Evidence map›Paper›PMID 31015124›Full record

ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2019

Is breast seroma after tumour resection associated with patient-reported breast appearance change following radiotherapy? Results from the IMPORT HIGH (CRUK/06/003) trial.

Indrani S Bhattacharya, Joanne S Haviland, Carola Perotti, David Eaton, Sarah Gulliford, Emma Harris, Charlotte E Coles, Cliona C Kirwan, Judith M Bliss, Anna M Kirby and 1 more

Open access · hybridAbstract read
In one paragraph

Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Indrani S BhattacharyaThe Institute of Cancer Research Clinical Trials and Statistics Unit (ICR-CTSU), United Kingdom. Electronic address: indrani.bhattacharya@icr.ac.uk.
Joanne S HavilandThe Institute of Cancer Research Clinical Trials and Statistics Unit (ICR-CTSU), United Kingdom. Electronic address: jo.haviland@icr.ac.uk.
Carola PerottiThe Royal Marsden NHS Foundation Trust, United Kingdom.
David EatonMount Vernon Hospital, National Radiotherapy Trials QA Group, United Kingdom. Electronic address: davideaton@nhs.net.
Sarah GullifordThe Institute of Cancer Research, Radiotherapy and Imaging, United Kingdom; University College London Hospital, London, UK. Electronic address: s.gulliford@nhs.net.
Emma HarrisThe Institute of Cancer Research, Radiotherapy and Imaging, United Kingdom. Electronic address: emma.harris@icr.ac.uk.
Charlotte E ColesCambridge University, Department of Oncology, United Kingdom. Electronic address: colesc@doctors.org.uk.
Cliona C KirwanInstitute of Cancer Sciences, University of Manchester, University Hospital of South Manchester, United Kingdom. Electronic address: cliona.kirwan@manchester.ac.uk.
Judith M BlissThe Institute of Cancer Research Clinical Trials and Statistics Unit (ICR-CTSU), United Kingdom. Electronic address: judith.bliss@icr.ac.uk.
Anna M KirbyRoyal Marsden NHS Foundation Trust and Institute of Cancer Research, Radiotherapy and Imaging, United Kingdom. Electronic address: anna.kirby@rmh.nhs.uk.
IMPORT Trialists
Institute of Cancer Research · GBRoyal Marsden NHS Foundation Trust · GBMount Vernon Hospital · GBUniversity College Hospital · GBUniversity of Cambridge · GBUniversity of Manchester · GB

Funding

Cancer Research UK 16831Cancer Research UK 19727Cancer Research UK 21752Cancer Research UK C1491/A16831Cancer Research UK C1491/A8895Department of Health NIHR300024Department of Health NIHR-CS-011-014
6 · The paper itself

Abstract

backgroundSeroma describes a collection of serous fluid within a cavity, occurring following surgery. Seroma is associated with normal tissue effects (NTE) following breast radiotherapy, as reported by clinicians and on photographs. This study investigates the association between seroma and the NTE breast appearance change collected using patient-reported outcome measures (PROMs) in IMPORT HIGH, as well as investigating the association between breast appearance change and patient/tumour/treatment factors.

methodsCase-control methodology was used for seroma analysis within IMPORT HIGH. Cases were patients reporting moderate/marked breast appearance change and controls reported none/mild changes at year-3. One control was selected at random for each case. Seromas were graded as not visible/subtle or visible/highly visible on CT radiotherapy planning scans. Logistic regression tested associations, adjusting for patient/tumour/treatment factors.

results1078/1149 patients consented to PROMs, of whom 836 (78%) reported whether they had 3-year breast appearance change; 231 cases and 231 controls were identified. 304/462 (66%) patients received chemotherapy. Seroma prevalence was 20% (41/202) in cases and 16% (32/205) in controls, and less frequent in patients receiving adjuvant chemotherapy [10% (24/246) compared with 29% (40/138) without]. Visible seroma was not significantly associated with breast appearance change [OR 1.38 (95%CI 0.83-2.29), p = 0.219]. Larger tumour size, haematoma, current smoking and body image concerns at baseline were independent risk factors.

conclusionsSeroma was not associated with patient-reported breast appearance change, but haematoma and smoking were significant risk factors. Lack of association may be related to lower prevalence of seroma compared with previous reports, perhaps reflecting patients receiving adjuvant chemotherapy in whom seroma resolves prior to radiotherapy.

Indexed as

BreastBreast NeoplasmsCase-Control StudiesCombined Modality TherapyFemaleHumansLogistic ModelsMiddle AgedPatient Reported Outcome MeasuresRisk FactorsSeromaBreast appearance changeBreast seromaNormal tissue effectsPatient-reported outcomes

Identifiers

PMID31015124
PMCPMC6598856
OpenAlexW2935935168

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.