Faculty Opinions recommendation of Patients with t1 to t2 breast cancer with one to three positive nodes have higher local and regional recurrence risks compared with node-negative patients after breast-conserving surgery and whole-breast radiotherapy.

To compare the cosmetic outcome and acute cutaneous, cardiac, and pulmonary toxicity profile of accelerated hypofractionated and conventional whole breast radiotherapy (WBRT).This was a blocked randomized, clinical trial on women with early-stage node-negative invasive breast cancer after breast conservation surgery (BCS) with clear margins randomly assigned to receive WBRT either at a conventional dose of 50.0 grays (Gy) in 25 fractions (the conventional group) or at a dose of 42.5 Gy in 16 fractions (the hypofractionated group). Boost irradiation was permitted in both groups. Data were analyzed by SPSS V21.0 using Mann–Whitney U, independent-samples t- and Chi-Square/Fisher's exact tests at the level of P≤0.05.The median follows up was 16 months. Forty-one patients in the conventional WBRT arm and 45 patients in the hypofractionated WBRT group were enrolled. No significant difference was observed in terms of left and right ventricle systolic dysfunction and diastolic dysfunction. Pulmonary function tests after 6 and 12 months follow up, were comparable in both groups (P=0.2). Skin toxicity during and after treatment was acceptable in both groups. Breast size change in the conventional and the hypofractionated WBRT groups was 14.3% and 7.1%, respectively (P=0.6). Excellent or good cosmetic outcome was similar in both groups.The results of our study support the use of accelerated hypofractionated WBRT in women with invasive breast cancer less than five cm and node-negative after breast-conserving surgery, which provides a more convenient shorter course of radiotherapy with a comparable cosmetic outcome and cutaneous, cardiac, and pulmonary toxicity profile.

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ASO Author Reflections: Effect Sizes of Whole Breast Radiotherapy and Systemic Therapies on Regional Recurrence Incidence in Breast Cancer Patients

Annals of Surgical Oncology ◽

10.1245/s10434-020-08434-5 ◽

2020 ◽

Vol 27 (9) ◽

pp. 3412-3413

Author(s):

Julia E. C. van Steenhoven ◽

Thijs van Dalen

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Effect Sizes ◽

Regional Recurrence ◽

Breast Cancer Patients ◽

Breast Radiotherapy ◽

Whole Breast Radiotherapy ◽

Systemic Therapies

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Acute and Late Toxicity In Breast Cancer Patient That Received Hypofractionated Adjuvant Radiotherapy after Breast Conserving Surgery: A Case Report

Indonesian Journal of Cancer ◽

10.33371/ijoc.v14i4.741 ◽

2020 ◽

Vol 14 (4) ◽

pp. 144

Author(s):

Sinta Prastiana Dewi

Keyword(s):

Breast Cancer ◽

Adjuvant Radiotherapy ◽

Late Toxicity ◽

Skin Toxicity ◽

Breast Conserving Surgery ◽

Hypofractionated Radiotherapy ◽

Breast Cancer Patients ◽

Breast Radiotherapy ◽

Whole Breast Radiotherapy

Introduction: Breast cancer is the most common female malignancy worldwide. Breastconserving surgery followed by adjuvant radiotherapy is a preferable treatment option. Hypofractionated radiotherapy is an attractive fractionation scheme because of its shorter treatment duration. This paper aims to report the short-term and long-term toxicity of hypofractionated radiotherapy in breast cancer patients at our institution. Case Presentation: A 58-year-old woman with right breast cancer T2N1M0 had undergone breast-conserving surgery with axilla lymph node dissection. This patient underwent adjuvant whole breast radiotherapy with a dose of 42.56 Gy in 16 fractions followed by tumor bed boost with a dose of 16 Gy in 8 fractions. After undergoing the fourth fraction of boost, she had hyperpigmentation on her radiation area (RTOG skin toxicity grade 1). At the 6-month follow-up, the hyperpigmentation still appeared. Until the 24-month follow-up, after she completed radiotherapy, there was no sign of tumor recurrence and toxicity.Conclusion: Hypofractionated radiotherapy could be an option for breast cancer treatment that provides equivalent local control, survival, and side effects to conventional fractionation radiotherapy.

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Moderate hypofractionation remains the standard of care for whole-breast radiotherapy in breast cancer: Considerations regarding FAST and FAST-Forward

Strahlentherapie und Onkologie ◽

10.1007/s00066-020-01744-3 ◽

2021 ◽

Author(s):

David Krug ◽

◽

René Baumann ◽

Stephanie E. Combs ◽

Marciana Nona Duma ◽

...

Keyword(s):

Breast Cancer ◽

Late Effects ◽

Late Toxicity ◽

Standard Of Care ◽

Breast Conserving Surgery ◽

Breast Radiotherapy ◽

Recurrence Rates ◽

Whole Breast Radiotherapy ◽

The Difference ◽

Moderate Hypofractionation

AbstractModerate hypofractionation is the standard of care for adjuvant whole-breast radiotherapy after breast-conserving surgery for breast cancer. Recently, 10-year results from the FAST and 5‑year results from the FAST-Forward trial evaluating adjuvant whole-breast radiotherapy in 5 fractions over 5 weeks or 1 week have been published. This article summarizes recent data for moderate hypofractionation and results from the FAST and FAST-Forward trial on ultra-hypofractionation. While the FAST trial was not powered for comparison of local recurrence rates, FAST-Forward demonstrated non-inferiority for two ultra-hypofractionated regimens in terms of local control. In both trials, the higher-dose experimental arms resulted in elevated rates of late toxicity. For the lower dose experimental arms of 28.5 Gy over 5 weeks and 26 Gy over 1 week, moderate or marked late effects were similar in the majority of documented items compared to the respective standard arms, but significantly worse in some subdomains. The difference between the standard arm and the 26 Gy of the FAST-Forward trial concerning moderate or marked late effects increased with longer follow-up in disadvantage of the experimental arm for most items. For now, moderate hypofractionation with 40–42.5 Gy over 15–16 fractions remains the standard of care for the majority of patients with breast cancer who undergo whole-breast radiotherapy without regional nodal irradiation after breast-conserving surgery.

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Does Surgical Margin Width Remain a Challenge for Triple-Negative Breast Cancer? A Retrospective Analysis

Medicina ◽

10.3390/medicina57030203 ◽

2021 ◽

Vol 57 (3) ◽

pp. 203

Author(s):

Eduard-Alexandru Bonci ◽

Ștefan Țîțu ◽

Alexandru Marius Petrușan ◽

Claudiu Hossu ◽

Vlad Alexandru Gâta ◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Surgical Margin ◽

Final Analysis ◽

Breast Conserving Surgery ◽

Breast Radiotherapy ◽

Margin Width ◽

Whole Breast Radiotherapy ◽

The Impact

Background and Objectives: Local and distant relapse (LR, DR) in breast cancer vary according to its molecular subtypes, with triple-negative breast cancer (TNBC) being the most aggressive. The surgical resection margin width (SRMW) for breast-conserving surgery (BCS) has been intensely debated, especially for the aforementioned subtype. The aim of this study was to examine the impact of SRMW on LR following BCS in TNBC patients. Materials and Methods: We conducted a retrospective study including all patients with TNBC for whom BCS was performed between 2005 and 2014. Results: Final analysis included a total of 92 patients, with a median tumor size of 2.5 cm (range 0–5 cm) and no distant metastasis at the time of diagnosis. A total of 87 patients had received neoadjuvant and/or adjuvant chemotherapy, and all patients had received adjuvant whole-breast radiotherapy. After a median follow-up of 110.7 months (95% CI, 95.23–126.166), there were 5 local recurrences and 8 regional/distant recurrences with an overall LR rate of 5.4%. The risk of LR and DR was similar between groups of patients with several SRMW cut-off values. Conclusions: Our study supports a safe “no ink on tumor” approach for TNBC patients treated with BCS.

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