Hypofractionated Radiotherapy for Breast Cancer: Experience of the Radiotherapy Department of the Mali Hospital

Aim: To evaluate the outcomes of hypofractionated radiotherapy in breast cancer. Patients and Methods: It was a retrospective study over a 3-year period, from January 2016 to December 2018, of breast cancer patients treated with hypofractionated radiotherapy at Mali Hospital. All patients with histologically confirmed breast cancer without distant metastases were included. We excluded all patients treated for breast cancer with palliative or normofractionated radiotherapy, patients with metastatic disease on admission and incomplete records. Patients were classified according to the 7th edition TNM classification. Radiotherapy was administered using an Elekta Compact 6MV linear accelerator with the 3D conformal technique, at a total dose of 42 Gy at a rate of 2.8Gy/fraction in 15 sessions, and 5 sessions/week. Data were collected from medical records and treatment sheets, entered into Excel and analysed using SPSS version 23 software. Results: Sixty-four patients out of 129 met our selection criteria (49.61%). The mean age was 44.65+/-11.11 with extremes of 25 and 88 years. Previous hormonal contraception was found in 23.43% of cases, familial breast cancer in 6.25% and nulliparity in 4.68% of cases. Ultramammography was performed in all patients. Assessment of distant extension consisted of a thoraco-abdominal CT scan in 92.18% of cases, and abdominal ultrasound combined with a chest X-ray in 7.82% of cases. Histology of the biopsy specimen showed non-specific carcinoma in 96.87% of cases, Scarf-Bloom and Richardson (SBR) grade II in 64.81% and grade III in 27.78%. Immunohistochemistry was performed in 26 patients, hormone receptor positive in 57.69% (n=15) and triple negative in 42.31% (n=11). Patients were classified as stage T3 or T4 in 82.68% of cases. 95.4% of patients underwent mastectomy and 4.6% lumpectomy; all patients underwent axillary curage. The patients were treated with hypofractionated radiotherapy on the wall and the supra- and sub-clavicular lymph