PO-0965: Cardiac dosimetry with or without ABC in left breast cancer irradiation: Single institute experience

2020 ◽  
Vol 152 ◽  
pp. S514-S515
Author(s):  
V. Pareek ◽  
R. Bhalavat ◽  
M. Chandra ◽  
P. Bauskar ◽  
N. Kumar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Left Breast ◽  
Cancer Irradiation

Dosimetric Correlation Between The Depth of Chest Wall Expansion and Heart Dose in Left Breast Cancer Irradiation Using Deep Inspiratory Breath Hold Technique

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 34-34
Author(s):  
Ehab Saad ◽  
Khaled.M. Elshahat ◽  
Sarah Hazem ◽  
Nadia Ebrahim ◽  
Nada Osama ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Chest Wall ◽  
Adjuvant Radiotherapy ◽  
Left Lung ◽  
Left Breast ◽  
Breath Hold ◽  
Heart Dose ◽  
The Mean ◽  
Mean Heart Dose ◽  
Cancer Irradiation

Introduction and Objective: In adjuvant radiotherapy for left breast cancer, a significant heart volume may be included in the radiation field leading to long-term cardiac toxicities. Deep inspiratory breath hold technique (DIBH) leads to chest wall separation away from the heart and thus can reduce the heart dose compared to free breathing technique. The aim of this study is to correlate dosimetrically the degree of chest wall expansion measured on planning 4D-CT scan to the heart dose in left breast cancer irradiation using DIBH technique. Materials and Methods: Thirty four patients with left breast cancer planned for adjuvant radiotherapy were included. All patients were scanned by Varian RPM (Real Time Position Managment) respiratory gating system using infrared reflecting markers and a video camera to detect the respiratory motion. IMRT or VMAT plans were done for all patients with a prescribed dose 50Gy/25fr/5w with or without operative bed boost dose 10Gy/5fr/1w. The degree of chest wall expansion was identified by measuring the amplitude of DIBH breathing curve from baseline in planning 4D-CT scan in centimeters. The depth of expansion was correlated dosimetrically with the heart V20, V30, and mean heartdose. Results: The mean distance of chest wall expansion was 2.9cm. The mean left lung dose was 8.6Gy. The mean left lung V20 was 13.8%. The mean heart dose was 1.8Gy. The mean heart V30 was 0.6%. A statistically significant reduction of the mean heart dose and V30 was observed with chest wall expansion of 1.4cm or higher (p<0.05). Conclusion: In DIBH technique, the depth of chest wall expansion in 4DCT planning is dosimetrically correlated with the cardiac dose reduction during adjuvant irradiation of left breast cancer. Further clinical studies are needed to translate this dosimetric advantage into clinical benefit.

PH-0167: Dosimetric stability of left breast cancer irradiation in DIBH triggered with RPM

2020 ◽  
Vol 152 ◽  
pp. S81
Author(s):  
S. Bermejo ◽  
G. Gómez de Segura Melcón ◽  
X. Nolla Nieto ◽  
N. Ventosa Lli ◽  
P. Carrasco de Fez
Keyword(s):  
Breast Cancer ◽  
Left Breast ◽  
Cancer Irradiation

PO-0836: Coronary arteries preservation through VMAT use in adjuvant left breast cancer irradiation

2014 ◽  
Vol 111 ◽  
pp. S74-S75
Author(s):  
C. Bourgier ◽  
C. Lemanski ◽  
L. Bedos ◽  
O. Riou ◽  
J. Molinier ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Coronary Arteries ◽  
Left Breast ◽  
Cancer Irradiation

scholarly journals Deep-inspirational breath-hold (DIBH) technique in left-sided breast cancer: various aspects of clinical utility

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Szilvia Gaál ◽  
Zsuzsanna Kahán ◽  
Viktor Paczona ◽  
Renáta Kószó ◽  
Rita Drencsényi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Clinical Utility ◽  
Prospective Trial ◽  
Conformal Radiotherapy ◽  
Free Breathing ◽  
Left Breast ◽  
Breath Hold ◽  
Ipsilateral Lung ◽  
Breast Cancer Radiotherapy

Abstract Background Studying the clinical utility of deep-inspirational breath-hold (DIBH) in left breast cancer radiotherapy (RT) was aimed at focusing on dosimetry and feasibility aspects. Methods In this prospective trial all enrolled patients went through planning CT in supine position under both DIBH and free breathing (FB); in whole breast irradiation (WBI) cases prone CT was also taken. In 3-dimensional conformal radiotherapy (3DCRT) plans heart, left anterior descending coronary artery (LAD), ipsilateral lung and contralateral breast doses were analyzed. The acceptance of DIBH technique as reported by the patients and the staff was analyzed; post-RT side-effects including radiation lung changes (visual scores and lung density measurements) were collected. Results Among 130 enrolled patients 26 were not suitable for the technique while in 16, heart or LAD dose constraints were not met in the DIBH plans. Among 54 and 34 patients receiving WBI and postmastectomy/nodal RT, respectively with DIBH, mean heart dose (MHD) was reduced to < 50%, the heart V25 Gy to < 20%, the LAD mean dose to < 40% and the LAD maximum dose to about 50% as compared to that under FB; the magnitude of benefit was related to the relative increase of the ipsilateral lung volume at DIBH. Nevertheless, heart and LAD dose differences (DIBH vs. FB) individually varied. Among the WBI cases at least one heart/LAD dose parameter was more favorable in the prone or in the supine FB plan in 15 and 4 cases, respectively; differences were numerically small. All DIBH patients completed the RT, inter-fraction repositioning accuracy and radiation side-effects were similar to that of other breast RT techniques. Both the patients and radiographers were satisfied with the technique. Conclusions DIBH is an excellent heart sparing technique in breast RT, but about one-third of the patients do not benefit from that otherwise laborious procedure or benefit less than from an alternative method. Trial registration: retrospectively registered under ISRCTN14360721 (February 12, 2021)

Pleomorphic Invasive Lobular Cancer of the Breast Presenting with Orbital Metastasis: A Case Report

2021 ◽  
Vol 17 ◽  
Author(s):  
Ebru Yılmaz ◽  
Nilgün Güldoğan ◽  
Aydan Arslan ◽  
Ceyda Civan
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Cancer Metastasis ◽  
Left Breast ◽  
Breast Cancer Metastasis ◽  
Mri Findings ◽  
Blurred Vision ◽  
Orbital Metastasis ◽  
Invasive Lobular Cancer ◽  
Lobular Cancer

Background: Orbital metastasis of breast cancer is an unusual condition, especially in the absence of a previous diagnosis of primary breast cancer. The main MRI findings in patients with orbital metastasis are retroorbital soft tissue with thickening of extraocular muscles. Paradoxical enophtalmos secondary to fibrosis can be seen. Case Report: In this case report we present a 75-year-old female patient with left eye pain and blurred vision and retraction. Although there was no evidence of malignancy in the biopsy of the orbita; since the patient's complaints continued despite idiopathic pseudotumor treatment; mammography was recommended to rule out the possibility of breast cancer metastasis. Her mammography revealed a suspicious lesion in the left breast and proved to be pleomorphic invasive lobular cancer. Conclusion: Breast cancer metastasis should be kept in mind in women with pseudotumor -like involvement of the orbita.

Predominance of RAD21 and ERBB2 amplification and progesterone receptor positivity in tumors of the right breast support breast cancer lateralization.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12557-e12557
Author(s):  
Zachary Spigelman ◽  
Jo-Ellen Murphy
Keyword(s):  
Breast Cancer ◽  
Progesterone Receptor ◽  
Cancer Patients ◽  
Breast Tumors ◽  
Left Breast ◽  
Breast Cancers ◽  
Her2 Expression ◽  
Breast Cancer Patients ◽  
The Right ◽  
Chi Square Analysis

e12557 Background: Biologic lateralization broadly impacts breast cancer. Malignancies originating in the left breast compared to the right breast tend to be more frequent, larger and of poorer prognosis. Left breast tumors respond differently to HER2-neu signaling and have lateralized Ki67 expression. In a prior study a right-left asymmetry in the neutrophil/lymphocyte ratio (NLR) of breast cancers was identified (ASCO 2018, e13094). As a follow-up, retrospective analysis of results from comprehensive genomic profiling (CGP) of right and left side breast cancer specimens was performed to determine a potential genomic etiology for the observed NLR lateralization. Methods: Tumors from 43 consecutive breast cancer patients underwent analysis for all classes of genomic alterations by hybrid capture-based CGP (Foundation Medicine). The CGP results from the 25 left- and 18 right-sided breast cancer samples were analyzed along with the histologic grade and status of estrogen receptor (ER), progesterone receptor (PR), and HER2 expression. Results: In this cohort of advanced breast cancer patients (stage 3-4), no statistically significant differences in lateralization were identified based on patient age, tumor stage, or frequency of ER or Her2 expression (Table). A predominance of PR positivity (p=0.14 chi square analysis) and amplifications in the ERBB2 (p=0.37) and RAD21 (p=0.08) genes were detected in right side tumors. Conclusions: Together with the prior study, trends in asymmetry based on genomic, pathologic, and immunohistologic differences have been detected in breast cancers, including an increased incidence of ERBB2 and RAD21 amplification in right-side breast tumors in this cohort. The predominance of lower PR positivity in the left breast tumors may be due to preferential hypermethylation, consistent with reports that it mediates biologic lateralization changes, downregulates PR expression, and alters amplification rates. Epigenetic methylation, may contribute to asymmetric breast cancer biology and have implications for therapeutic strategy. Further study is warranted.[Table: see text]

Case of second primary breast cancer in ectopic breast tissue and review of the literature

2021 ◽  
Vol 14 (4) ◽  
pp. e241361
Author(s):  
Jamin Kweku Addae ◽  
Thomas Genuit ◽  
Joseph Colletta ◽  
Kathy Schilling
Keyword(s):  
Breast Cancer ◽  
Primary Breast Cancer ◽  
Breast Tissue ◽  
Delayed Diagnosis ◽  
Left Breast ◽  
Second Primary ◽  
Female Population ◽  
Accessory Breast ◽  
History Of ◽  
High Index Of Suspicion

Accessory breast tissue (ABT) is found in approximately 2%–6% of the female population and are subject to most of the physiological and pathological changes that occur in pectoral breast. Primary breast cancer occurring in ABT is a rare occurrence and a second primary breast cancer occurring in an accessory breast has never been reported. We report the case of a 60-year-old woman with a history of mastectomy for left breast cancer 5 years prior to presentation, who presented with an enlarging right axilla mass found to be a second primary breast cancer in an accessory tissue on biopsy. Many physicians are unfamiliar with the clinical presentation of accessory breast cancer due to the rarity of the condition and this ultimately results in delayed diagnosis and advanced disease at presentation. It is therefore prudent that physicians have a high index of suspicion when patients present with axillary masses.

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