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Breast radiotherapy

Arash Momeni, Suhail K Kanchwala
BACKGROUND: Autologous breast reconstruction is associated with long-term patient satisfaction that is superior to implant-based approaches. Occasionally, however, patients who desire autologous reconstruction present with inadequate donor-site volume. A hybrid approach, combining free flap reconstruction with simultaneous implant placement, is a solution. We present our experience with the use of mesh for improved pocket control using this reconstructive modality. METHODS: A retrospective analysis of a prospectively maintained database of patients undergoing autologous breast reconstruction was performed...
October 22, 2016: Microsurgery
Hae Jin Park, Kyung Hwan Shin, Jin Ho Kim, Seung Do Ahn, Ja Young Kim, Won Park, Yong Bae Kim, Yeon-Joo Kim, Jin Hee Kim, Kyubo Kim, Kyung Ran Park, Hyun Soo Shin, Bae Kwon Jeong, Sun Young Lee, Suzy Kim
Purpose: In a recent meta-analysis, post-mastectomy radiotherapy (PMRT) reduced any first recurrence (AFR) and improved survival in N1 and N2 patients. We investigated risk factors for AFR in N1 after optimal systemic therapy without PMRT, to define a subgroup of patients who may benefit from PMRT. Materials and Methods: 1,382 pT1-2N1M0 breast cancer patients treated with mastectomy without PMRT between 2005 and 2010 were retrospectively analyzed. Only 0.6% had no systemic therapy...
October 19, 2016: Cancer Research and Treatment: Official Journal of Korean Cancer Association
Prunella Blinman, Linda Mileshkin, Pearly Khaw, Geraldine Goss, Carol Johnson, Anne Capp, Susan Brooks, Gerard Wain, Ilka Kolodziej, Anne-Sophie Veillard, Rachel O'Connell, Carien L Creutzberg, Martin R Stockler
BACKGROUND: To determine the minimum survival benefits that patients, and their clinicians, judged sufficient to make adjuvant chemotherapy (ACT) worthwhile, in addition to pelvic radiotherapy, for women with high risk and advanced stage endometrial cancer. METHODS: Eighty-three participants in the PORTEC-3 trial completed a time trade-off questionnaire before and after adjuvant therapy; 44 of their clinicians completed it once only. The questionnaire used four hypothetical scenarios including baseline survival times without ACT of 5 and 8 years, and baseline survival rates at 5 years without ACT of 50 and 65%...
October 20, 2016: British Journal of Cancer
Meriem Slaoui, Fatima Zahra Mouh, Imane Ghanname, Rachid Razine, Mohammed El Mzibri, Mariam Amrani
BACKGROUND: Breast cancer in young women is quite uncommon and shows more aggressive characteristics with major disparities between worldwide populations. Prognosis and outcome of breast cancer in young patients are widely studied, but still no consensus is available. METHODS: We retrospectively included 716 cases of breast cancer women diagnosed in 2009 at the National Institute of Oncology of Rabat. Patients were divided into two groups according to their age: women aged ≤40 years (Group 1) and women aged >40 years (Group 2)...
2016: PloS One
Azhar Z Abbasi, Claudia R Gordijo, Mohammad Ali Amini, Azusa Maeda, Andrew M Rauth, Ralph S DaCosta, Xiao Yu Wu
Hypoxia in the tumor microenvironment (TME) mediates resistance to radiotherapy (RT) and contributes to poor prognosis in patients receiving RT. Here we report the design of clinically suitable formulations of hybrid manganese dioxide (MnO2) nanoparticles (MDNP) using biocompatible materials to re-oxygenate the TME by reacting with endogenous H2O2. MDNP containing hydrophilic terpolymer-protein-MnO2 or hydrophobic polymer-lipid-MnO2 provided different oxygen generation rates in the TME relevant to different clinical settings...
October 6, 2016: Cancer Research
Hyunjung Kim, Jinyoung Kim
Prone position radiotherapy for a small (< 750 cm3) breast is controversial because of the variable benefits for the irradiated heart volume. The objective anatomical parameters related with chest wall shape that can determine the heart dose sparing patients in the prone position.Twenty-one patients underwent CT-simulation in supine and prone position. Dose volume parameters were compared and the objective indexes such as the Haller index, anthropometric index, mid-sternum thickness, and central lung distance (CLD) were evaluated the relationship between the shape of the chest wall and irradiated normal tissue volume in prone position...
October 14, 2016: Oncotarget
Vera Ramos, João Fraga, Teresa Simões, Margarida Figueiredo Dias
We report a case of a 36-year-old woman that presented with a painful mass in the outer quadrants of the left breast that had grown rapidly. Physical examination revealed a well circumscribed elastic mass and breast ultrasound showed a cyst measuring 26 mm with vegetation growing on the inner wall. Microscopic evaluation, after fine needle aspiration cytology (FNAC), suggested benign lesion. Tumorectomy was performed and the final diagnosis was a pure squamous cell carcinoma (SCC) of the breast. A simple mastectomy with sentinel node biopsy was performed...
2016: Case Reports in Obstetrics and Gynecology
Marco Krengli, Carla Pisani, Letizia Deantonio
The guidelines of the European and American Societies of Radiation Oncology (GEC-ESTRO and ASTRO) defined the selection criteria to offer partial breast irradiation (PBI) after lumpectomy in patients with low risk breast cancer regardless pre-operative staging. A recent publication by Tallet et al. explored the impact of preoperative magnetic resonance imaging (MRI) on patient eligibility for PBI. From their study, an ipsilateral BC was detected in 4% of patients, excluding these patients from intraoperative radiotherapy (IORT)...
September 2016: Journal of Thoracic Disease
Charlotte Schillebeeckx, Guy Verbeeck, Geert Daenen, Dirk Servaes, Marc Bronckaers
Phyllodes tumors of the breast are rare, accounting for less than 1% of the breast tumors. They are mostly seen in women between 45 and 49 years old. These are fast growing tumors with a large spectrum of behavior (from benign to metastatic) and can resemble fibroadenomas. Correct diagnosis mostly through core needle biopsy is important to decide whether a surgical excision has to be done. Here we report a case of a 57-year-old woman with a fast growing, ulcerated tumor in the left breast. Core needle biopsy suggested a malignant phyllodes tumor with heterologous liposarcomatous differentiation...
September 5, 2016: Rare Tumors
Vikneswary Batumalai, Penny Phan, Callie Choong, Lois Holloway, Geoff P Delaney
INTRODUCTION: To compare the differences in setup errors measured with electronic portal image (EPI) and cone-beam computed tomography (CBCT) in patients undergoing tangential breast radiotherapy (RT). Relationship between setup errors, body mass index (BMI) and breast size was assessed. METHODS: Twenty-five patients undergoing postoperative RT to the breast were consented for this study. Weekly CBCT scans were acquired and retrospectively registered to the planning CT in three dimensions, first using bony anatomy for bony registration (CBCT-B) and again using breast tissue outline for soft tissue registration (CBCT-S)...
May 31, 2016: Journal of Medical Radiation Sciences
Jenna Dean, Carmen J Hansen, Justin Westhuyzen, Brett Waller, Kirsty Turnbull, Maree Wood, Andrew Last
INTRODUCTION: Inverse-planned intensity modulated radiation therapy (IP-IMRT) has potential benefits over other techniques for tangential intact breast radiotherapy. Possible benefits include increased homogeneity, faster planning time, less inter-planner variability and lower doses to organs at risk (OAR). We therefore conducted a pilot study of previously treated intact breast patients to compare the current forward-planned 'field-in-field' technique (FP-IMRT) with an IP-IMRT alternative...
July 18, 2016: Journal of Medical Radiation Sciences
Xin Ming, Yuanming Feng, Chengwen Yang, Wei Wang, Ping Wang, Jun Deng
BACKGROUND: Radiation-induced heart disease (RIHD), which affects the patients' prognosis with both acute and late side effects, has been published extensively in the radiotherapy of breast cancer, lymphoma and other benign diseases. Studies on RIHD in lung cancer radiotherapy, however, are less extensive and clear even though the patients with lung cancer are delivered with higher doses to the heart during radiation treatment. METHODS: In this article, after extensive literature search and analysis, we reviewed the current evidence on RIHD in lung cancer patients after their radiation treatments and investigated the potential risk factors for RIHD as compared to other types of cancers...
October 2016: Medicine (Baltimore)
Tosol Yu, Bong Jun Cho, Eun Jung Choi, Ji Min Park, Dan Hyo Kim, In Ah Kim
Trastuzumab has been widely used for the treatment of human epidermal growth factor receptor 2 (HER2)-overexpressing breast cancer, however, it cannot easily cross the blood-brain barrier (BBB) and is known to increase the incidence of brain metastases. In contrast, lapatinib has a low molecular weight and can cross the BBB and it could be useful to treat brain metastases in patients with HER2-positive breast cancer.To explore the impact of lapatinib on radiation response, we conducted an in vitro experiment using SKBR3 and BT474 breast carcinoma cells exhibiting HER2/neu amplification...
October 12, 2016: Oncotarget
R H Hamunyela, A M Serafin, J M Akudugu
Targeting pro-survival cell signaling components has been promising in cancer therapy, but the benefit of targeting with single agents is limited. For malignancies such as triple-negative breast cancer, there is a paucity of targets that are amenable to existing interventions as they are devoid of the human epidermal growth factor receptor 2 (HER2), progesterone receptor (PR), and estrogen receptor (ER). Concurrent targeting of cell signaling entities other than HER2, PR and ER with multiple agents may be more effective...
October 10, 2016: Toxicology in Vitro: An International Journal Published in Association with BIBRA
Ismail Jatoi, John R Benson, Masakazu Toi
With the advent of sentinel lymph node biopsy, surgical methods for accurately staging the axilla in patients with early-stage breast cancer have become progressively less extensive, with formal axillary lymph node dissection confined to a dwindling group of patients. Although details of methods for sentinel lymph node biopsy have yet to be standardised, this technique is now widely practised and accepted as standard of care worldwide. In the past 5 years, attention has focused on minimisation of surgical morbidity by restricting further axillary surgery or considering radiotherapy in patients with a small tumour burden in their sentinel nodes...
October 2016: Lancet Oncology
Koichi Tomita, Kenji Yano, Akimitsu Nishibayashi, Shien Seike, Ko Hosokawa
BACKGROUND: When the inframammary fold (IMF) is excised in mastectomy procedures for oncologic reasons, it must be recreated to restore a natural breast shape. Despite refinements in surgical techniques, postoperative loss of a well-defined IMF can occur. This study aimed to assess the outcomes of IMF recreation after two-stage, implant-based breast reconstruction. METHODS: We retrospectively reviewed 75 consecutive patients who underwent unilateral, two-stage, implant-based breast reconstruction between 2013 and 2015 at the authors' institution...
2016: SpringerPlus
Jinhyun Choi, Yong Bae Kim, Kyung Hwan Shin, Sung-Ja Ahn, Hyung-Sik Lee, Won Park, Su Ssan Kim, Jin Hee Kim, Kyu Chan Lee, Dong Won Kim, Hyun Suk Suh, Kyung Ran Park, Hyun Soo Shin, Chang-Ok Suh
PURPOSE: The aim of this study is to present the incidence of radiation pneumonitis (RP) reported within 6 months after treatment for breast cancer with or without internal mammary node irradiation (IMNI). METHODS: In the Korean Radiation Oncology Group (KROG) 08-06 phase III randomized trial, patients who were node-positive after surgery were randomly assigned to receive radiotherapy either with or without IMNI. A total of 747 patients were enrolled, and three-dimensional treatment planning with computed tomography simulation was performed for all patients...
September 2016: Journal of Breast Cancer
Alba Fiorentino, Umberto Tebano, Ruggero Ruggieri, Francesco Ricchetti, Filippo Alongi
AIM: For simultaneous bilateral breast cancer (SBBC) treatment, conventional radiotherapy (RT) has a number of critical shortcomings. Thus, the usefulness of volumetric arc therapy (VMAT) for SBBC is undeniable. CASE REPORT: A 34-year-old woman with SBBC received neoadjuvant chemotherapy followed by breast-conserving surgery and bilateral lymph node dissection. Given the conservative surgery and the nodal involvement after neoadjuvant chemotherapy, bilateral adjuvant RT to the breasts and regional nodes with doses of 50 Gy in 25 fractions and a simultaneous integrated boost (SIB) of 60 Gy to the surgical bed was proposed...
September 27, 2016: Tumori
Luciana Lastrucci, Simona Borghesi, Silvia Bertocci, Chiara Gasperi, Andrea Rampini, Giovanna Buonfrate, Paola Pernici, Roberta De Majo, Pietro Giovanni Gennari
PURPOSE: To compare 3D-conformal radiotherapy (3D-CRT) treatment plans based on free-breathing (FB) and deep inspiration breath hold (DIBH) and investigated whether DIBH technique enables a decrease of cardiac left anterior descending coronary artery (LADCA) and lungs dose with respect to the FB. METHODS: Twenty-three left-sided breast cancer patients referred for breast radiotherapy were included. The planning target volume (PTV) encompassed the breast and organs at risk including heart, LADCA, lungs, and contralateral breast, which were contoured in FB and DIBH CT scans...
September 27, 2016: Tumori
Xin-Bin Pan, Shi-Ting Huang, Yan-Ming Jiang, Jia-Lin Ma, Xiao-Dong Zhu
Secondary malignancies are a common complication for patients receiving radiotherapy. Here, we compared rates of secondary malignancies after partial breast irradiation (PBI) and whole breast irradiation (WBI). The MEDLINE, EMBASE, and the Cochrane Library databases were systematically searched to identify relevant randomized clinical trials comparing PBI with WBI in breast cancer patients treated with breast-conserving therapy. Four studies including 2,185 patients were selected. Compared to WBI, the pooled odds ratios (OR) for contralateral breast cancer were 0...
October 4, 2016: Oncotarget
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