Effect of Inherited Breast Cancer Susceptability on Treatment Outcomes After Conservative Surgery and Radiation Therapy

1999 ◽  
Author(s):  
Asa J. Nixon
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Treatment Outcomes ◽  
Conservative Surgery ◽  
Inherited Breast Cancer

Correlation Between Toxicity and Dosimetric Parameters in Patients Treated with Adjuvant Intensity-Modulated Radiation Therapy for Breast Cancer: The Results of a Prospective Study.

2020 ◽  
Author(s):  
David Pasquier ◽  
Benoit Bataille ◽  
Florence Le Tinier ◽  
Raoudha Bennadji ◽  
Hélène Langin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Late Onset ◽  
Univariate Analysis ◽  
Intensity Modulated Radiation Therapy ◽  
Conservative Surgery ◽  
High Dose ◽  
Total Mastectomy ◽  
Intensity Modulated ◽  
A Prospective Study

Abstract Background. In the treatment of breast cancer, intensity-modulated radiation therapy (IMRT) reportedly reduces the high-dose irradiation of at-risk organs and decreases the frequency of adverse events (AEs). Comparisons with conventional radiotherapy have shown that IMRT is associated with lower frequencies of acute and late-onset AEs. Here, we extended a prospective, observational, single-center study of the safety of IMRT to a second investigating center. Methods. Patients scheduled for adjuvant IMRT after partial or total mastectomy were given a dose of 50 Gy (25 fractions of 2 Gy over five weeks), with a simultaneous integrated boost in patients having undergone conservative surgery. Results. 300 patients were included in the study, and 288 were analyzed. The median follow-up period was 2.1 years. Most AEs were mild. The most common AEs were skin-related - mainly radiodermatitis (in 266 patients (92.4%)) and hyperpigmentation (in 178 (61.8%)). Smoking (odds ratio) [95%CI] = 2.10 [1.14–3.87]; p = 0.017), no prior chemotherapy (0.52 [0.27–0.98]; p = 0.044), and D98% for subclavicular skin (1.030 [1.001–1.061]; p = 0.045) were associated with grade ≥ 2 acute AEs. In a univariate analysis, the mean dose, (p < 0.0001), D2% (p < 0.0001), D50% (p = 0.037), D95% (p = 0.0005), D98% (p = 0.0007), V30Gy (p < 0.0001), and V45Gy (p = 0.0001) were significantly associated with grade ≥ 1 acute esophageal AEs. In a multivariate analysis, D95% for the skin (p < 0.001), D98% for the subclavicular skin and low D95% for the internal mammary lymph nodes were associated with grade ≥ 1 medium-term AEs. Conclusions. The safety profile of adjuvant IMRT after partial or total mastectomy is influenced by dosimetric parameters. Trial registration: ClinicalTrials.gov NCT02281149

Patient preferences concerning the trade-off between the risks and benefits of routine radiation therapy after conservative surgery for early-stage breast cancer.

1997 ◽  
Vol 15 (3) ◽  
pp. 1252-1260 ◽  
Author(s):  
J A Hayman ◽  
D L Fairclough ◽  
J R Harris ◽  
J C Weeks
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Local Recurrence ◽  
Early Stage ◽  
Conservative Surgery ◽  
Sociodemographic Factors ◽  
Early Stage Breast Cancer ◽  
Health States ◽  
Trade Off ◽  
Risks And Benefits

PURPOSE To assess patients' preferences regarding the trade-off between risks and benefits of radiation therapy after conservative surgery for early-stage breast cancer. PATIENTS AND METHODS Utilities (measures of preference) of 97 early-stage breast cancer patients treated with conservative surgery and radiation therapy and 20 medical oncology nurses were assessed for five health states using standard gambles. RESULTS Patients had the highest mean utility for treatment with conservative surgery and radiation therapy without a local recurrence (0.92), intermediate utilities for treatment with conservative surgery alone followed either by no local recurrence or by a local recurrence salvaged by conservative surgery and radiation therapy (0.88 and 0.87, respectively), and the lowest utilities for treatment with or without radiation therapy followed by a local recurrence salvaged by mastectomy and reconstructive surgery (0.82 and 0.81, respectively). All differences between health states' utilities were significant (P < .0001), except between the two intermediate and two lowest rated health states. None of the clinical or sociodemographic factors examined explained more than 5% of the variability in the patients' utilities or their differences. Nurses' utilities were similar to those of the patients. CONCLUSIONS These results strongly suggest that fear of a local recurrence and an actual local recurrence leading to mastectomy have such a negative impact on quality of life that patients are willing to accept the risks and inconvenience of radiation therapy to avoid them. There is also considerable interpatient variability that was not explained by the clinical or sociodemographic factors examined.

No long-term increase in cardiac-related mortality after breast-conserving surgery and radiation therapy using modern techniques.

1998 ◽  
Vol 16 (4) ◽  
pp. 1374-1379 ◽  
Author(s):  
A J Nixon ◽  
J Manola ◽  
R Gelman ◽  
B Bornstein ◽  
A Abner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Conservative Surgery ◽  
Breast Conserving Surgery ◽  
Breast Irradiation ◽  
Breast Radiotherapy ◽  
Treatment Characteristics ◽  
Increased Risk ◽  
Significant Difference ◽  
Related Mortality

PURPOSE To determine whether left-breast irradiation using modern techniques after breast-conserving surgery leads to an increased risk of cardiac-related mortality. METHODS Between 1968 and 1986, 1,624 patients were treated for unilateral stage I or II breast cancer at the Joint Center for Radiation Therapy, Harvard Medical School, Boston, MA, with conservative surgery and breast irradiation. Seven hundred forty-five patients with a potential follow-up of at least 12 years were analyzed. Clinical, pathologic, and treatment characteristics were compared between the 365 patients (49%) who received left-sided irradiation and the 380 patients (51%) who received right-sided irradiation. The relationship between left-sided breast irradiation and the risk of nonbreast cancer- and cardiac-related mortality was examined. RESULTS There was no significant difference in the distribution of clinical, pathologic, or treatment characteristics between the two groups, with the exception of a small difference in pathologic tumor size (medians, left, 2.0 cm, right, 1.5 cm; P = .007). At 12 years, a majority of patients still were alive. Slightly more patients with left-sided tumors had died of breast cancer (31% v 27%; P = NS). Equivalent proportions from each group died of nonbreast cancer causes (11%), including nine patients (2%) from each group who died from cardiac causes. The risk of cardiac mortality did not increase as time after treatment increased for patients who received left-sided irradiation compared with right-sided irradiation. A model that controlled for clinical, pathologic, and treatment differences showed no significant increase in any category of cause of death (breast, cardiac, or other) for patients who received left-sided irradiation. CONCLUSION These results suggest that modern breast radiotherapy is not associated with an increased risk of cardiac-related mortality within at least the first 12 years after treatment.

Early-stage breast cancer: local control after conservative surgery and radiation therapy with immediate interstitial boost.

Radiology ◽  
1993 ◽  
Vol 187 (1) ◽  
pp. 95-98 ◽  
Author(s):  
L Krishnan ◽  
W R Jewell ◽  
C M Mansfield ◽  
E K Reddy ◽  
J H Thomas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Local Control ◽  
Early Stage ◽  
Conservative Surgery ◽  
Early Stage Breast Cancer
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