Background: In situations where the risk of local recurrence is high after mastectomy for breast cancer, the patient may be offered an increase in dose to the chest wall, more or less to the lymph node drainage areas, or an increase in dose beyond 50 Gy. This attitude is known as boost. This paper presents a quantitative, qualitative and temporal analysis of boost prescription in postmastectomy in Cameroon. 

Methodology. We conducted a retrospective study between April 2025 and June 2025 at the Cameroon Oncology Center (COC). The population of interest and study period was: all women who received chest wall radiotherapy for breast cancer at the COC between April 2019 and December 2023. Excluded were: all those who had received radiotherapy to the mammary gland, those who had received palliative radiotherapy to the chest wall, and those whose complete medical records could not be located. We collected various clinical and therapeutic parameters for each patient. We then determined the proportion of boosted (PB+) and unboosted (PB-) patients. A chi2 test was used to measure the association between boost prescription and categorical variables. A multivariate logistic regression analysis was performed to investigate risk factors associated with post-mastectomy boosting. Data were analyzed using PYTHON 3.8 .11

 Results. Of the 57 patients, more than 2/3 (n=38) had received a boost. The mean total boost dose was 10 Gy in conventional fractionation (2 Gy per fraction), with a mean spread of one week and three days. The volume boosted was the mastectomy scar and a 4cm margin around the scar in the majority (75% (n=21). In this study, the decision to exceed 50Gy postmastectomy was influenced in order of importance by non-accuracy of the presence of vascular emboli (OR=2.66), triple-negative IHC status (OR=2.56), luminal A IHC status (OR=2.02) and T4c tumour size (OR=1.53). conclusion. Once the indications for post-mastectomy boost have been standardized between radiotherapists, prospective multicenter trials should be carried out to assess the benefit of this approach on recurrence-free survival.

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