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37 papers 25 to 100 followers
By Alessandro Franciscon doctor
Abram Recht, Elizabeth A Comen, Richard E Fine, Gini F Fleming, Patricia H Hardenbergh, Alice Y Ho, Clifford A Hudis, E Shelley Hwang, Jeffrey J Kirshner, Monica Morrow, Kilian E Salerno, George W Sledge, Lawrence J Solin, Patricia A Spears, Timothy J Whelan, Mark R Somerfield, Stephen B Edge
PURPOSE: A joint American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology panel convened to develop a focused update of the American Society of Clinical Oncology guideline concerning use of postmastectomy radiotherapy (PMRT). METHODS: A recent systematic literature review by Cancer Care Ontario provided the primary evidentiary basis. The joint panel also reviewed targeted literature searches to identify new, potentially practice-changing data...
September 19, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Jianhua Wang, Mei Shi, Rui Ling, Yuesheng Xia, Shanquan Luo, Xuehai Fu, Feng Xiao, Jianping Li, Xiaoli Long, Jianguo Wang, Zengxia Hou, Yunxia Chen, Bin Zhou, Man Xu
BACKGROUND AND PURPOSE: Triple-negative breast cancer (TNBC) presents a high risk breast cancer that lacks the benefit from hormone treatment, chemotherapy is the main strategy even though it exists in poor prognosis. Use of adjuvant radiation therapy, which significantly decreases breast cancer mortality, has not been well described among poor TNBC women. The aim of this study was to evaluate whether the combination of chemotherapy and radiotherapy could significantly increase survival outcomes in TNBC women after mastectomy...
August 2011: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Pauline T Truong, Mary Lesperance, Aydin Culhaci, Hosam A Kader, Caroline H Speers, Ivo A Olivotto
PURPOSE: To identify patient subsets with T1-T2N0 breast cancer at high risk of locoregional recurrence (LRR) who may warrant consideration for postmastectomy radiotherapy. METHODS AND MATERIALS: Data were analyzed for 1505 women referred between 1989 and 1999 with pathologic T1-T2N0M0 breast cancer treated with mastectomy with clear margins and no adjuvant radiotherapy. Logistic regression analysis was performed to identify statistically significant factors associated with LRR...
May 1, 2005: International Journal of Radiation Oncology, Biology, Physics
Harry Bartelink, Jean-Claude Horiot, Philip M Poortmans, Henk Struikmans, Walter Van den Bogaert, Alain Fourquet, Jos J Jager, Willem J Hoogenraad, S Bing Oei, Carla C Wárlám-Rodenhuis, Marianne Pierart, Laurence Collette
PURPOSE: To investigate the long-term impact of a boost radiation dose of 16 Gy on local control, fibrosis, and overall survival for patients with stage I and II breast cancer who underwent breast-conserving therapy. PATIENTS AND METHODS: A total of 5,318 patients with microscopically complete excision followed by whole-breast irradiation of 50 Gy were randomly assigned to receive either a boost dose of 16 Gy (2,661 patients) or no boost dose (2,657 patients), with a median follow-up of 10...
August 1, 2007: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Beryl McCormick, Margie Hunt
Intensity-modulated radiation therapy (IMRT) became available to the radiation oncology community in the late 1990s, and its initial applications were to increase conformality of dose to the target, allowing for both dose escalation and decreased radiation to adjacent normal organs. In most disease sites, these continue to be the goals of IMRT. However, for breast cancer, IMRT has emerged with a different endpoint, namely improving dose homogeneity throughout the targeted breast. In 2 recent prospective randomized trials comparing IMRT with "standard" planning, IMRT was associated with a significant decrease in both acute side effects and late fibrosis, which was related directly to dose homogeneity...
January 2011: Seminars in Radiation Oncology
Theodora A Koulis, Tien Phan, Ivo A Olivotto
Adjuvant radiotherapy (RT) is an important part of breast cancer management but the dose and fractionation schedules used are variable. A total of 50 Gy in 25 daily fractions delivered over 5 weeks is often considered the "standard" adjuvant RT prescription. Hypofractionated regimes such as 42.5 Gy in 16 daily fractions or 40 Gy in 15 daily fractions following breast-conserving surgery have proven to be equally effective and achieve similar or better cosmetic and normal tissue outcomes for both invasive and in situ diseases and when treating the regional nodes...
2015: Breast Cancer: Targets and Therapy
Jo Anne Zujewski, Leah Kamin
Novel genetic profiling tests of breast cancer tissue have been shown to be prognostic for overall survival and predictive of local and distant rates of recurrence in breast cancer patients. One of these tests, Oncotype DXtrade mark, is a diagnostic test comprised of a 21-gene assay applied to paraffin-embedded breast cancer tissue, which allows physicians to predict subgroups of hormone-receptor-positive, node-negative patients who may benefit from hormonal therapy alone or require adjuvant chemotherapy to attain the best survival outcome...
October 2008: Future Oncology
Debra Nana Yeboa, Suzanne Buckley Evans
Long-term cardiac effects are an important component of survivorship after breast radiotherapy. The pathophysiology of cardiotoxicity, history of breast radiotherapy, current methods of cardiac avoidance, modern outcomes, context of historical outcomes, quantifying cardiac effects, and future directions are reviewed in this article. Radiation-induced oxidative stress induces proinflammatory cytokines and is a process that potentiates late effects of fibrosis and intimal proliferation in endothelial vasculature...
January 2016: Seminars in Radiation Oncology
Benjamin Y Tan, Geza Acs, Sophia K Apple, Sunil Badve, Ira J Bleiweiss, Edi Brogi, José P Calvo, David J Dabbs, Ian O Ellis, Vincenzo Eusebi, Gelareh Farshid, Stephen B Fox, Shu Ichihara, Sunil R Lakhani, Emad A Rakha, Jorge S Reis-Filho, Andrea L Richardson, Aysegul Sahin, Fernando C Schmitt, Stuart J Schnitt, Kalliopi P Siziopikou, Fernando A Soares, Gary M Tse, Anne Vincent-Salomon, Puay Hoon Tan
Phyllodes tumours constitute an uncommon but complex group of mammary fibroepithelial lesions. Accurate and reproducible grading of these tumours has long been challenging, owing to the need to assess multiple stratified histological parameters, which may be weighted differently by individual pathologists. Distinction of benign phyllodes tumours from cellular fibroadenomas is fraught with difficulty, due to overlapping microscopic features. Similarly, separation of the malignant phyllodes tumour from spindle cell metaplastic carcinoma and primary breast sarcoma can be problematic...
January 2016: Histopathology
Timothy J Whelan, Ivo A Olivotto, Wendy R Parulekar, Ida Ackerman, Boon H Chua, Abdenour Nabid, Katherine A Vallis, Julia R White, Pierre Rousseau, Andre Fortin, Lori J Pierce, Lee Manchul, Susan Chafe, Maureen C Nolan, Peter Craighead, Julie Bowen, David R McCready, Kathleen I Pritchard, Karen Gelmon, Yvonne Murray, Judy-Anne W Chapman, Bingshu E Chen, Mark N Levine
BACKGROUND: Most women with breast cancer who undergo breast-conserving surgery receive whole-breast irradiation. We examined whether the addition of regional nodal irradiation to whole-breast irradiation improved outcomes. METHODS: We randomly assigned women with node-positive or high-risk node-negative breast cancer who were treated with breast-conserving surgery and adjuvant systemic therapy to undergo either whole-breast irradiation plus regional nodal irradiation (including internal mammary, supraclavicular, and axillary lymph nodes) (nodal-irradiation group) or whole-breast irradiation alone (control group)...
July 23, 2015: New England Journal of Medicine
Mila Donker, Geertjan van Tienhoven, Marieke E Straver, Philip Meijnen, Cornelis J H van de Velde, Robert E Mansel, Luigi Cataliotti, A Helen Westenberg, Jean H G Klinkenbijl, Lorenzo Orzalesi, Willem H Bouma, Huub C J van der Mijle, Grard A P Nieuwenhuijzen, Sanne C Veltkamp, Leen Slaets, Nicole J Duez, Peter W de Graaf, Thijs van Dalen, Andreas Marinelli, Herman Rijna, Marko Snoj, Nigel J Bundred, Jos W S Merkus, Yazid Belkacemi, Patrick Petignat, Dominic A X Schinagl, Corneel Coens, Carlo G M Messina, Jan Bogaerts, Emiel J T Rutgers
BACKGROUND: If treatment of the axilla is indicated in patients with breast cancer who have a positive sentinel node, axillary lymph node dissection is the present standard. Although axillary lymph node dissection provides excellent regional control, it is associated with harmful side-effects. We aimed to assess whether axillary radiotherapy provides comparable regional control with fewer side-effects. METHODS: Patients with T1-2 primary breast cancer and no palpable lymphadenopathy were enrolled in the randomised, multicentre, open-label, phase 3 non-inferiority EORTC 10981-22023 AMAROS trial...
November 2014: Lancet Oncology
Viviana Galimberti, Bernard F Cole, Stefano Zurrida, Giuseppe Viale, Alberto Luini, Paolo Veronesi, Paola Baratella, Camelia Chifu, Manuela Sargenti, Mattia Intra, Oreste Gentilini, Mauro G Mastropasqua, Giovanni Mazzarol, Samuele Massarut, Jean-Rémi Garbay, Janez Zgajnar, Hanne Galatius, Angelo Recalcati, David Littlejohn, Monika Bamert, Marco Colleoni, Karen N Price, Meredith M Regan, Aron Goldhirsch, Alan S Coates, Richard D Gelber, Umberto Veronesi
BACKGROUND: For patients with breast cancer and metastases in the sentinel nodes, axillary dissection has been standard treatment. However, for patients with limited sentinel-node involvement, axillary dissection might be overtreatment. We designed IBCSG trial 23-01 to determine whether no axillary dissection was non-inferior to axillary dissection in patients with one or more micrometastatic (≤2 mm) sentinel nodes and tumour of maximum 5 cm. METHODS: In this multicentre, randomised, non-inferiority, phase 3 trial, patients were eligible if they had clinically non-palpable axillary lymph node(s) and a primary tumour of 5 cm or less and who, after sentinel-node biopsy, had one or more micrometastatic (≤2 mm) sentinel lymph nodes with no extracapsular extension...
April 2013: Lancet Oncology
Jose G Bazan, Julia R White
When surgery is the first line of breast cancer treatment, numerous randomized clinical trials and meta-analyses have demonstrated that postmastectomy radiation therapy (PMRT) improves locoregional control and survival for many women with axillary lymph node-positive disease. In contrast, there are no randomized data regarding the use of PMRT in women who receive neoadjuvant chemotherapy (NAC) first followed by mastectomy. This has led to controversy regarding which patient with breast cancer will benefit from PMRT after NAC, particularly in women with clinically node-positive axillary disease that responds well and is down staged to pathologically negative disease at surgery (ypN0)...
January 2016: Seminars in Radiation Oncology
Reshma Jagsi
Radiation therapy is a critical component of the multidisciplinary management of invasive breast cancer. In appropriately selected patients, radiation not only improves local control, sparing patients the morbidity and distress of local recurrence, but it also improves survival by preventing seeding and reseeding of distant metastases from persistent reservoirs of locoregional disease. In recent years, considerable progress has been made toward improving our ability to select patients most likely to benefit from radiotherapy and to administer treatment in ways that maximize clinical benefit while minimizing toxicity and burden...
March 2014: CA: a Cancer Journal for Clinicians
Katrina B Mitchell, Henry Kuerer
Ductal carcinoma in situ (DCIS) traditionally has been managed through various combinations of surgery, radiation, and endocrine therapy. However, concern for under- or over-treatment of DCIS has led many surgeons to question historically standardized approaches and instead begin to tailor treatment based on individual prognostic indicators. Recent and ongoing clinical trials have investigated the potential for active surveillance in DCIS, the possibility of eliminating radiation therapy (RT), and ways in which adjuvant systemic therapy may be refined...
November 2015: Current Oncology Reports
C Bourgier, L Aimard, V Bodez, M A Bollet, B Cutuli, D Franck, C Hennequin, Y M Kirova, D Azria
PURPOSE: To actualize and to detail guidelines used in technical radiotherapy and indications for innovative radiation technologies in early axillary node negative breast cancer (BC). METHODS: Dosimetric and treatment planning studies, phase II and III trials, systematic reviews and retrospective studies were all searched (Medline(®) database). Their quality and clinical relevance were also checked against validated checklists. A level of evidence was associated for each result...
April 2013: Critical Reviews in Oncology/hematology
Stefan Janssen, Edna Holz-Sapra, Dirk Rades, Alexander Moser, Gabriela Studer
The present study aimed to evaluate the role of adjuvant radiotherapy (RT) following nipple-sparing mastectomy (NSM) for patients with ductal carcinoma in situ and invasive breast cancer, based on the published literature. Currently, there is no standard for RT following NSM. NSM aims to spare the nipple areola complex (NAC) without compromising locoregional control. Long-term follow-up studies have begun to show promising results. A search of the English literature was performed using the Medline database and Cochrane central library, with the keywords 'nipple/areola-sparing mastectomy', 'whole skin mastectomy' and 'NAC preservation'...
June 2015: Oncology Letters
Vijayashree Murthy, Ronald S Chamberlain
Breast cancer is a diverse disease that requires a fully integrated multidisciplinary approach. Breast surgery has undergone a revolutionary change leading us from the conventional radical mastectomy of the Halstedian era to the current motion of nipple sparing mastectomy (NSM). Despite the lack of randomized controlled trials, the technique of NSM continues to gain popularity as a prophylactic procedure in high risk patients. The current indications for NSM, if any, in the treatment of early invasive breast cancer remains uncertain and requires rigorous scientific scrutiny...
November 2013: Breast Journal
Armando E Giuliano, Kelly K Hunt, Karla V Ballman, Peter D Beitsch, Pat W Whitworth, Peter W Blumencranz, A Marilyn Leitch, Sukamal Saha, Linda M McCall, Monica Morrow
CONTEXT: Sentinel lymph node dissection (SLND) accurately identifies nodal metastasis of early breast cancer, but it is not clear whether further nodal dissection affects survival. OBJECTIVE: To determine the effects of complete axillary lymph node dissection (ALND) on survival of patients with sentinel lymph node (SLN) metastasis of breast cancer. DESIGN, SETTING, AND PATIENTS: The American College of Surgeons Oncology Group Z0011 trial, a phase 3 noninferiority trial conducted at 115 sites and enrolling patients from May 1999 to December 2004...
February 9, 2011: JAMA: the Journal of the American Medical Association
M Untch, N Harbeck, J Huober, G von Minckwitz, B Gerber, H-H Kreipe, C Liedtke, N Marschner, V Möbus, H Scheithauer, A Schneeweiss, C Thomssen, C Jackisch, M W Beckmann, J-U Blohmer, S-D Costa, T Decker, I Diel, P A Fasching, T Fehm, W Janni, H-J Lück, N Maass, A Scharl, S Loibl
For the first time, this year's St. Gallen International Consensus Conference on the treatment of patients with primary breast cancer, which takes place every two years, was held not in St. Gallen (Switzerland) but - for logistical reasons - in Vienna (Austria) under its usual name. The 2015 St. Gallen International Consensus Conference was the 14th of its kind. As the international panel of the St. Gallen conference consists of experts from different countries, the consensus mirrors an international cross-section of opinions...
June 2015: Geburtshilfe und Frauenheilkunde
2015-09-23 16:55:31
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