Follow-up and endpoint outcomes

Patients were followed until January 2016 at a rate of every 3 months for the first 2 years and every 6 months thereafter. Follow-up was performed immediately after completion of radiation therapy and at 6 weeks, 6 months and 12 months post-therapy as part of the previous study, and at 24 months and 60 months specifically for the present study. The initial cosmetic breast condition were scored based on surgical scarring, breast size difference, nipple, nipple retraction, and the areola (acceptable = 0; no significant difference = 1). The patients were put into four categories based on their scores: excellent (0-1), good (2), fair (3) and weak (4-5). At each follow-up visit, factors affecting appearance (such as onset of radiotherapy), fibrosis and telangiectasia as late skin toxicity, and local and distant recurrence were investigated. The study’s primary endpoint was locoregional recurrence. Secondary endpoints included late skin toxicity and cosmetic outcome. Locoregional was defined as the area of the breast and the supraclavicular lymph drainage area within the radiation field; definite diagnosis of locoregional recurrence was confirmed by both clinical and imaging examinations.