TPT 4.18 Patient-Reported, Volumetric and Kinematic Breast Asymmetry after Breast Cancer Surgery and Radiotherapy

Abstract Aims Breast asymmetry after breast cancer treatment is associated with reduced satisfaction and health-related quality-of-life. This study aimed to establish patient-reported and biomechanical (volumetric and kinematic) breast asymmetry after surgery and radiotherapy across a range of surgical procedures. Methods NHS REC approval was obtained for this clinical feasibility trial (IRAS 348050, REC24/SC/0408). Participants were women >18 years treated for unilateral breast cancer at a single UK oncoplastic centre (N=35). Participants completed questionnaires on breast asymmetry. Biomechanical analysis included three-dimensional surface imaging (Artec Eva 3D, Artec, Luxembourg) to measure breast volume, and collection of three-dimensional nipple/torso coordinate positions during treadmill walking (Liberty, Polhemus, USA). Volume asymmetry was measured by median percentage difference in breast volume and kinematic asymmetry by median percentage difference in resultant breast range of motion (ROM). Results Patient-reported breast asymmetry increased from 37% (13/35) pre-operatively to 64%% (18/28) post-operatively and 57% (8/14) post-radiotherapy. Perceived breast asymmetry affecting bra choice was reported by 71% (20/28) post-operatively and 38% (5/13) post-radiotherapy. Volumetric asymmetry varied from median (range) 1% (–20 to +19%) pre-operatively to 0.5% (–100% to +29%) post-operatively and –3.5% (–24% to +1%) post-radiotherapy, indicating a small increase in volume asymmetry. Kinematic asymmetry increased from median 0.8% pre-operatively to –19% post-operatively and –26% post-radiotherapy, indicating asymmetrical reduction in breast ROM. Conclusions Patient-reported and biomechanical breast asymmetry after breast cancer treatment is common and has functional and quality-of-life implications. Further longitudinal studies are needed to determine breast asymmetry throughout survivorship and its implications for breast support requirements and bra design.