Half Beam Technique in Patient with Left Breast Cancer and Evaluate its Dosimetry Parameters from Dosevolume Histograms

2020 ◽  
Keyword(s):  
Breast Cancer ◽  
Left Breast ◽  
Beam Technique

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.

Neoadjuvant Chemotherapy for Breast Cancer: Evaluation by PET / CT

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rania Ali Maarouf ◽  
Amgad S Abdel-Rahman ◽  
Samar Ibrahim Mohamed
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Therapeutic Response ◽  
Left Breast ◽  
Breast Lesions ◽  
Mean Values ◽  
Pet Ct ◽  
The Mean ◽  
Neo Adjuvant Chemotherapy ◽  
Fdg Pet Ct

Abstract Background Breast cancer (BC)is the most commonly occurring cancer in women and the second most common cancer overall.An increase in the rate of breast preservation has come to be expected because of tumor reduction using neo-adjuvant chemotherapy (NAC) for locally advanced cancer and it is important to accurately determine the effects of NAC. Patients and Methods This study was conducted on 30 female patients with histopathologically confirmed breast cancer referred for a PET/CT scan aiming to demonstrate the role of 18F-FDG PET/CT in detecting the pathological response to NAC in BC patients. Results No statistically significant differences were found between the baseline number of lesions and that after three cycles of chemotherapy. Also, no statistically significant differences were found between the mean values of baseline and after three cycles of chemotherapy of both liver activity and size of right breast lesions. Meanwhile, the mean values of SUV of right and left breast lesions as well as the size of left breast lesions were significantly lower after three cycles of chemotherapy when compared to their baseline values. And no statistically significant differences were found between complete and partial therapeutic response in the right breast lesions as well as between complete and no therapeutic response in the left breast lesions as regards baseline SUV and SUV after 3 cycles of chemotherapy. Conclusion It can be concluded that FDG-PET/CT is useful for evaluation of neo-adjuvant chemotherapy for breast cancer. However, more studies are needed to validate the results of the current study.

scholarly journals Tangent-based volumetric modulated arc therapy for advanced left breast cancer

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Pei-Chieh Yu ◽  
Ching-Jung Wu ◽  
Hsin-Hua Nien ◽  
Louis Tak Lui ◽  
Suzun Shaw ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Volumetric Modulated Arc Therapy ◽  
Left Breast ◽  
Arc Therapy

scholarly journals Is It Contralateral Axillary Metastasis or Occult Breast Cancer: A Confusing Case Report

2015 ◽  
Vol 8 (3) ◽  
pp. 498-502 ◽  
Author(s):  
Yong Gi Son ◽  
Woon Won Kim ◽  
Ki Hoon Kim ◽  
Jin Soo Kim
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Growth Factor Receptor ◽  
Immunohistochemical Analysis ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
Lymph Node Biopsy ◽  
Adjuvant Radiation ◽  
Axillary Lymph ◽  
Axillary Metastasis

We report the case of a 43-year-old woman with primary left breast cancer presenting metastatic lymphadenopathy in the contralateral axilla. This patient represents a diagnostic and therapeutic challenge because primary breast cancer, occult contralateral breast cancer, and extra-mammary primary lesion can all be the source of the contralateral axillary metastasis. Left breast-conserving surgery, left sentinel lymph node biopsy, right breast mass excision, and right axillary lymph node dissection were performed. Immunohistochemical analysis revealed that the left breast cancer specimen was positive for estrogen receptor (ER) and progesterone receptor (PR), but negative for human epidermal growth factor receptor 2 (HER2). In contrast, the right axillary lymphadenopathy specimen was negative for ER and PR, but positive for HER2. Further investigation revealed no evidence of occult primary cancers or extra-mammary tumors. After surgical intervention, the patient was treated with adjuvant chemotherapy, adjuvant radiation therapy, and targeted therapy with trastuzumab. Two years after diagnosis, she is free of disease and presently being treated with tamoxifen.

scholarly journals Metastasis of breast cancer to bladder

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Asma Hadhri ◽  
Rim Abidi ◽  
Najet Mahjoub ◽  
Alia Mousli ◽  
Khalil Mahjoubi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lobular Carcinoma ◽  
Bladder Wall ◽  
Hormonal Treatment ◽  
Left Breast ◽  
Case Presentation ◽  
History Of ◽  
Bladder Metastasis ◽  
One Year ◽  
Immunohistochemical Studies

Abstract Background Breast cancer is the leading cause of cancer death in women, and most breast cancer related deaths are due to metastasis. Urinary bladder metastasis from breast cancer is rarely reported in the literature. Case presentation We report a case of a 77-year-old female with history of left breast cancer, who presented a thickening of the bladder wall at pelvic ultrasound. Biopsy confirmed that the origin was lobular carcinoma of breast origin. The patient received chemotherapy, but the clinical course of the patient was very aggressive and she died one year later. Conclusion Bladder metastasis from breast cancer is rare, but the literature reveals an increase in such occurrence over the last few years. Pathologic diagnosis relies on immunohistochemical studies. Chemotherapy and hormonal treatment represent the standard therapy, with radiotherapy being used only to control bladder bleeding. The prognosis is usually poor.

scholarly journals Modern Rotational Radiation Techniques with Volumetric Modulated Arc Therapy or Helical Tomotherapy for Optimal Sparing of the Lung and Heart in Left-Breast Cancer Radiotherapy Plus Regional Nodal Irradiation: A Comparative Dosimetric Analysis

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5043
Author(s):  
Pei-Yu Hou ◽  
Chen-Hsi Hsieh ◽  
Le-Jung Wu ◽  
Chen-Xiong Hsu ◽  
Deng-Yu Kuo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Subgroup Analysis ◽  
Helical Tomotherapy ◽  
Volumetric Modulated Arc Therapy ◽  
Left Breast ◽  
Contralateral Breast ◽  
Normal Organ ◽  
Regional Nodal Irradiation ◽  
Optimal Technique ◽  
Arc Therapy

Background: For advanced breast cancer with lymph node involvement, adjuvant radiotherapy (RT) with regional nodal irradiation (RNI) has been indicated to reduce cancer recurrence and mortality. However, an extensive RT volume is associated with normal organ exposure, which increases the toxicity and affects patient outcomes. Modern arc RT techniques can improve normal organ sparing compared with conventional techniques. The aim of this study was to explore the optimal technique for left-breast RT with RNI. Methods: We retrospectively reviewed patients receiving RT with RNI for left-breast cancer. We used modern arc RT techniques with either volumetric-modulated arc therapy (VMAT) or helical tomotherapy (HT) with a novel block technique, and compared differences in dosimetry parameters between the two groups. Subgroup analysis of RNI with or without internal mammary node (IMN) volume was also performed. Results: A total of 108 eligible patients were enrolled between 2017 and 2020, of whom 70 received VMAT and 38 received HT. The median RT dose was 55 Gy. No significant differences were found regarding the surgery, RT dose, number of fractions, target volume, and RNI volume between the VMAT and HT groups. VMAT reduced the heart mean dose more than HT (3.82 vs. 5.13 Gy, p < 0.001), as well as the cardiac parameters of V5-V20, whole-lung mean dose, lung parameters of V5-V20, and contralateral-breast and esophagus mean dose. In the subgroup analysis of RNI with IMNs, the advantage of VMAT persisted in protecting the heart, lung, contralateral breast, and esophagus. HT was beneficial for lowering the thyroid mean dose. For RNI without IMN, VMAT improved the low-dose exposure of the heart and lung, but HT was similar to VMAT in terms of heart, whole-lung, and contralateral-breast mean dose. Conclusions: For patients with left-breast cancer receiving adjuvant RT with RNI, VMAT reduced the exposure dose to the heart, lung, contralateral breast, and esophagus compared with HT. VMAT was superior to HT in terms of normal organ sparing in the patients who underwent RNI with IMN irradiation. Considering the reduction in normal organ exposure and potential toxicity, VMAT is the optimal technique for patients receiving RNI when deep inspiration breath-hold is not available.

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