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https://www.readbyqxmd.com/read/28799263/characterization-of-a-novel-scale-maille-contralateral-breast-shield-smart-armor
#1
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
#2
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
#3
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...
August 2, 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
#4
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
#5
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
#6
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...
July 19, 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28559768/intraoperative-radiotherapy-of-breast-cancer-and-its-biological-effects
#13
REVIEW
Igor Piotrowski, Katarzyna Kulcenty, Mateusz Wichtowski, Dawid Murawa, Wiktoria Suchorska
Conservative breast cancer surgery followed by radiation therapy is the standard treatment for this type of cancer. Numerous studies demonstrate that 90% of local recurrences after traditional surgery occur in the same quadrant as the primary cancer. The published data suggest that the wound healing process after surgery alters the area surrounding the original tumor and the modified microenvironment is more favorable for the tumor to recur. The majority of metastases within scar initiated much research, and the consequences of these studies led to clinical trials aimed at assessing whether localized radiotherapy, such as intraoperative radiotherapy (IORT), would be more effective in inhibiting formation of local recurrence than the standard postoperative whole breast radiotherapy...
May 2017: Breast Care
https://www.readbyqxmd.com/read/28559459/tamoxifen-acceptance-and-adherence-among-patients-with-ductal-carcinoma-in-situ-dcis-treated-in-a-multidisciplinary-setting
#14
Lindsey C Karavites, Anna K Kane, Shruti Zaveri, Yanfei Xu, Irene Helenowski, Nora Hansen, Kevin P Bethke, Laura J Rasmussen-Torvik, Seema A Khan
Tamoxifen and other endocrine agents have proven benefits for women with ductal carcinoma in situ (DCIS), but low patient acceptance is widely reported. We examined factors associated with tamoxifen acceptance and adherence among DCIS patients who received a recommendation for therapy in a multidisciplinary setting. Using our institutional database, we identified women diagnosed with DCIS, 1998 to 2009, who were offered tamoxifen. We recorded data on demographics, tumor and therapy variables, tamoxifen acceptance, and adherence to therapy for ≥4 years...
May 30, 2017: Cancer Prevention Research
https://www.readbyqxmd.com/read/28556781/supine-mri-for-regional-breast-radiotherapy-imaging-axillary-lymph-nodes-before-and-after-sentinel-node-biopsy
#15
Tristan C F van Heijst, Debora Eschbach-Zandbergen, Nienke Hoekstra, Bram van Asselen, Jan Lagendijk, Helena Verkooijen, Ruud Pijnappel, Stephanie de Waard, Arjen Witkamp, Thijs van Dalen, H J G van den Bongard, Marielle Philippens
Regional radiotherapy (RT) is increasingly used in breast-cancer treatment. Conventionally, computed tomography (CT) is performed for RT planning. Lymph node (LN) target levels are delineated according to anatomical boundaries. MRI could enable individual LN delineation. The purpose was to evaluate applicability of MRI for LN detection in supine treatment position, before and after sentinel-node biopsy (SNB). 23 female breast-cancer patients (cTis-3N0M0) underwent 1.5T MRI, before and after SNB, additional to CT...
May 30, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28466122/objective-breast-symmetry-analysis-with-the-breast-analyzing-tool-bat-improved-tool-for-clinical-trials
#16
Wilfried Krois, Alexander Ken Romar, Thomas Wild, Peter Dubsky, Ruth Exner, Peter Panhofer, Raimund Jakesz, Michael Gnant, Florian Fitzal
PURPOSE: Objective cosmetic analysis is important to evaluate the cosmetic outcome after breast surgery or breast radiotherapy. For this purpose, we aimed to improve our recently developed objective scoring software, the Breast Analyzing Tool (BAT(®)). METHODS: A questionnaire about important factors for breast symmetry was handed out to ten experts (surgeons) and eight non-experts (students). Using these factors, the first-generation BAT(®) software formula has been modified and the breast symmetry index (BSI) from 129 women after breast surgery has been calculated by the first author with this new BAT(®) formula...
July 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28432730/assessment-of-voluntary-deep-inspiration-breath-hold-with-cine-imaging-for-breast-radiotherapy
#17
Reuben Patrick Estoesta, Lani Attwood, Diana Naehrig, Elizabeth Claridge-Mackonis, David Odgers, Darren Martin, Melissa Pham, Joanne Toohey, Susan Carroll
Deep Inspiration Breath-Hold (DIBH) techniques for breast cancer radiation therapy (RT) have reduced cardiac dose compared to Free Breathing (FB). Recently, a voluntary deep inspiration breath-hold (vDIBH) technique was established using in-room lasers and skin tattoos to monitor breath-hold. An in-house quality assessment of positional reproducibility during RT delivery with vDIBH in patients with left-sided breast cancer was evaluated. The electronic portal imaging device (EPID) was used in cinematographic (CINE) mode to capture a sequence of images during beam delivery...
April 22, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28427525/precision-medicine-for-early-breast-cancer-radiotherapy-opening-up-new-horizons
#18
REVIEW
Jacques Bernier
So far most efforts put forth to test the value of predictive and prognostic tools in the field of breast radiotherapy remained globally disappointing, or at least below the convincing levels reached for systemic therapy. Nevertheless the addition of predictive tools to the clinical armament tends to prevail over the use of the sole prognostic factors, also in radiotherapy. A number of predictive assays, clinically validated or not, have recently elicited significant associations between molecular profiles and tumor biological aggressiveness and/or radiosensitivity levels...
May 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28392704/predictive-parameters-in-hypofractionated-whole-breast-3d-conformal-radiotherapy-according-to-the-ontario-canadian-trial
#19
Grazia Lazzari, Angela Terlizzi, Giuseppina Della Vittoria Scarpati, Francesco Perri, Vincenzo De Chiara, Barbara Turi, Giovanni Silvano
AIM: To evaluate the possible role of dosimetric parameters according Normal Tissue Complication Probability (NTCP) model as predictive of late toxicity and cosmesis in hypofractionated whole-breast three-dimensional conformal radiotherapy. PATIENTS AND METHODS: A retrospective analysis on 215 consecutive early breast cancer patients treated with breast conserving surgery and adjuvant hypofractionated whole-breast radiotherapy (according the Ontario Canadian trial), with a 6 years median follow-up was conducted...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28358936/association-of-radiotherapy-boost-for-ductal-carcinoma-in-situ-with-local-control-after-whole-breast-radiotherapy
#20
Meena S Moran, Yinjun Zhao, Shuangge Ma, Youlia Kirova, Alain Fourquet, Peter Chen, Karen Hoffman, Kelly Hunt, Julia Wong, Lia M Halasz, Gary Freedman, Robert Prosnitz, Michael Yassa, David H A Nguyen, Tarek Hijal, Bruce G Haffty, Elaine S Wai, Pauline T Truong
Importance: The use of a radiotherapy (RT) boost to the tumor bed after whole-breast RT (WBRT) for ductal carcinoma in situ (DCIS) is largely extrapolated from invasive cancer data, but robust evidence specific to DCIS is lacking. Objective: To compare ipsilateral breast tumor recurrence (IBTR) in women with DCIS treated with vs without the RT boost after breast-conserving surgery and WBRT. Design, Setting, and Participants: This retrospective analysis pooled deidentified patient-level data from 10 academic institutions in the United States, Canada, and France from January 1, 1980, through December 31, 2010...
August 1, 2017: JAMA Oncology
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