scholarly journals PO-1001: Evaluation of target volume delineation of the regional lymph nodes in breast cancer patients

2017 ◽  
Vol 123 ◽  
pp. S552
Author(s):  
M. Mast ◽  
E. Gagesteijn ◽  
T. Stam ◽  
N. Knotter ◽  
E. Kouwenhoven ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Target Volume ◽  
Breast Cancer Patients ◽  
Regional Lymph Nodes ◽  
Target Volume Delineation ◽  
Volume Delineation

scholarly journals Patterns of supraclavicular area failure after mastectomy in breast cancer patients: implications for target volume delineation

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095331
Author(s):  
Pei-cheng Lin ◽  
Xi-jin Lin ◽  
Jin-luan Li ◽  
Fei-fei Lin ◽  
Qing-yang Zhuang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Target Volume ◽  
Breast Cancer Patients ◽  
Target Volume Delineation ◽  
Volume Delineation ◽  
Supraclavicular Lymph Nodes ◽  
Level I ◽  
Metastatic Involvement ◽  
Medial Supraclavicular

Purpose To characterize the pattern of post-mastectomy supraclavicular lymph node (LN) metastases in patients with breast cancer (BC) and to provide insights for individualized clinical target volume delineation for radiotherapy. Methods We retrospectively analyzed 88 patients with BC who developed post-mastectomy regional LN metastases. The affected regional LNs were categorized as the ipsilateral medial supraclavicular LN area (IMSC-LN), ipsilateral lateral supraclavicular LN area (ILSC-LN), ipsilateral infraclavicular LN area (IIC-LN), and ≥2 groups in the ipsilateral clavicular LN area (MMIC-LN). Clinical characteristics were included in a multivariate analysis to identify risk factors for clavicular LN metastases. Results The ILSC-LNs (68.2%) were the most common metastatic site. IMSC-LN metastases showed a significant association with estrogen-receptor (ER) negative status, left-sided BC, and positive axillary LNs. Tumor size ≥2.4 cm and Her2 type were predictors of ILSC-LN metastases. Additionally, tumor size ≥2.4 cm, and level I ipsilateral axillary metastases were associated with MMIC-LN metastasis. Conclusion ILSC-LN was the most frequently affected group of supraclavicular lymph nodes. ER-negative status, left-sided BC, tumor size, and positive ipsilateral axillary LNs are potentially associated with the pattern of supraclavicular LN metastatic involvement.

scholarly journals The metastasis of the internal mammary lymph node-a neglected strategic high point of radiotherapy for breast cancer

2019 ◽  
Author(s):  
Li Li ◽  
Hongyan Zhang ◽  
Linwei Wang ◽  
Conghua xie ◽  
Yunfeng Zhou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Adjuvant Radiotherapy ◽  
Target Volume ◽  
Breast Cancer Patients ◽  
Metastatic Rate ◽  
Supraclavicular Lymph Nodes ◽  
Internal Mammary

Abstract Background : To investigate the metastatic rate of internal mammary lymph nodes (IMNs) and to provide recommendations on target volume delineation of IMNs for adjuvant radiotherapy of breast cancer patients. Methods : We retrospectively analyzed 114 breast cancer patients treated only by surgery without adjuvant radiotherapy who developed local and/or regional lymph node recurrence/metastasis in our institute from January 2015 to January 2019, and patients with widely lung or pleural metastases were excluded. We first analyzed the recurrence rate of the chest wall, the metastatic rate of internal mammary/anterior mediastinal, ipsilateral axillary and supraclavicular lymph nodes, and then investigated distribution of the IMNs. Results : Among all of these 114 patients, the recurrence rate of chest wall, the metastatic rate of IMNs, the IMNs/anterior mediastinal lymph nodes, the ipsilateral axillary lymph nodes, and the ipsilateral supraclavicular lymph nodes were 43%, 37.7%, 59.6%, 12.3% and 22.8%, respectively. The metastatic IMNs were mainly located from the first to the second intercostal space. However, metastatic lymph nodes could also be observed above the upper edge of the first rib. Conclusions : The metastatic rate is high in the IMNs and irradiation of the internal mammary lymphatic chain is indispensable. It is suggested that the upper bound of the internal mammary lymphatic chain should be up to the subclavian vein with 5 mm margin, thus connecting to the caudal border of supraclavicular CTV(Clinical Target Volume)in breast cancer patients with high risk of recurrence.

SU-GG-T-140: Treatment Planning of Left-Sided Breast Cancer Patients with Regional Lymph Nodes Using Dynamic Jaws and Dynamic Couch Technique on TomoTherapy

2010 ◽  
Vol 37 (6Part17) ◽  
pp. 3217-3217
Author(s):  
S Goddu ◽  
M Michaletz-Lorenz ◽  
V Rodriguez ◽  
O Pechenaya Green ◽  
I Zoberi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Treatment Planning ◽  
Breast Cancer Patients ◽  
Regional Lymph Nodes

scholarly journals An Update on Regional Nodal Irradiation: Indication, Target Volume Delineation, and Radiotherapy Techniques

Breast Care ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. 128-135
Author(s):  
Marciana Nona Duma
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Metastatic Lymph Node ◽  
Target Volume ◽  
Breath Hold ◽  
Breast Cancer Patients ◽  
Target Volume Delineation ◽  
Regional Nodal Irradiation ◽  
Volume Delineation ◽  
Radiotherapy Techniques

Background: Tremendous changes have occurred in the treatment of breast cancer. This paper reviews and unifies the available data on modern axillary management of breast cancer patients with focus on the target volume delineation for regional nodal irradiation according to the most important contouring guidelines, the European Society for Radiotherapy and Oncology (ESTRO) and the Radiation Therapy and Oncology Group (RTOG). Summary: The use of extensive radiotherapy target volumes (level I, II, III, IV) is probably not necessary for all patients to reproduce the clinical benefit shown in the available randomized trials (EORTC, MA.20, AMAROS, Z0011). Nevertheless, given the results in the MA.20 trial, where the patients received more modern systemic therapies and high irradiation doses in the medial paraclavicular region (level IV) and level II, it can be justified to include these regions completely in selected high-risk patients. Key Messages: High-tangent irradiation results in a similar dose distribution in axillary levels I and II compared to the AMAROS treatment field design in some patients. This supports earlier assumptions that irradiation may have accounted for the good results after sentinel lymph node dissection alone in the Z0011 trial. The ESTRO and RTOG clinical target volume (CTV) definitions cover sufficiently the metastatic lymph node hotspots, with a better coverage for the ESTRO CTV. Further, contouring according to the ESTRO would spare a significantly larger part of the healthy lymphatic system, making it our preferred contouring atlas. Modern radiotherapy techniques, such as deep inspiration breath hold, should be cautiously employed in patients treated according to the inclusion criteria of the Z0011 as it will result in a lower dose to the axillary levels.

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