose or Objective In 2018, a study on the distribution patterns of PET positive lymph node metastases (LNM) in breast cancer patients (Borm KJ et al., IJROBP 2018) was published. Therein, LNM of patients with recurrent breast cancer were analysed. The aim of the current study was to assess whether the pattern of lymph node recurrences differs between patients with prior axillary lymph node dissection (ALND) vs. no prior ALND. Material and Methods