scholarly journals Comparison of cosmetic results after treatment in women with breast cancer who received additional radiation to the tumor bed

2021 ◽  
Vol 16 (3) ◽  
pp. 57-66
Author(s):  
I. A. Akulova ◽  
S. N. Novikov ◽  
A. I. Tseluyko ◽  
A. V. Chernaya ◽  
Zh. V. Bryantseva ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Subcutaneous Fat ◽  
Objective Evaluation ◽  
Cosmetic Result ◽  
Self Assessment ◽  
Cosmetic Results ◽  
Tumor Bed ◽  
Results Of Treatment ◽  
Independent Expert ◽  
Physical Examinations

Objective: to compare cosmetic result of two techniques of boost delivery to the tumor bed after breast concerving treatment.Materials and methods. A retrospective analysis of the results of treatment of patients with stage IA–IIIA breast cancer from three groups was carried out: 1) 45 women received tumor bed boost with interstitial brachytherapy; 2) 48 women with electrons (energies from 6 to 18 MeV); 3) 59 women did not receive additional irradiation of the removed tumor bed. The analysis of the cosmetic results of treatment was carried out using subjective and objective methods using mammographic data, including information about the most common complications from the skin, subcutaneous fat and remaining breast tissue, such as telangiectasias, fibrosis, and fatty necrosis.Results. According to the results of self-assessment by patients and assessment by independent expert (oncologist), carried out on a 4-point Harvard scale, the cosmetic result in most cases was characterized as “excellent” or “good”. Frequency and grade of telangiectasia were used for objective evaluation of skin complications and were similar in all 3 groups. The incidence of localized fibrosis also did not differ and was most often observed as absent or moderate (grade 1–2). There were no significant differences between the severity and incidence of fatty necrosis on both physical examinations and when it was evaluated on mammography.Conclusions. additional irradiation of the tumor bed does not compromise cosmetic result of the treatment. In most cases (57–78 %) estimated as “good” and “excellent”. The cosmetic result of the treatment does not depend on the technology of boost delivery.

Breast retraction assessment: an objective evaluation of cosmetic results of patients treated conservatively for breast cancer

1985 ◽  
Vol 11 (3) ◽  
pp. 575-578 ◽  
Author(s):  
Richard D. Pezner ◽  
Mary P. Patterson ◽  
L.Robert Hill ◽  
Nayana Vora ◽  
Kanta R. Desai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Objective Evaluation ◽  
Cosmetic Results

scholarly journals Intra-Operative Electron Radiation Therapy (IOERT) Anticipated Boost in Breast Cancer Treatment: An Italian Multicenter Experience

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 292
Author(s):  
Antonella Ciabattoni ◽  
Fabiana Gregucci ◽  
Karen Llange ◽  
Marina Alessandro ◽  
Francesca Corazzi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Local Control ◽  
Early Stage ◽  
Disease Free Survival ◽  
Large Data ◽  
Late Toxicity ◽  
Conservative Surgery ◽  
Early Stage Breast Cancer ◽  
Cosmetic Result ◽  
Tumor Bed

In breast cancer, the use of a boost to the tumor bed can improve local control. The aim of this research is to evaluate the safety and efficacy of the boost with intra-operative electron radiotherapy (IOERT) in patients with early-stage breast cancer undergoing conservative surgery and postoperative whole breast irradiation (WBI). The present retrospective multicenter large data were collected between January 2011 and March 2018 in 8 Italian Radiation Oncology Departments. Acute and late toxicity, objective (obj) and subjective (subj) cosmetic outcomes, in-field local control (LC), out-field LC, disease-free survival (DFS) and overall survival (OS) were evaluated. Overall, 797 patients were enrolled. IOERT-boost was performed in all patients during surgery, followed by WBI. Acute toxicity (≥G2) occurred in 179 patients (22.46%); one patient developed surgical wound infection (G3). No patients reported late toxicity ≥ G2. Obj-cosmetic result was excellent in 45%, good in 35%, fair in 20% and poor in 0% of cases. Subj-cosmetic result was excellent in 10%, good in 20%, fair in 69% and poor in 0.3% of cases. Median follow-up was 57 months (range 12–109 months). At 5 years, in-field LC was 99.2% (95% CI: 98–99.7); out-field LC 98.9% (95% CI: 97.4–99.6); DFS 96.2% (95% CI: 94.2–97.6); OS 98.6% (95% CI: 97.2–99.3). In conclusion, IOERT-boost appears to be safe, providing excellent local control for early-stage breast cancer. The safety and long-term efficacy should encourage use of this treatment, with the potential to reduce local recurrence.

Comparison between different boost dose delivery techniques to the tumor bed of right sided breast cancer patients.

2017 ◽  
Vol 13 (1) ◽  
pp. 4605-4617
Author(s):  
Aly Mahmoud El-Hdidy
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Target Location ◽  
Breast Cancer Patients ◽  
Photon Beams ◽  
Lung Dose ◽  
Dose Volume Histograms ◽  
Tumor Bed ◽  
Boost Dose ◽  
Treatment Plans

Comparisons between three different techniques by which the boost dose was delivered to the tumor bed were carried out , aiming to present the best technique of treatment for right breast cancer patients.In this study, ten right sided breast cancer computed tomography (CT) scans were selected for ten early right breast cancer patients. We made three different treatment plans for each patient CT using three different irradiation techniques to deliver a prescribed boost dose of 10 Gy in 5 fractions to the boost PTV. In the first technique, two tangential photon beams were used, in the second technique we, two oblique photon beams were used and in the third technique, a single electron beam was used. The comparative analyses between the three techniques were performed by comparing the boost PTV- dose volume histograms (DVHs), the ipsilateral breast (right breast) DVHs, the ipsilateral lung (right lung) DVHs and the heart DVHs of the three techniques for each patient. Furthermore the dose that covering 100% , 95% of the volume (D100% , D95%) and the volume covered by 95% of the dose (V95%)of  the boost PTV of all techniques, were calculated for each patient to investigate the dose coverage of the target.Results showed that there were variations of the dose received by tumor bed, right breast and OARs depending on the technique used and the target location and size. A decrease of D100% than 90% of the prescribed dose was observed with the 3rd technique for patients 8, 9 and 10, and was observed with the 2nd technique for patient 5. A reduction of right breast dose was observed when the 3rd technique was use in comparison with the 1st and the 2nd techniques for patients 1, 2, 3, 4, 6 and 8.  Also reduction of right breast was observed when the 2nd technique used in comparison with 1st technique. An increase of lung dose was observed with the 3rd technique for patients 1, 2, 5 and 6, also was observed with 2nd technique in patient 3, 5 and 7. A decrease of lung dose was observed with the 1st technique for patients 2, 4, 5, 6, 7, 8 and 9An individualized treatment, several plans using different irradiation techniques should be developed for each patient individually to reach the best boost PTV dose coverage with minimal OARs’ dose. 

EXPERIENCE OF RECONSTRUCTION OF THE BREAST WITH THE USE OF THORACODORSAL FLAP

2018 ◽  
Vol 64 (2) ◽  
pp. 206-210
Author(s):  
Petr Krivorotko ◽  
Vladimir Semiglazov ◽  
Aleksey Belyaev ◽  
Kirill Nikolaev ◽  
Tengiz Tabagua ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Plastic Material ◽  
Breast Cancer Patients ◽  
Anterior Axillary Line ◽  
National Medical ◽  
Results Of Treatment ◽  
Implant Placement ◽  
Quality Of Medical Care ◽  
Low Incidence

Purpose: To analyze the results of treatment and the quality of medical care for breast cancer patients with breast reconstruction using thoracodorsal flap (TDF). Material and methods: The study was conducted on the basis of the N.N. Petrov National Medical Research Center of Oncology at the Department of Breast Tumors for the period 2016-2017. When using the reconstruction of the breast with the help of TDF the feature was the complete intersection of the muscle in the anterior-axillary line before closing the defect of the breast tissue but with the preservation of the thoracodorsal vascular sheaf. Surgical treatment was provided to 67 patients with breast cancer including after neoadjuvant therapy. Results: One-time reconstruction was performed in 16 (23.8%) patients under the organ-preserving surgery, mastectomy in two (2.9%) patients and mastectomy with implant placement in 27 (40.2%) patients. Delayed reconstruction of the breast: TDF in combination with the implant - 20 (29.8%), the use of TDF without an implant - 2 (2.9%) patients. Complications were observed in 6 (8.9%) patients. Conclusion: Reconstruction of the breast with TDF is the method of choice and priority for patients who underwent radiation therapy with a lack of integumentary tissues to cover the implant. TDF is a «good» plastic material and could be used in patients with severe defect of breast shape after organ-preserving surgery and mastectomy. TDF is characterized by a low incidence of complications. The use of TDF does not worsen the rehabilitation of patients and does not shift the timing of adjuvant treatment.

Abstract PS8-37: A breast cancer risk self-assessment model for Japanese women

2021 ◽  
Author(s):  
Michiyo Yamada ◽  
Takashi Ishikawa ◽  
Sadatoshi Sugae ◽  
Kazutaka Narui ◽  
Peter Tonellato ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Japanese Women ◽  
Assessment Model ◽  
Self Assessment

Five-day accelerated partial breast irradiation (APBI) using intensity modulated radiation therapy (IMRT) in stage 0-II breast cancer: A report of 214 cases with up to 39 month follow-up.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12508-e12508
Author(s):  
Rufus J. Mark ◽  
Valerie Gorman ◽  
Michal Wolski ◽  
Steven McCullough
Keyword(s):  
Breast Cancer ◽  
Intensity Modulated Radiation Therapy ◽  
Target Volume ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Skin Reactions ◽  
Cosmetic Results ◽  
Non Invasive

e12508 Background: Randomized trials in stage 0-II breast cancer have proven that APBI given via HDR implant in 5 days is equivalent to whole breast irradiation (WBI) given in 5-6 weeks in regard to breast tumor local recurrence (LR). However, complications have been significant. Recently APBI using non-invasive IMRT given in 5 fractions has been shown in another randomized trial with 10 year follow-up to be equivalent to WBI in 6 weeks, with respect to LR. IMRT was superior in regard to acute effects, late effects, and cosmesis. In the randomized clinical trial of APBI IMRT, the Clinical Target Volume (CTV) was defined by the injection of individual fiducial markers bordering the surgical cavity. We have used the Biozorb fiducial system to localize the CTV for IMRT. We sought to confirm the APBI IMRT results with this simpler less labor intensive fiducial placement system. Methods: Between 2017 and 2021, 214 patients have undergone IMRT targeted to a Biozorb defined CTV with the walls of the surgical cavity sewn to the Biozorb device. Eligible patients were older than age 40, had tumor sizes < 3 cm, negative surgical margins, and negative sentinel node dissections. IMRT dose was 30 Gy given in 5 fractions. Dose Constraints were as follows : V-30 Gy < 105%, Ipsilateral Breast V-15 Gy < 50%, Ipsilateral Lung V-10 Gy < 20%, Contralateral Lung V-5 Gy < 10%, Heart V-3 Gy < 20%, Contralateral Breast Dmax < 2 Gy and Skin Dmax < 27 Gy. The Planning Target Volume (PTV) ranged from 27 to 355 cc with a median of 80 cc. PTV = CTV + 1-2 cm. Results: Follow-up ranged from 1-39 months with a median of 20 months. LR has been 0% (0/214). There have been no skin reactions or seromas. Infection has occurred in one patient (0.5%). Four (1.9%) patients developed pain around the Biozorb site. This resolved on a short courses of steroids in all cases. Cosmetic results as rated by the Surgeon, Radiation Oncologist, and Nurse, were rated excellent in 99.0% (212/214) of cases. Conclusions: Non-invasive APBI with IMRT given qd over 5 days targeted to Biozorb has resulted in LR, complications, and cosmetic results which compare favorably to invasive APBI given bid with HDR implant. At last follow-up, there have been no LR, skin reactions, or significant complications. Cosmesis has been excellent in 99.0% of patients.

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