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https://www.readbyqxmd.com/read/28929041/severe-late-toxicity-after-adjuvant-breast-radiotherapy-in-a-patient-with-a-germline-ataxia-telangiectasia-mutated-gene-future-treatment-decisions
#1
Maryam Dosani, Kasmintan A Schrader, Alan Nichol, Sophie Sun, Tamara Shenkier, Zoe Lohn, Gudrun Aubertin, Scott Tyldesley
Ataxia telangiectasia mutated (ATM) gene mutations may confer increased sensitivity to ionizing radiation and increased risk of late toxicity for cancer patients. We present the case of a 55-year-old female treated with adjuvant breast and regional nodal radiation following lumpectomy and axillary lymph node dissection for stage II invasive ductal carcinoma of the breast. She developed severe telangiectasia, fibrosis, induration, chest wall pain (with evidence of rib fractures on imaging), and painful limitation in her range of motion at the shoulder...
July 11, 2017: Curēus
https://www.readbyqxmd.com/read/28923574/a-systematic-review-of-health-economic-evaluation-in-adjuvant-breast-radiotherapy-quality-counted-by-numbers
#2
Chris Monten, Liv Veldeman, Nick Verhaeghe, Yolande Lievens
BACKGROUND: Evolving practice in adjuvant breast radiotherapy inevitably impacts healthcare budgets. This is reflected in a rise of health economic evaluations (HEE) in this domain. The available HEE literature was analysed qualitatively and quantitatively, using available instruments. METHODS: HEEs published between 1/1/2000 and 31/10/2016 were retrieved through a systematic search in Medline, Cochrane and Embase. A quality-assessment using CHEERS (Consolidated Health Economic Evaluation Reporting Standards) was translated into a quantitative score and compared with Tufts Medical Centre CEA registry and Quality of Health Economic Studies (QHES) results...
September 15, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28917445/margin-width-and-local-recurrence-after-breast-conserving-surgery-for-ductal-carcinoma-in-situ
#3
Gregory E Ekatah, Arran K Turnbull, Laura M Arthur, Jeremy Thomas, Christine Dodds, J Michael Dixon
INTRODUCTION: Ductal Carcinoma in situ (DCIS) represents 5% of symptomatic and 20-30% of screen detected cancers. Breast conserving surgery (BCS) ± radiotherapy is performed in over 70% of women with DCIS. What constitutes an adequate margin for BCS remains unclear. METHODS: A single institution follow up study has been conducted of 466 patients with pure DCIS treated by BCS between 2000 and 2010 of whom 292 received whole breast radiotherapy and 167 did not...
September 4, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28891772/cognitive-behavioral-therapy-plus-hypnosis-for-distress-during-breast-radiotherapy-a-randomized-trial
#4
Guy H Montgomery, Madalina Sucala, Matthew J Dillon, Julie B Schnur
Radiotherapy is a common and effective treatment for women with breast cancer. However, radiotherapy has also been shown to adversely affect patients' emotional well-being. Currently, few mind-body interventions are designed to improve patients' quality of life during radiotherapy. One intervention which has demonstrated clinical efficacy in the breast cancer radiotherapy setting is Cognitive-Behavioral Therapy plus Hypnosis. The goal of this study was to investigate the impact of Cognitive-Behavioral Therapy plus Hypnosis on emotional distress in women with breast cancer undergoing radiotherapy...
October 2017: American Journal of Clinical Hypnosis
https://www.readbyqxmd.com/read/28887654/-critical-consideration-of-ipsilateral-axillary-recurrence-after-breast-conservative-surgery-and-the-protective-effect-of-whole-breast-radiotherapy
#5
Frederik Wenz, Elena Sperk
No abstract text is available yet for this article.
September 8, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28863179/the-feasibility-of-a-heart-block-with-an-electron-compensation-as-an-alternative-whole-breast-radiotherapy-technique-in-patients-with-underlying-cardiac-or-pulmonary-disease
#6
Hye Jin Kang, Shin-Wook Kim, Seok Hyun Son
PURPOSE: We aimed to evaluate the feasibility of the heart block with electron compensation (HBE) technique, based on three-dimensional conformal radiotherapy (3D-CRT) in left-sided breast cancer patients with underlying cardiac or pulmonary disease. METHODS: Twenty patients with left-sided breast cancer who were treated with whole breast radiotherapy (WBRT) were included in this study. Intensity-modulated radiotherapy (IMRT), 3D-CRT, and HBE treatment plans were generated for each patient...
2017: PloS One
https://www.readbyqxmd.com/read/28834326/proposal-for-a-gold-standard-for-cosmetic-evaluation-after-breast-conserving-therapy-results-from-the-st-george-and-wollongong-breast-boost-trial
#7
Roya Merie, Lois Browne, Jaime S Cardoso, Maria J Cardoso, Yaw Chin, Catherine Clark, Peter Graham, Alison Szwajcer, Eric Hau
INTRODUCTION: Breast cosmesis is an important endpoint of breast conserving therapy (BCT), but a gold standard method of its evaluation is not yet established. The St. George and Wollongong Randomised Breast Boost trial used five different methods of cosmetic assessment, including both subjective and objective, to comprehensively evaluate the cosmetic outcome of the trial patients. This current study analyses the level of concordance between these methods in an attempt to determine a possible standard in the evaluation of breast cosmesis...
August 18, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28826308/the-influence-of-breathing-motion-and-a-variable-relative-biological-effectiveness-in-proton-therapy-of-left-sided-breast-cancer
#8
Jakob Ödén, Iuliana Toma-Dasu, Kjell Eriksson, Anna Maria Flejmer, Alexandru Dasu
BACKGROUND: Proton breast radiotherapy has been suggested to improve target coverage as well as reduce cardiopulmonary and integral dose compared with photon therapy. This study aims to assess this potential when accounting for breathing motion and a variable relative biological effectiveness (RBE). METHODS: Photon and robustly optimized proton plans were generated to deliver 50 Gy (RBE) in 25 fractions (RBE = 1.1) to the CTV (whole left breast) for 12 patients...
August 22, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28799263/characterization-of-a-novel-scale-maille-contralateral-breast-shield-smart-armor
#9
Macinley Butson, Susan Carroll, Martin Butson, Robin Hill
During breast radiotherapy treatment, the contralateral breast receives radiation doses to the skin and subcutaneous tissue caused mainly from incident electron contamination and low energy photon scatter radiation. Measurements have shown that for a typical hybrid tangential treatment, these dose levels can be up to 17% of maximum applied prescription dose if no shielding is used during the treatment process. This work examined the use of different shielding metals, aluminum, copper, and lead to reduce peripheral radiation dose to evaluate the optimal metal to form the basis of a contralateral breast radiation shield...
August 11, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28791694/improved-prognosis-of-young-patients-with-breast-cancer-undergoing-breast-conserving-surgery
#10
E Botteri, P Veronesi, J Vila, N Rotmensz, V Galimberti, M V Thomazini, G Viale, R Orecchia, A Goldhirsch, O Gentilini
BACKGROUND: The aim of the present study was to evaluate how breast cancer prognosis has evolved over time in young women treated with breast-conserving surgery (BCS). METHODS: Data from patients younger than 40 years who had BCS and whole-breast radiotherapy in a single cancer centre between 1997 and 2010 were analysed. The patients were followed until 2016. Endpoints were local recurrence, any breast cancer-related event and death from any cause. RESULTS: A total of 1331 patients were included in the study...
August 9, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28779963/partial-breast-radiotherapy-after-breast-conservation-surgery-for-patients-with-early-breast-cancer-uk-import-low-trial-5-year-results-from-a-multicentre-randomised-controlled-phase-3-non-inferiority-trial
#11
Charlotte E Coles, Clare L Griffin, Anna M Kirby, Jenny Titley, Rajiv K Agrawal, Abdulla Alhasso, Indrani S Bhattacharya, Adrian M Brunt, Laura Ciurlionis, Charlie Chan, Ellen M Donovan, Marie A Emson, Adrian N Harnett, Joanne S Haviland, Penelope Hopwood, Monica L Jefford, Ronald Kaggwa, Elinor J Sawyer, Isabel Syndikus, Yat M Tsang, Duncan A Wheatley, Maggie Wilcox, John R Yarnold, Judith M Bliss
BACKGROUND: Local cancer relapse risk after breast conservation surgery followed by radiotherapy has fallen sharply in many countries, and is influenced by patient age and clinicopathological factors. We hypothesise that partial-breast radiotherapy restricted to the vicinity of the original tumour in women at lower than average risk of local relapse will improve the balance of beneficial versus adverse effects compared with whole-breast radiotherapy. METHODS: IMPORT LOW is a multicentre, randomised, controlled, phase 3, non-inferiority trial done in 30 radiotherapy centres in the UK...
September 9, 2017: Lancet
https://www.readbyqxmd.com/read/28776318/ten-year-results-of-accelerated-hypofractionated-adjuvant-whole-breast-radiation-with-concomitant-boost-to-the-lumpectomy-cavity-after-conserving-surgery-for-early-breast-cancer
#12
Domenico Cante, Edoardo Petrucci, Piera Sciacero, Cristina Piva, Silvia Ferrario, Silvia Bagnera, Sebastiano Patania, Guido Mondini, Massimo Pasquino, Valeria Casanova Borca, Giorgio Vellani, Maria Rosa La Porta, Pierfrancesco Franco
Accelerated hypofractionated whole-breast radiotherapy (WBRT) is considered a standard therapeutic option for early breast cancer (EBC) in the postoperative setting after breast conservation (BCS). A boost to the lumpectomy cavity may further increase local control. We herein report on the 10-year results of a series of EBC patients treated after BCS with hypofractionated WBRT with a concomitant photon boost to the surgical bed over 4 weeks. Between 2005 and 2007, 178 EBC patients were treated with a basic course of radiotherapy consisting of 45 Gy to the whole breast in 20 fractions (2...
September 2017: Medical Oncology
https://www.readbyqxmd.com/read/28766200/keynote-address-at-the-american-society-of-breast-surgeons-18th-annual-meeting-current-and-future-application-of-intraoperative-radiotherapy-iort-in-the-curative-and-palliative-treatment-of-breast-cancer
#13
Frederik Wenz
Intraoperative radiotherapy (IORT) is increasingly used worldwide. Breast cancer is the most rapidly growing indication for IORT, approaching 70-80% of cases in most centers. This report reviews the theoretical background and clinical use of IORT for primary and metastasized breast cancer. There are established applications such as tumor bed boost during breast-conserving surgery followed by whole breast radiotherapy or IORT as a form of accelerated partial-breast irradiation (APBI) for selected patients. Novel applications such as IORT for vertebral or brain metastases are presented as well as technological developments, widening the spectrum of potential clinical applications for IORT...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28734546/whole-breast-radiotherapy-in-the-lateral-isocentric-lateral-decubitus-position-long-term-efficacy-and-toxicity-results
#14
Estelle Bronsart, Sylvain Dureau, Hao Ping Xu, Louis Bazire, Anne Chilles, Emilie Costa, Christelle Logerot, Marie-Christine Falcou, Francois Campana, Frédérique Berger, Alain Fourquet, Youlia M Kirova
PURPOSE: To evaluate previously published whole breast radiotherapy (WBRT) using ILD (isocentring lateral decubitus) technique in terms of toxicity and efficacy. MATERIALS AND METHODS: From 2006 to 2010, 832 female patients with early-stage breast cancer (BC) treated by conservative surgery underwent 3D-conformal WBRT-ILD at Institut Curie. The acute toxicity of treatment was evaluated weekly and the late toxicity (6months and later after the treatment) was evaluated every 6months till the 5th year after the end of the radiotherapy using NCI CTC v3...
August 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28715150/intraoperative-radiotherapy-patient-selection-management-and-follow-up
#15
REVIEW
Dennis R Holmes, Robert Zimmerman
Intraoperative partial breast radiotherapy is an alternative or an adjunct to fractionated whole breast irradiation for the administration of adjuvant radiotherapy in breast cancer following breast conserving surgery. Establishing intraoperative radiotherapy as a therapeutic modality requires a multidisciplinary approach to patient selection, workup, surgery, radiation protocols, chemotherapy, and patient follow up. In this article, we review the published evidence for best clinical practice, as a guide to the introduction of intraoperative radiotherapy for breast cancer treatment...
July 17, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28702770/oncologic-outcomes-after-treatment-for-mri-occult-breast-cancer-pt0n
#16
Damian P McCartan, Emily C Zabor, Monica Morrow, Kimberly J Van Zee, Mahmoud B El-Tamer
BACKGROUND: Studies assessing outcomes in occult breast cancer have often included women treated before the routine use of magnetic resonance imaging (MRI). This study examined outcomes for patients presenting with axillary adenopathy and no primary breast tumor detectable by MRI or other imaging methods. METHODS: All patients with axillary nodal metastases consistent with breast carcinoma and no breast primary tumor detectable by physical exam, mammography, or MRI treated between 1 January 1996 and 30 June 2011 were identified from an institutional database...
July 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28652810/an-effective-deep-inspiration-breath-hold-radiotherapy-technique-for-left-breast-cancer-impact-of-post-mastectomy-treatment-nodal-coverage-and-dose-schedule-on-organs-at-risk
#17
Lynsey Rice, Christy Goldsmith, Melanie Ml Green, Susan Cleator, Patricia M Price
BACKGROUND: We developed, applied, and prospectively evaluated a novel deep-inspiration breath-hold (DIBH) screening and delivery technique to optimize cardiac sparing in left-breast radiotherapy (RT) at our clinic. The impact of set-up and dose variables upon organs at risk (OAR) dose in DIBH RT was investigated. METHODS AND MATERIALS: All patients with left-breast cancer referred between 2011 and 2014 - of all disease stages, set-up variations, and dose prescriptions - were included...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28639030/utilization-of-hypofractionated-whole-breast-radiation-therapy-in-patients-receiving-chemotherapy-a-national-cancer-database-analysis
#18
Tejan P Diwanji, Jason K Molitoris, Arpit M Chhabra, James W Snider, Soren M Bentzen, Katherine H Tkaczuk, Paula Y Rosenblatt, Susan B Kesmodel, Emily C Bellavance, Randi J Cohen, Sally B Cheston, Elizabeth M Nichols, Steven J Feigenberg
PURPOSE: Results from four major hypofractionated whole-breast radiotherapy (HF-WBRT) trials have demonstrated equivalence in select patients with early-stage breast cancer when compared with conventionally fractionated WBRT (CF-WBRT). Because relatively little data were available on patients receiving neoadjuvant or adjuvant chemotherapy, consensus guidelines published in 2011 did not endorse the use of HF-WBRT in this population. Our goal is to evaluate trends in utilization of HF-WBRT in patients receiving chemotherapy...
June 21, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28608120/cosmetic-outcome-and-chronic-breast-toxicity-after-intraoperative-radiation-therapy-iort-as-a-single-modality-or-as-a-boost-using-the-intrabeam-%C3%A2-device-a-prospective-study
#19
Stéphane Key, Petra Miglierini, Pierre-François Dupré, Sandrine Guilbert, Anne-Sophie Lucia, Ronan Abgral, Virginie Conan-Charlet, Arnaud Uguen, Olivier Pradier, Ulrike Schick
PURPOSE: We aim to report our results in terms of chronic toxicities and cosmetic outcomes after intraoperative radiotherapy (IORT) using kV X-rays in women treated for early breast cancer at our institution. METHODS: Patients with early breast carcinoma were recruited between April 2011 and November 2014. After breast-conserving surgery, patients were treated with IORT using the Intrabeam(®) device. IORT was completed by whole-breast radiotherapy (WBRT) at a dose of 46-50...
June 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28595775/surface-dose-measurements-in-and-out-of-field-implications-for-breast-radiotherapy-with-megavoltage-photon-beams
#20
Peta Lonski, Prabhakar Ramachandran, Rick Franich, Tomas Kron
This study examines the difference in surface dose between flat and flattening filter free (FFF) photon beams in the context of breast radiotherapy. The surface dose was measured for 6MV, 6MV FFF, 10MV, 10MV FFF and 18MV photon beams using a thin window ionisation chamber for various field sizes. Profiles were acquired to ascertain the change in surface dose off-axis. Out-of-field measurements were included in a clinically representative half beam block tangential breast field. In the field centres of FFF beams the surface dose was found to be increased for small fields and decreased for large fields compared to flat beams...
June 5, 2017: Zeitschrift Für Medizinische Physik
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