|
| ||
|
|
||
Breast Irradiation (breast + irradiation)
Kinds of Breast Irradiation Selected AbstractsShort-Term Quality of Life Following Partial Breast Irradiation with Balloon Brachytherapy- Comparison with Whole Breast IrradiationTHE BREAST JOURNAL, Issue 3 2010Kevin Albuquerque MD No abstract is available for this article. [source] Centre credentialing for Trans Tasman Radiation Oncology Group trial 06.02: multicentre feasibility study of accelerated partial breast irradiationJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 4 2009T Kron Summary Introduction:, Inconsistencies in contouring target volumes for partial breast irradiation (PBI) may result in geographical misses and compromise treatment outcomes. The present study aimed to (1) determine the variability of the target volumes contoured and treatment plans generated by participating centres in credentialing for participation in a multicentre PBI trial; and (2) assess dosimetric changes when standardized target volumes were used. Methods:, The CT image sets of two de-identified patients post-breast conserving surgery were used. Contouring of the target volumes for the two cases was performed and a treatment plan as per protocol specifications was generated for each case by the seven participating centres. Planning of both cases was repeated by five centres using a set of standardized target volumes to evaluate resulting dosimetric changes in the treatment plans. Results:, The surgical cavity, the part of the planning target volume used for dose evaluation and ipsilateral whole breast volumes contoured by the centres varied by 25%, 16% and 21% (1 standard deviation), respectively. The dosimetric variations found when the standardized target volumes were used were smaller than those noted when centre-specific volumes were used. The volumes of the ipsilateral lungs receiving 30% of the prescribed dose and the volumes of the ipsilateral whole breasts receiving 95% and 50% of the prescribed dose were reduced in the treatment plans developed using the standardized target volumes. Conclusions:, Given the impact of contouring on dose distributions, quality assurance procedures in clinical trials of PBI need to take into account both the technical approaches and the contouring. [source] Systemic Lupus Erythematosus and Breast CancerTHE BREAST JOURNAL, Issue 1 2008Michalis Kontos MD Abstract:, There is evidence that certain connective tissue diseases such as scleroderma are associated with an increased risk of malignancy. Although it has been claimed that systemic lupus erythematosus (SLE) carries an increased risk of breast cancer, review of the available literature suggests that this is not the case, or, any increase is very small. Women with SLE do not need to be under close surveillance for breast cancer. In patients suffering from both SLE and breast cancer, radiotherapy has been regarded as relatively contraindicated because of fears concerning early and late complications. This view is not supported by the available literature and the majority of such cases can be treated by standard breast-conserving therapy, including breast irradiation. [source] Communication with Older Breast Cancer PatientsTHE BREAST JOURNAL, Issue 4 2007Ian S. Fentiman MD Abstract:, An increasing proportion of patients with breast cancer are aged above 70 at the time of diagnosis and yet this particular age group has been underserved in terms of clinical research. Good communication between a doctor and a patient implies giving the advice and treatment most appropriate to that particular individual's needs, based upon their health and the tumor characteristics in the framework of their experience and belief system. Doctors need to be able to pick up both verbal and nonverbal cues and whenever possible to place the needs of the patient rather than her relatives as paramount. Consultations may be blighted at the onset by delays, unsympathetic staff, and patronizing doctors. Many older patients will wish to avoid mastectomy and for those with hormonally sensitive tumors wide excision and tamoxifen without axillary clearance or breast irradiation may provide a safe option. Undertreatment of those with hormonally insensitive cancer may lead to an increased risk of recurrence and premature death from breast cancer. Although there is an increasing realization of the need for clinical studies in older patients this group are grossly under-represented in trial portfolios [source] Is there a relationship between skin erythema and fatigue in women undergoing irradiation after breast conserving surgery for early breast cancer?ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 4 2009A prospective study Abstract Aim: A prospective study was conducted to determine whether any relationship exits between skin erythema, fatigue and biological factors during and after adjuvant radiotherapy for early breast cancer. Methods: Breast erythema was assessed objectively using reflectance spectrophotometry. Fatigue was recorded utilising the functional assessment of cancer therapy fatigue subscale. A number of potential systemic indicators (biological factors) of the effects of radiotherapy was measured, including circulating cytokines, coagulation factors, peripheral blood indices and biochemistry. Measurements for erythema, fatigue and biological factors were taken at baseline and intervals during and following completion of radiotherapy. Results: A total of 52 eligible patients was included in the analysis. Breast erythema was shown to progressively increase during treatment, peaking on day 36 and returning to baseline by 4 months post-irradiation. Fatigue also progressively increased during treatment, reaching a plateau between day 22 and 2 weeks post-radiotherapy. A statistically significant association was demonstrated between total breast erythema and fatigue at days 4, 8, 22 and 29 of irradiation and 2 and 6 weeks post-radiotherapy. When only the increase in erythema attributable to radiotherapy was considered, statistically significant associations remained for day 4 of irradiation and 2 and 6 weeks post-radiotherapy. When multiple time points were considered together, an association between increased erythema and fatigue was present only post-radiotherapy. No relationship was demonstrated between the biological factors and erythema or fatigue during radiotherapy. Conclusion: This study demonstrates a significant and consistent relationship between radiotherapy-induced breast erythema and fatigue, particularly in the period immediately following breast irradiation. [source] Results of breast-conserving therapy for multifocal or multicentric breast cancersASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 3 2009Eui Kyu CHIE Abstract Aim: To evaluate the outcome of breast-conserving treatment including adjuvant radiotherapy in patients with multifocal or multicentric breast cancers. Methods: Between February 1996 and January 2002 13 patients presented with multifocal or multicentric breast tumors underwent breast-conserving therapy. Their median age was 44 years (range; 32,56). Nine patients had T1 disease and four had T2 disease. Nodal involvement was confirmed in three patients. All patients had breast-conserving surgery and axillary lymph node dissection with clear resection margin. Whole breast irradiation was given up to 50.4 Gy in 28 fractions followed by 10 Gy boost to tumor bed. Twelve patients received adjuvant systemic therapy: chemotherapy in four patients, hormonal therapy in five patients and both in three patients. Results: At a median follow-up duration of 70 months, all patients were alive without evidence of disease. The cosmetic outcome was evaluated in 11 patients. Cosmesis was excellent in two patients, good in six patients and fair in three patients. Conclusion: Multifocal and/or multicentric breast cancers can be successfully treated with breast-conserving surgery and adjuvant radiotherapy when complete microscopic resection and contemporary systemic therapy are given. [source] Preoperative breast magnetic resonance imaging in early breast cancer,CANCER, Issue 8 2009Implications for partial breast irradiation Abstract BACKGROUND: Accelerated partial breast irradiation (APBI) of patients with early breast cancer is being investigated on a multi-institutional protocol National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39/RTOG 0413. Breast magnetic resonance imaging (MRI) is more sensitive than mammography (MG) and may aid in selection of patients appropriate for PBI. METHODS: Patients with newly diagnosed breast cancer or ductal carcinoma in situ (DCIS) routinely undergo contrast-enhanced, bilateral breast MRI at the Cleveland Clinic. We retrospectively reviewed the medical records of all early-stage breast cancer patients who had a breast MRI, MG, and surgical pathology data at our institution between June of 2005 and December of 2006. Any suspicious lesions identified on MRI were further evaluated by targeted ultrasound ± biopsy. RESULTS: A total of 260 patients met eligibility criteria for NSABP B-39/RTOG 0413 by MG, physical exam, and surgical pathology. The median age was 57 years. DCIS was present in 63 patients, and invasive breast cancer was found in 197 patients. MRI identified suspicious lesions in 35 ipsilateral breasts (13%) and in 16 contralateral breasts (6%). Mammographically occult, synchronous ipsilateral foci were found by MRI in 11 patients (4.2%), and in the contralateral breast in 4 patients (1.5%). By univariate analysis, lobular histology (infiltrating lobular carcinoma [ILC]), pathologic T2, and American Joint Committee on Cancer stage II were significantly associated with additional ipsilateral disease. Of patients with ILC histology, 18% had ipsilateral secondary cancers or DCIS, compared with 3% in the remainder of histologic subtypes (P = .004). No patient older than 70 years had synchronous cancers or DCIS detected by MRI. CONCLUSIONS: Breast MRI identified synchronous mammographically occult foci in 5.8% of early breast cancer patients who would otherwise be candidates for APBI. Cancer 2009. © 2009 American Cancer Society. [source] Breast radiation therapy guideline implementation in low- and middle-income countries,CANCER, Issue S8 2008Nuran Senel Bese MD Abstract Radiation therapy plays a critical role in the management of breast cancer and often is unavailable to patients in low- and middle-income countries (LMCs). There is a need to provide appropriate equipment and to improve the techniques of administration, quality assurance, and use of resources for radiation therapy in LMCs. Although the linear accelerator is the preferred equipment, telecobalt machines may be considered as an acceptable alternative in LMCs. Applying safe and effective treatment also requires well trained staff, support systems, geographic accessibility, and the initiation and completion of treatment without undue delay. In early-stage breast cancer, standard treatment includes the irradiation of the entire breast with an additional boost to the tumor site and should be delivered after treatment planning with at least 2-dimensional imaging. Although postmastectomy radiation therapy (PMRT) has demonstrated local control and overall survival advantages in all patients with axillary lymph node metastases, preference in limited resource settings could be reserved for patients who have ,4 positive lymph nodes. The long-term risks of cardiac morbidity and mortality require special attention to the volume of heart and lungs exposed. Alternative treatment schedules like hypofractionated radiation and partial breast irradiation currently are investigational. Radiation therapy is an integral component for patients with locally advanced breast cancer after initial systemic treatment and surgery. For patients with distant metastases, radiation is an effective tool for palliation, especially for bone, brain, and soft tissue metastases. The implementation of quality-assurance programs applied to equipment, the planning process, and radiation treatment delivery must be instituted in all radiation therapy centers. Cancer 2008;113(8 suppl):2305,14. © 2008 American Cancer Society. [source] The incidence of lung carcinoma after surgery for breast carcinoma with and without postoperative radiotherapy,CANCER, Issue 7 2003Bowel Project (NSABP) clinical trials B-0, Results of National Surgical Adjuvant Breast Abstract BACKGROUND In the current study, the authors compared the incidence of subsequent primary lung carcinoma in patients with breast carcinoma who received radiotherapy as part of their treatment and in those patients who did not. The patients were participants in two large National Surgical Adjuvant Breast and Bowel Project (NSABP) breast carcinoma trials, B-04 and B-06, which prospectively randomized women to either undergo surgery alone or to undergo surgery and postoperative radiotherapy. METHODS The NSABP trial B-04 (1971,1974) randomized patients to undergo radical mastectomy versus total (simple) mastectomy and radiotherapy to the chest wall, axilla, and supraclavicular and internal mammary lymph node areas. For patients with a clinically uninvolved axilla, there was a third randomization arm: total mastectomy without radiotherapy. The B-06 trial (1976,1984) randomized patients between those undergoing total mastectomy versus lumpectomy versus those undergoing lumpectomy and breast irradiation, with all patients undergoing an axillary lymph node dissection. The records of all patients who developed a recurrence in the lung or a new primary lung tumor were reviewed to determine the incidence and laterality of confirmed and probable primary lung carcinoma. RESULTS For the 1665 evaluable patients on the NSABP B-04 trial (mean follow-up of 21.4 years), there was a total of 23 subsequent confirmed and probable ipsilateral or contralateral primary lung carcinomas. In those patients who had received comprehensive postmastectomy radiotherapy, there was a statistically significant increase in the incidence of these new primary tumors (P = 0.029). With regard to the development of confirmed new primary ipsilateral lung carcinoma alone, the incidence was statistically significantly increased (P = 0.013) in those patients who had received radiotherapy as part of their treatment, and when confirmed and probable ipsilateral lung carcinomas were analyzed, there was a strong trend toward a statistically significant increase in those patients who had received radiotherapy (P = 0.066). For the 1850 evaluable patients on the NSABP trial B-06 (mean follow-up of 19.0 years), there was a total of 30 second primary lung carcinomas but no increase in either ipsilateral or contralateral primary tumors of the lung in those patients who had received radiotherapy. CONCLUSIONS Extensive postmastectomy irradiation of the chest wall and regional lymphatic node areas, with consequent exposure of a greater volume of lung to higher doses as administered in the NSABP B-04 trial compared with postlumpectomy breast irradiation in the NSABP B-06 trial, was associated with an increased incidence of subsequent primary lung tumors, both ipsilateral and contralateral. Cancer 2003;98:1362,8. © 2003 American Cancer Society. DOI 10.1002/cncr.11655 [source] | ||||||||||