scholarly journals Breast cancer associated with pregnancy

2021 ◽  
Vol 20 (2) ◽  
pp. 75-79
Author(s):  
N. V. Zakharova ◽  
О. S. Tereshin ◽  
D. N. Bulinsky ◽  
I. V. Udovichenko ◽  
V. V. Samylov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Hormone Therapy ◽  
Left Lung ◽  
Detection Methods ◽  
Special Treatment ◽  
Long Time ◽  
Chemotherapeutic Treatment ◽  
Long Term Prognosis ◽  
Late Childbearing

Introduction. The problem of breast cancer associated with pregnancy for a long time attracts close attention. The incidence is relatively increasing, thanks in part to improved detection methods, but also to the growing trend towards late childbearing.Material and methods. The features of breast cancer treatment during pregnancy were studied, and the effect of pregnancy on the long-term prognosis and clinical course of breast cancer was evaluated.Results. All patients received treatment according to the clinical recommendations. Chemotherapeutic treatment was performed in 44 (77%) patients, surgical treatment in 54 (96%) cases, radiation therapy in 40(72%) patients, and hormone therapy in 24 (42%) women. Among the newborns, there were no significant malformations, one child (a girl) had an underdevelopment of the left lung tissue, and laterphysical development in accordance with age.Conclusion. The decision on the special treatment of breast cancer associated with pregnancy is made individually, the treatment has been planned together with obstetricians and gynecologists. Surgical and chemotherapeutic treatment (starting at 13 weeks) can be performed during pregnancy. Radiation therapy, hormone therapy, and targeted therapy should be postponed until delivery. Most patients have common forms of the disease and aggressive biological types of tumors. Currently, the features of the course of the disease, the prognosis, and the features of treatment in this category of patients are being studied.

scholarly journals Clinical case of the treatment of metastatic luminal breast cancer

2021 ◽  
pp. 160-166
Author(s):  
A. F. Nasretdinov ◽  
A. V. Sultanbaev ◽  
K. V. Menshikov ◽  
Sh. I. Musin ◽  
N. I. Sultanbaeva ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Hormone Therapy ◽  
Hormone Receptor ◽  
Clinical Case ◽  
Luminal Breast Cancer ◽  
Hormone Receptor Positive ◽  
Long Time ◽  
Visceral Metastases

Hormone therapy currently open up the prospect of long-term, comfortable and relatively low-toxic treatment for patients with hormone receptor – positive advanced breast cancer. For a long time, the presence of visceral metastases prompted oncologists to abandon hormone therapy in favor of cytostatic agents. Now days, even in the presence of visceral metastases, clinical guidelines allow use of modern hormonal therapy in the absence of a visceral crisis. In particular, the so-called CDK 4/6 inhibitors, presented on the Russian market by drugs: palbociclib, ribociclib and abemacyclib, became the drugs that significantly improved the  results of  hormone therapy. Each of  them has demonstrated its effectiveness in  clinical trials; moreover, there are lots of clinical cases demonstrating the benefits of this therapy in real clinical practice. The article presents a clinical case of treatment of advanced hormone receptor-positive breast cancer. The effectiveness of treatment with CDK 4/6 inhibitors has been demonstrated, a comparatively analysed with the data obtained in the course of clinical trials. The analysis of the tactics of treatment of cytomegalovirus infection of the cornea during therapy with ribociclib was carried out. 

Radiation Therapy Without Hormone Therapy for Women Age 70 or Above with Low-Risk Early Breast Cancer: A Microsimulation

2019 ◽  
Vol 105 (2) ◽  
pp. 296-306 ◽  
Author(s):  
Matthew C. Ward ◽  
Frank Vicini ◽  
Manjeet Chadha ◽  
Lori Pierce ◽  
Abram Recht ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Hormone Therapy ◽  
Early Breast Cancer ◽  
Low Risk

scholarly journals 5 years of experience with DIBH (Deep inspiration breath-hold) combined with SGRT (Surface-Guided Radiation Therapy) in left-sided breast cancer

2020 ◽  
Vol 17 (01) ◽  
pp. 14-23
Author(s):  
Claudia Steffal ◽  
Annemarie U. Schratter-Sehn ◽  
Karin Brinda-Raitmayr ◽  
Thomas Kann ◽  
Daniela Mailat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Side Effects ◽  
Left Lung ◽  
Breath Hold ◽  
Relative Reduction ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Ipsilateral Lung

Abstract Background Radiation treatment to the left breast is associated with increased cardiac morbidity as well as mortality. Deep inspiration breath-hold (DIBH) technique with Surface Guided Radiation Therapy (SGRT) could have dosimetric advantages over the free breathing technique (NB, normal breathing) in cardiac (heart and LAD) and ipsilateral lung sparing in patients with left-sided breast cancer after surgery. Therefore this technique was implemented in 2013 at the institute of radiooncology at the KFJ/SMZ-South – Hospital Vienna. Methods From Oct 2013 – December 2018 548 patients were referred to radiotherapy following conservative operation of left-sided invasive breast cancer. All patients gave their informed consent and underwent training sessions for the DIBH-technique independent of age or breathing activity or respiratory disorders. Patients who turned out to be unfit for DIBH were enrolled for NB. The relative reduction in Dmean heart and left lung dose was compared between the two cohorts. Acute radiation induced side effects were classified according to the Radiation Therapy Oncology Group/The European Organisation for Research (RTOG) 37; late toxicity rates according to the Common Terminology Criteria for Adverse Events (CTCAE Version 4.03) Results The median age of the DIBH-patients was 58 years (27–90), of the NB-patients 65 (30–80) years. Follow-up was obtained until June 2019. The median follow-up was 52 months (range 7–73 m). The average coverage of Dmean left lung was 6.91 Gy (1.44 Gy – 12.4 Gy). The average coverage of Dmean heart was 1.17 Gy (0.12 Gy – 3.19 Gy) in the DIBH-cohort. The NB – plans had a Dmean of 8.92 Gy (5.23–16.9 Gy) at the ipsilateral lung and a Dmean of 2.31 Gy (0.71–4.21 Gy) at the heart. This shows that the DIBH-technique halved the Dmean of the heart. The amount of acute side effects was comparable between the two groups: RTOG 1: 70.8 % vs. 64 %, RTOG 3 6.6 % vs. 5.6 %, no reaction 3.2 % vs. 1.4 %. There were more CTCAE 1-late events in the NB-group (51.6 % vs. 12.67 %). Conclusion Deep inspiration breath-hold (DIBH) technique with Surface Guided Radiation Therapy (SGRT) is a rather simple, reproducable method with a high acceptance of the patients who can actively participate in the whole treatment process. The mean dose at the heart and the left lung can be reduced, at the heart even by as much as 50 %.

3-D irradiated lung and heart volume predictions from 2-D datasets: Value of CT-based treatment planning in postmastectomy tangential beam radiation therapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11013-11013
Author(s):  
V. Shankar ◽  
C. Haritha ◽  
H. J. Prajapati ◽  
R. Bhatt ◽  
J. Parmar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Lung Volume ◽  
Left Lung ◽  
Slice Thickness ◽  
Breast Irradiation ◽  
Heart Volume ◽  
Beam Radiation ◽  
Lung Area ◽  
The Impact

11013 Background: Lung and heart complications in breast cancer treatment are directly related to the irradiated volumes, technique, total radiation dose and type of chemotherapy. 3D dose calcuations allow computation of the DVH’s & a realistic NTCP associated with breast cancer RT. 1) Study aims to evaluate the impact of the 2-D radiographic parameters on the volumetric dose of the lung and heart, for patients undergoing postmastectomy,postchemo radiation therapy. (2)To deduce the analytical equations for the quick estimation of the irradiated volume based on the distances obtained from the digitally reconstructed radiographs. Methods: Between August 2002–2006, 162 postmastectomy patients underwent 5wk course of tangential CW irradiation ± Axillary / SCL radiation to a total dose of 50gy/25#. After adequate immobilization on the CT compatable breast board, CT scans with 1cm slice intervalsof the chest were performed, covering lung apex to lung base. The ipsilateral total lung area and the lung area included within the treatment port were countered on each CT slice.It is multiplied by slice thickness, and then integrated in all CT slices to give volumes.Parameters used to deduce irradited lung volume (n=104) studied from the DRR included Central lung distance-CLD, Maximum perpendicular distance-MPD, Length of the lung-L & Parameters related to heart are measured only in left breast irradiation (n=58) included: Maximum heart distance-MHD, Maximum heart length MHL.Linear regression analysis is applied to test relationship between the percentage of ipsilateral lung volume involved and the CLD / MPD / L and similarly between MHD / MHL and the cardiac volume in irradiation. Results: Predicted irradiated volume for: Right Lung = 4.0118+6.6474(CLD) OR -5.965 + 6.827(MLD) Left Lung = 6.6395(CLD) OR 5.431(MLD) Heart = 7.325(MHD) OR 6.742(CLD) Conclusions: The conclusion of the present study, to the best of our knowledge, is the largest series reported so far in the literature. CLD and MLD deduced from the DRR, are the direct measures of the lung volumes irradiated in tangential breast irradiation ( r2=0.91 & 0.79).While MHD and CLD appear to be direct measure of the irraidiated heart volume (r2=0.98 & 0.91). No significant financial relationships to disclose.

Second Malignancies After Treatment of Early-Stage Breast Cancer: Lumpectomy and Radiation Therapy Versus Mastectomy

2000 ◽  
Vol 18 (12) ◽  
pp. 2406-2412 ◽  
Author(s):  
Edward Obedian ◽  
Diana B. Fischer ◽  
Bruce G. Haffty
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Hormone Therapy ◽  
Detailed Analysis ◽  
Cancer Patients ◽  
Early Stage ◽  
Contralateral Breast ◽  
Second Malignancies ◽  
Breast Cancer Patients

PURPOSE: To determine the risk of second malignancies after lumpectomy and radiation therapy (LRT), and to compare it with that in a similar cohort of early-stage breast cancer patients undergoing mastectomy without radiation (MAST). PATIENTS AND METHODS: Between January 1970 and December 1990, 1,029 breast cancer patients at our institution underwent LRT. A cohort of 1,387 breast cancer patients who underwent surgical treatment by mastectomy (MAST), and who did not receive postoperative radiation during the same time period, served as a comparison group. Second malignancies were categorized as contralateral breast versus nonbreast. In the cohort of patients undergoing LRT, a detailed analysis was carried out with respect to age, disease stage, smoking history, radiation therapy technique, dose, the use of chemotherapy or hormone therapy, and other clinical and/or pathologic characteristics. RESULTS: As of March 1999, the median follow-up was 14.6 years for the LRT group and 16 years for the MAST group. The 15-year risk of any second malignancy was nearly identical for both cohorts (17.5% v 19%, respectively). The second breast malignancy rate at 15 years was 10% for both the MAST and LRT groups. The 15-year risk of a second nonbreast malignancy was 11% for the LRT and 10% for the MAST group. In the subset of patients 45 years of age or younger at the time of treatment, the second breast and nonbreast malignancy rates at 15 years were 10% and 5% for patients undergoing LRT versus 7% and 4% for patients undergoing mastectomy (P, not statistically significant). In the detailed analysis of LRT patients, second lung malignancies were associated with a history of tobacco use. There were fewer contralateral breast tumors in patients undergoing adjuvant hormone therapy, although this did not reach statistical significance. The adjuvant use of chemotherapy did not significantly affect the risk of second malignancies. CONCLUSION: There seems to be no increased risk of second malignancies in patients undergoing LRT using modern techniques, compared with MAST. Continued monitoring of these patient cohorts will be required in order to document that these findings are maintained with even longer follow-up periods. With nearly 15 years median follow-up periods, however, these data should be reassuring to women who are considering LRT as a treatment option.

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