DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.006

Pages: 2202-2208

Introduction: Breast cancer is the most common cancer in women. Conservative treatment combines surgery and radiotherapy, whose efficacy on tumor control and survival has been clearly established. However, acute and late toxicity, particularly cutaneous toxicity, remains a major concern that can compromise the aesthetic outcome. Objective: This retrospective study aimed to evaluate the incidence and severity of acute toxicities associated with 3D conformal radiotherapy (3D RT) and to identify the associated clinical and dosimetric risk factors. Materials and Methods: We analyzed the records of 250 patients treated with 3D RT at the National Institute of Oncology in Rabat between June 2022 and June 2023. Toxicities were evaluated according to CTCAE v4.0 criteria. The aesthetic outcome was objectified by the Harvard aesthetic evaluation scale. Quality of life was measured using the EORTC QLQ-C30 questionnaire. Results: The majority of patients had stage T2 infiltrating ductal carcinoma and SBR grade II. Grade 2 or 3 radiation dermatitis was observed in 18.4% of patients. BMI greater than 25 kg/m² was a significant risk factor (OR = 3.61; p < 0.0001). Aesthetic results were judged satisfactory in only 35.2% of cases, with moderate to severe fibrosis in 26.4% of patients. The 2-year overall survival rate was 96.5%, and the recurrence-free survival rate was 94.5%. Multivariate analysis confirmed BMI as the only independent factor for cutaneous toxicity. Conclusion: 3D RT is well tolerated from an oncological perspective. However, the high rate of late toxicity and breast fibrosis highlights an urgent need for treatment optimization to preserve aesthetic outcome and quality of life, particularly in patients with identified risk factors such as high BMI.