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https://www.readbyqxmd.com/read/28103903/intraoperative-radiotherapy-iort-as-boost-in-breast-cancer
#1
REVIEW
Felix Sedlmayer, Roland Reitsamer, Frederik Wenz, Elena Sperk, Christoph Fussl, Julia Kaiser, Ingrid Ziegler, Franz Zehentmayr, Heinz Deutschmann, Peter Kopp, Gerd Fastner
The term IORT (intraoperative radiotherapy) is currently used for various techniques that show huge differences in dose delivery and coverage of the tissue at risk. The largest evidence for boost IORT preceding whole breast irradiation (WBI) originates from intraoperative electron treatments (IOERT) with single doses around 10 Gy. At median follow-up periods at 6 years, outstandingly low local recurrence rates of less than 1% are observed. Higher local relapse rates were described for G3 tumors and triple negative breast cancers as well as for IORT following primary systemic treatment for locally advanced tumors...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28079816/a-comparison-study-between-gross-tumor-volumes-defined-by-preoperative-magnetic-resonance-imaging-postoperative-specimens-and-tumor-bed-for-radiotherapy-after-breast-conserving-surgery
#2
Aiping Zhang, Jianbin Li, Wei Wang, Yongsheng Wang, Dianbin Mu, Zhaoqiu Chen, Qian Shao, Fengxiang Li
BACKGROUND: The identification and contouring of target volume is important for breast-conserving therapy. The aim of the study was to compare preoperative magnetic resonance imaging (MRI), postoperative pathology, excised specimens' (ES) size, and tumor bed (TB) delineation as methods for determining the gross tumor volume (GTV) for radiotherapy after breast-conserving surgery (BCS). METHODS: Thirty-three patients with breast cancer who underwent preoperative MRI and radiotherapy after BCS were enrolled...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28063816/trends-in-the-use-of-implantable-accelerated-partial-breast-irradiation-for-ductal-carcinoma-in-situ-implications-of-the-recent-amendments-to-the-american-society-for-radiation-oncology-consensus-guidelines
#3
Waqar Haque, Vivek Verma, Anam Haque, E Brian Butler, Bin S Teh
PURPOSE: In 2009, the American Society for Radiation Oncology (ASTRO) published consensus recommendations that stated ductal carcinoma in situ (DCIS) patients were in a "cautionary" group for accelerated partial breast irradiation (APBI) and should not receive APBI outside of a clinical trial. However, very recently, ASTRO placed low-risk DCIS patients in the "suitable" category. Given this recent change, we aimed to use the Surveillance, Epidemiology, and End Results (SEER) database to evaluate past patterns of implantable APBI (IAPBI) utilization in women with DCIS...
January 4, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28062931/fewer-reoperations-after-lumpectomy-for-breast-cancer-with-neoadjuvant-rather-than-adjuvant-chemotherapy-a-report-from-the-national-cancer-database
#4
Jeffrey Landercasper, Barbara Bennie, Benjamin M Parsons, Leah L Dietrich, Caprice C Greenberg, Lee G Wilke, Jared H Linebarger
BACKGROUND: Reoperations occur frequently after initial lumpectomy for breast cancer. The authors hypothesized that the receipt of neoadjuvant chemotherapy (NAC) is associated with fewer reoperations. METHODS: The association between timing of chemotherapy and reoperation rates (ROR) after lumpectomy was investigated for patients with stages 1-3 breast cancer in the National Cancer Database (NCDB) from 2010 to 2013 by multivariable logistic regression modeling. Then propensity score-matching was performed...
January 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28058560/intraoperative-margin-management-in-breast-conserving-surgery-a-systematic-review-of-the-literature
#5
Richard J Gray, Barbara A Pockaj, Erin Garvey, Sarah Blair
BACKGROUND: Breast surgeons have a wide variety of intraoperative techniques available to help achieve low rates for positive margins of excision, with variable levels of evidence. METHODS: A systematic review of the medical literature from 1995 to July 2016 was conducted, with 434 abstracts identified and evaluated. The analysis included 106 papers focused on intraoperative management of breast cancer margins and contained actionable data. RESULTS: Ultrasound-guided lumpectomy for palpable tumors, as an alternative to palpation guidance, can lower positive margin rates, but the effect when used as an alternative to wire localization (WL) for nonpalpable tumors is less certain...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28053630/displacement-of-surgical-clips-during-postoperative-radiotherapy-in-breast-cancer-patients-who-received-breast-conserving-surgery
#6
SooYoon Sung, Joo Hwan Lee, Jong Hoon Lee, Sung Hwan Kim, Yoo-Kang Kwak, Sea-Won Lee, Ye Won Jeon, Young Jin Suh
PURPOSE: Surgical clips are used as a target for postoperative breast radiotherapy, and displacement of surgical clips would result in inaccurate delivery of radiation. We investigated the displacement range of surgical clips in the breast during postoperative radiotherapy following breast-conserving surgery. METHODS: A total of 178 patients who received breast-conserving surgery and postoperative radiation of 59.4 Gy in 33 fractions to the involved breast for 6...
December 2016: Journal of Breast Cancer
https://www.readbyqxmd.com/read/28052649/prognostic-impact-of-elective-supraclavicular-nodal-irradiation-for-patients-with-n1-breast-cancer-after-lumpectomy-and-anthracycline-plus-taxane-based-chemotherapy-krog-1418-a-multicenter-case-controlled-study
#7
Haeyoung Kim, Won Park, Jeong Il Yu, Doo Ho Choi, Seung Jae Huh, Yeon-Joo Kim, Eun Sook Lee, Keun Seok Lee, Han-Sung Kang, In Hae Park, Kyung Hwan Shin, Chan Woo Wee, Kyubo Kim, Kyung Ran Park, Yong Bae Kim, Sung Ja Ahn, Jong Hoon Lee, Jin Hee Kim, Mison Chun, Hyung-Sik Lee, Jung Soo Kim, Jihye Cha
Purpose: This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy. Materials and Methods: We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching...
January 4, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28049561/achieving-clear-margins-directed-shaving-using-marginprobe-as-compared-to-a-full-cavity-shave-approach
#8
Jeffrey Coble, Vincent Reid
BACKGROUND: Following lumpectomy, full cavity shaving approach is used to reduce positive margin rates, among other issues previously studied by others, at an expense of increase in tissue volume removed. We present our experience after switching from full cavity shaving to a targeted shaving approach using MarginProbe, an intra-operative margin assessment device. METHODS: Specimen excision was performed according to standard of care. Additional shavings were taken based on device readings on the lumpectomy specimen...
December 30, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28048434/su-f-t-654-pacemaker-dose-estimate-using-optically-stimulated-luminescent-dosimeter-for-left-breast-intraoperative-radiation-therapy
#9
Y Chen, A Goenka, A Sharma, L Wang, Y Cao, A Jamshidi
PURPOSE: To assess and report the in vivo dose for a patient with a pacemaker being treated in left breast intraoperative radiation therapy (IORT). The ZEISS Intrabeam 50 kVp X-ray beam with a spherical applicator was used. METHODS: The optically stimulated luminescent dosimeters (OSLDs) (Landauer nanoDots) were employed and calibrated under the conditions of the Intrabeam 50 kVp X-rays. The nanoDots were placed on the patient at approximately 15 cm away from the lumpectomy cavity both under and above a shield of lead equivalence 0...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048315/su-f-t-650-the-comparison-of-robotic-partial-breast-stereotactic-irradiation-using-mlc-vs-iris-cone
#10
C Ding, R Timmerman, S Jiang, A Rahimi
PURPOSE: To evaluate the dosimetric impact on treatment planning for partial breast stereotactic irradiation using Cyberknife with MLC versus Iris Cone. METHODS: Ten patients whom underwent lumpectomy for DCIS or stage I invasive non-lobular epithelial breast cancer were included in this study. All patients were previously treated on the Cyberknife using Iris cone with the prescription dose of 37.5Gy in 5 fractions covering at least 95% of PTV on our phase I SBRT 5 fraction partial breast irradiation trial...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048127/su-f-j-09-radioactive-seed-localization-for-breast-lumpectomy-towards-optimization
#11
M Aima, N Viscariello, T Patton, B Bednarz
PURPOSE: The aim of this work is to propose a method to optimize radioactive source localization (RSL) for non-palpable breast cancer surgery. RSL is commonly used as a guiding technique during surgery for excision of non-palpable tumors. A collimated hand-held detector is used to localize radioactive sources implanted in tumors. Incisions made by the surgeon are based on maximum observed detector counts, and tumors are subsequently resected based on an arbitrary estimate of the counts expected at the surgical margin boundary...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047660/we-de-bra-02-best-in-physics-joint-imaging-therapy-prototype-for-an-in-room-supercompounded-3d-volumetric-ultrasound-image-guidance-system-for-prone-breast-sbrt
#12
T Chiu, Y Zhang, B Hrycushko, B Zhao, R Chopra, S Jiang, X Gu
PURPOSE: SBRT requires both substantial positioning precision and accuracy. However, accurate dose delivery is challenging for prone breast SBRT due to breast deformation, lumpectomy cavity shrinkage and ineffective CT/CBCT on soft tissue. We developed a prototype in-room 3D volumetric ultrasound (US) image guidance system for prone breast SBRT. METHODS: The designed system, set beneath a prone breast board, consists of a customized breast cup, rotational scanning water container, and a portable US scanner...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047602/th-ab-209-10-breast-cancer-identification-through-x-ray-coherent-scatter-spectral-imaging
#13
A Kapadia, R Morris, K Albanese, J Spencer, S McCall, J Greenberg
PURPOSE: We have previously described the development and testing of a coherent-scatter spectral imaging system for identification of cancer. Our prior evaluations were performed using either tissue surrogate phantoms or formalin-fixed tissue obtained from pathology. Here we present the first results from a scatter imaging study using fresh breast tumor tissues obtained through surgical excision. METHODS: A coherent-scatter imaging system was built using a clinical X-ray tube, photon counting detectors, and custom-designed coded-apertures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046443/su-f-t-498-a-comparative-evaluation-of-6mv-flatten-beam-and-flattening-filter-free-photon-beam-in-carcinoma-breast
#14
Suresh Tamilarasu, Madeswaran Saminathan
PURPOSE: Aim of the current study is to look plan quality, treatment beam ON time for IMRT using 6MV FB (Flatten Beam) and FFFB (Flattening Filter Free Beam) in left breast cancer cases. METHODS: Ten left breast cancer patients treated with breast conserving surgical (BCS) procedure approach and adjuvant radiotherapy were selected from the department database. Simultaneous Integrated boost (SIB) technique was used to irradiate the total left breast (PTV) to a dose of 50...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046294/th-ab-209-12-tissue-equivalent-phantom-with-excised-human-tissue-for-assessing-clinical-capabilities-of-coherent-scatter-imaging-applications
#15
K Albanese, R Morris, J Spencer, J Greenberg, A Kapadia
PURPOSE: Previously we reported the development of anthropomorphic tissue-equivalent scatter phantoms of the human breast. Here we present the first results from the scatter imaging of the tissue equivalent breast phantoms for breast cancer diagnosis. METHODS: A breast phantom was designed to assess the capability of coded aperture coherent x-ray scatter imaging to classify different types of breast tissue (adipose, fibroglandular, tumor). The phantom geometry was obtained from a prone breast geometry scanned on a dedicated breast CT system...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046058/cavity-shaving-plus-lumpectomy-versus-lumpectomy-alone-for-patients-with-breast-cancer-undergoing-breast-conserving-surgery-a-systematic-review-and-meta-analysis
#16
Ke Wang, Yu Ren, Jianjun He
The margin status is a well-established prognostic predictor for patients undergoing breast-conserving surgery (BCS). Recent data suggested that cavity shaving in addition to lumpectomy might be a promising approach for improving the clinical outcomes. We aimed to compare the efficacy and safety between cavity shaving plus lumpectomy and lumpectomy alone with a systematic review and meta-analysis. We searched the PubMed, Embase, and Cochrane CENTRAL databases for studies comparing cavity shaving with lumpectomy before June 10, 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28041648/short-term-safety-of-oncoplastic-breast-conserving-surgery-for-larger-tumors
#17
D J Wijgman, B Ten Wolde, N R A van Groesen, M E Keemers-Gels, F J H van den Wildenberg, L J A Strobbe
BACKGROUND: Oncoplastic surgery (OPS) replaces lumpectomy as standard technique in breast conserving surgery (BCS). OPS has shown to give good cosmetic results, but is it as safe as standard lumpectomy? We conducted a retrospective cohort study to determine postoperative complications, resection margins and re-excision rates for OPS compared to standard lumpectomy. METHODS: Based on data from the 'Netherlands Cancer Registry' and medical records we scored patient, treatment and follow-up related variables...
December 18, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28005646/lymphoscintigraphic-spect-ct-contralateral-axillary-sentinel-lymph-node-drainage-in-breast-cancer
#18
Ratna T Koyyalamudi, Monica Anne Rossleigh
A 58-year-old woman with previous right breast carcinoma treated with lumpectomy, right axillary clearance, chemo-radiotherapy, and adjuvant hormonal therapy underwent a lymphoscintigraphy for a new right breast lesion. On planar images, an alternate route of lymphatic drainage was observed to the right internal mammary chain and the left axilla. A chest SPECT/CT was performed to confirm the location of the sentinel nodes. The patient underwent a right mastectomy and left axillary sentinel lymph node biopsy, which showed no evidence of lymphovascular invasion...
February 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27986343/nation-scale-adoption-of-shorter-breast-radiation-therapy-schedules-can-increase-survival-in-resource-constrained-economies-results-from-a-markov-chain-analysis
#19
Atif J Khan, Raza Rafique, Waleed Zafar, Chirag Shah, Bruce G Haffty, Frank Vicini, Arif Jamshed, Yao Zhao
PURPOSE: Hypofractionated whole breast irradiation and accelerated partial breast irradiation (APBI) offer women options for shorter courses of breast radiation therapy. The impact of these shorter schedules on the breast cancer populations of emerging economies with limited radiation therapy resources is unknown. We hypothesized that adoption of these schedules would improve throughput in the system and, by allowing more women access to life-saving treatments, improve patient survival within the system...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27935990/hyperalgesia-and-persistent-pain-after-breast-cancer-surgery-a-prospective-randomized-controlled-trial-with-perioperative-cox-2-inhibition
#20
Noud van Helmond, Monique A Steegers, Gertie P Filippini-de Moor, Kris C Vissers, Oliver H Wilder-Smith
BACKGROUND: Persistent pain is a challenging clinical problem after breast cancer treatment. After surgery, inflammatory pain and nociceptive input from nerve injury induce central sensitization which may play a role in the genesis of persistent pain. Using quantitative sensory testing, we tested the hypothesis that adding COX-2 inhibition to standard treatment reduces hyperalgesia after breast cancer surgery. A secondary hypothesis was that patients developing persistent pain would exhibit more postoperative hyperalgesia...
2016: PloS One
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