scholarly journals Breast Conserving Treatment for Breast Cancer: Dosimetric Comparison of Sequential versus Simultaneous Integrated Photon Boost

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Hilde Van Parijs ◽  
Truus Reynders ◽  
Karina Heuninckx ◽  
Dirk Verellen ◽  
Guy Storme ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Helical Tomotherapy ◽  
Organs At Risk ◽  
Standard Of Care ◽  
Breast Conserving Surgery ◽  
Conventional Technique ◽  
Breast Conserving Treatment ◽  
Safe Alternative ◽  
Dosimetric Comparison ◽  
Sequential Boost

Background. Breast conserving surgery followed by whole breast irradiation is widely accepted as standard of care for early breast cancer. Addition of a boost dose to the initial tumor area further reduces local recurrences. We investigated the dosimetric benefits of a simultaneously integrated boost (SIB) compared to a sequential boost to hypofractionate the boost volume, while maintaining normofractionation on the breast.Methods. For 10 patients 4 treatment plans were deployed, 1 with a sequential photon boost, and 3 with different SIB techniques: on a conventional linear accelerator, helical TomoTherapy, and static TomoDirect. Dosimetric comparison was performed.Results. PTV-coverage was good in all techniques. Conformity was better with all SIB techniques compared to sequential boost (P= 0.0001). There was less dose spilling to the ipsilateral breast outside the PTVboost (P= 0.04). The dose to the organs at risk (OAR) was not influenced by SIB compared to sequential boost. Helical TomoTherapy showed a higher mean dose to the contralateral breast, but less than 5 Gy for each patient.Conclusions. SIB showed less dose spilling within the breast and equal dose to OAR compared to sequential boost. Both helical TomoTherapy and the conventional technique delivered acceptable dosimetry. SIB seems a safe alternative and can be implemented in clinical routine.

scholarly journals Breast-conserving treatment in oncoplastic times: indications, cosmesis, and quality of life

Mastology ◽  
2021 ◽  
Vol 31 ◽  
Author(s):  
Idam de Oliveira-Junior ◽  
Raphael Luiz Haikel ◽  
René Aloísio da Costa Vieira
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Conserving Surgery ◽  
Safe Procedure ◽  
Breast Conserving Treatment ◽  
Oncological Treatment ◽  
Life Data ◽  
Generic Term ◽  
Cosmetic Outcomes

Breast-conserving treatment was established as an oncologically safe procedure for breast cancer. However, the cosmetic outcomes of breast-conserving treatments are often unsatisfactory. In this scenario, oncoplastic breast-conserving surgery incorporated plastic surgery concepts and techniques into the oncological treatment in order to ensure better cosmesis, thus increasing the indications for breast-conserving treatment. At the same time, oncoplastic breast-conserving surgery is usually presented as a generic term, which should be evaluated taking many aspects into account: indication, patient selection, the surgery itself, cosmetic quality, and quality of life — data that are still scarce in the literature.

Breast Cancer Surgery

2019 ◽  
pp. 144-156
Author(s):  
Peter A. van Dam ◽  
Cary Kaufman ◽  
Carlos Garcia-Etienne ◽  
Marie-Jeanne Vrancken Peeters ◽  
Robert Mansel
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Diseases ◽  
Breast Cancer Patients ◽  
Breast Conserving Treatment ◽  
Sentinel Node Concept

Abstract: The role of the surgeon managing breast diseases has been the subject of continuous evolution, moving from the cancer-extirpative surgeon to a deeply informed surgical leader, who interacts in a multidisciplinary setting also encompassing tasks for risk assessment, genetic counselling, and new diagnostic approaches. Surgical removal of the tumour remains the cornerstone in treating early stage breast cancer. During the last century, breast cancer surgery became less radical, breast-conserving treatment emerged, and the role of axillary lymphadenectomy changed from a therapeutic procedure into a staging procedure with prognostic implications. Later, the sentinel node concept reduced the need for complete axillary clearance in most cases. Nowadays, thanks to breast-conserving surgery, oncoplastic techniques, and reconstructive procedures, most breast cancer patients can overcome this disease without serious permanent physical mutilation. A multidisciplinary approach, benchmarking, and quality assurance have improved outcomes markedly.

Dosimetric comparison of volumetric-modulated arc therapy and helical tomotherapy for adjuvant treatment of bilateral breast cancer

2020 ◽  
pp. 1-9
Author(s):  
Reena Phurailatpam ◽  
Tabassum Wadasadawala ◽  
Kamalnayan Chauhan ◽  
Subhajit Panda ◽  
Rajiv Sarin
Keyword(s):  
Breast Cancer ◽  
Helical Tomotherapy ◽  
Treatment Time ◽  
Volumetric Modulated Arc Therapy ◽  
Bilateral Breast Cancer ◽  
Whole Body ◽  
Dosimetric Comparison ◽  
Significant Difference ◽  
Arc Therapy ◽  
The Mean

Abstract Purpose: Dosimetric comparison between volumetric-modulated arc therapy (VMAT) and helical tomotherapy (HT) in the treatment of bilateral breast cancer (BBC). Materials and methods: Ten patients treated on HT were selected retrospectively. Dose prescription was 50 Gy in 25 fractions to breast/chest wall and supraclavicular fossa (SCF) while tumour bed was simultaneously boosted to 61 Gy in 25 fractions. VMAT plans were made with four mono-isocentric partial arcs. The monitoring unit (MU) and treatment time were used to quantify the treatment efficiency. Target volumes were compared for homogeneity index (HI), conformity index (CI) while organs at risk (OARs) were compared for relevant dose volumes and integral doses (IDs). Result: For targets, no significant difference is observed between VMAT and HT in CI but VMAT could give better HI. The mean lung dose, V20 and V5 is 10·6 Gy versus 8·4 Gy (p-value 0·03), 12% versus 11·5% (p-value 0·5) and 78·1% versus 43·4% (p-value 0·005), respectively. The mean heart dose, V30 and V5 is 4·9 Gy versus 4·7 Gy (p-value 0·88), 0·5% versus 1·5% (p-value 0·18) and 26·2% versus 22·8% (p-value 0·4). Integral dose (ID) for the whole body and heart are comparable: 289 Gy kg versus 299 Gy kg (p-value 0·24) and 2·9 Gy kg versus 2·8 Gy kg (p-value 0·80). ID for lungs was significantly higher with VMAT: 7·9 Gy kg versus 6·3 Gy kg (p-value 0·03). There is a 53% reduction in treatment time and 78% in MU with VMAT against HT. Conclusion: VMAT can generate clinically acceptable plans comparable to HT for BBC. HT shows better control over low dose spillage in lungs compared to VMAT thereby increasing ID to lungs. VMAT shows better homogeneity and efficient treatment delivery than HT.

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