scholarly journals Optimization of Adjuvant Radiation in Breast Conservation Therapy: Can We Minimize without Compromise?

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Sophia M. Edwards-Bennett ◽  
Candace R. Correa ◽  
Eleanor E. Harris
Keyword(s):  
Radiation Therapy ◽  
Recent Literature ◽  
Radiation Treatment ◽  
Breast Conservation ◽  
Breast Conservation Therapy ◽  
Breast Conservation Surgery ◽  
Adjuvant Radiation ◽  
Time Commitment ◽  
Conservation Surgery ◽  
Overall Survival Benefit

Adjuvant breast radiation therapy after breast conservation surgery is recommended as it yields significant reduction in the risk of local recurrence, and confers a potential overall survival benefit. Although the standard breast radiation regimen has historically been delivered over 5–7 weeks; more novel, shorter courses of breast radiation are currently being employed, offering the advantage of more convenience and less time-commitment. Herein, we review the recent literature substantiating these abbreviated radiation treatment approaches and the methods of delivery thereof. In addition, we discuss imaged guided techniques currently being utilized to further refine the delivery of adjuvant breast radiation therapy.

scholarly journals INCIDENCE OF BREAST LYMPHEDEMA AND PREDICTORS OF ITS DEVELOPMENT IN PATIENTS RECEIVING WHOLE BREAST RADIATION THERAPY AFTER BREAST-CONSERVATION SURGERY

Lymphology ◽  
2020 ◽  
Vol 52 (3) ◽  
Author(s):  
RG Ganju ◽  
G Savvides ◽  
S Korentager ◽  
MJ Ward ◽  
M TenNapel ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Breast Conservation ◽  
Breast Conservation Surgery ◽  
Common Finding ◽  
Adjuvant Radiation ◽  
Increased Risk ◽  
Conservation Surgery ◽  
Arm Lymphedema ◽  
Chi Square Analysis

One common adverse effect following breast-conservation surgery and adjuvant radiation is lymphedema. While lymphedema of the arm has been well-characterized, there has been less investigation into lymphedema of the breast. We sought to characterize rates of breast lymphedema (BLE) in women with early-stage breast cancer and identify potential predictors in its development. Two hundred and thirty consecutive patients treated with lumpectomy and adjuvant whole breast radiation therapy (WBRT) from January 2016 - June 2017 were included. All patients were seen in our lymphedema monitoring clinic for baseline and at least one follow-up lymphedema measurement. BLE grades were assigned by trained nurses in the lymphedema clinic. Data regarding patient demographic and treatment factors were extracted from the electronic medical record. Comparisons between groups were made using Chi-Square analysis performed in SAS. The median age of the sample was 62 (range 31-90). Median follow-up from surgery was 15.3 months. Forty-three patients were diagnosed with lymphedema of the breast (18.7%). Rates of grade 1 and 2 BLE were 93% and 7%, respectively; there were no cases of severe lymphedema. Sixty-three percent of cases resolved by last follow-up with treatment recommendations. There was no association between development of BLE and patient factors investigated, including age, T stage, radiation dose and fractionation, lymph node biopsy, number of lymph nodes removed, development of arm lymphedema, and use of chemotherapy. Tumor subtype was found to be significant (P = 0.04) and there was a trend towards significance for receipt of trastuzumab (P = 0.09). BLE is a distinct entity from arm lymphedema and is a common finding in women treated with breast-conserving surgery and adjuvant WBRT. It is a generally mild and self-limiting process. There were no treatment or patient-related factors that correlated with increased risk of lymphedema development in our sample except for HER-2 positive disease and receipt of trastuzamab.

Experience with Reduction Mammaplasty following Breast Conservation Surgery and Radiation Therapy

1998 ◽  
Vol 102 (6) ◽  
pp. 1913-1916 ◽  
Author(s):  
Scott L. Spear ◽  
James Benjamin Burke ◽  
Douglas Forman ◽  
Rebeeca A. Zuurbier ◽  
Christine D. Berg
Keyword(s):  
Radiation Therapy ◽  
Reduction Mammaplasty ◽  
Breast Conservation ◽  
Breast Conservation Surgery ◽  
Conservation Surgery

scholarly journals Underuse of Radiation Therapy After Breast Conservation Surgery in Puerto Rico: A Puerto Rico Central Cancer Registry–Health Insurance Linkage Database Study

2018 ◽  
pp. 1-9
Author(s):  
William W. Chance ◽  
Karen J. Ortiz-Ortiz ◽  
Kai-Ping Liao ◽  
Diego E. Zavala Zegarra ◽  
Michael C. Stauder ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Puerto Rico ◽  
Radiation Therapy ◽  
Health Insurance ◽  
Invasive Breast Cancer ◽  
Breast Conservation ◽  
Breast Conservation Surgery ◽  
Conservation Surgery ◽  
To Receive ◽  
Central Cancer Registry

Purpose To identify rates of postoperative radiation therapy (RT) after breast conservation surgery (BCS) in women with stage I or II invasive breast cancer treated in Puerto Rico and to examine the sociodemographic and health services characteristics associated with variations in receipt of RT. Methods The Puerto Rico Central Cancer Registry–Health Insurance Linkage Database was used to identify patients diagnosed with invasive breast cancer between 2008 and 2012 in Puerto Rico. Claims codes identified the type of surgery and the use of RT. Logistic regression models were used to examine the independent association between sociodemographic and clinical covariates. Results Among women who received BCS as their primary definitive treatment, 64% received adjuvant RT. Significant predictors of RT after BCS included enrollment in Medicare (odds ratio [OR], 2.14; 95% CI, 1.46 to 3.13; P ≤ .01) and dual eligibility for Medicare and Medicaid (OR, 1.61; 95% CI, 1.14 to 2.27; P < .01). In addition, it was found that RT was more likely to have been received in certain geographic locations, including the Metro-North (OR, 2.20; 95% CI, 1.48 to 3.28; P < .01), North (OR, 1.78; 95% CI, 1.20 to 2.64; P < .01), West (OR, 4.04; 95% CI, 2.61 to 6.25; P < .01), and Southwest (OR, 2.79; 95% CI, 1.70 to 4.59; P < .01). Furthermore, patients with tumor size > 2.0 cm and ≤ 5.0 cm (OR, 0.61; 95% CI, 0.40 to 0.93; P = .02) and those with tumor size > 5.0 cm (OR, 0.37; 95% CI, 0.15 to 0.92; P = .03) were found to be significantly less likely to receive RT. Conclusion Underuse of RT after BCS was identified in Puerto Rico. Patients enrolled in Medicare and those who were dually eligible for Medicaid and Medicare were more likely to receive RT after BCS compared with patients with Medicaid alone. There were geographic variations in the receipt of RT on the island.

Predictors of adjuvant radiation therapy in the treatment of male breast cancer and its impact on outcomes: A propensity matched analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12516-e12516
Author(s):  
Veli Bakalov ◽  
Thejus Thayyil Jayakrishnan ◽  
Stephen Abel ◽  
Christie Hilton ◽  
Bindu Rusia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Male Breast Cancer ◽  
Cox Regression ◽  
Breast Conservation ◽  
Male Breast ◽  
Breast Conservation Surgery ◽  
P Value ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy

e12516 Background: Male breast cancer (MBC) accounts for 1% of all breast cancers and there is a paucity of data on factors impacting the treatment strategies and outcomes. We hypothesized that adjuvant radiation therapy (Adj-RT) may improve survival outcomes and sought to examine predictive factors for Adj-RT receipt. Methods: We queried the National Cancer Database (NCDB) for patients with stages I-III MBC treated with surgery (breast conservation surgery- BCS or mastectomy-MS) within 180 days of diagnosis (years 2004-2015). Multivariable logistic regression identified predictors of adjuvant radiation therapy receipt. Multivariable Cox regression evaluated predictors of survival. Propensity matching for adj-RT accounted for indication biases. Results: We identified 6,217 patients meeting the eligibility criteria (1457 BCS vs. 4760 MS). The majority of patients were white (85%) and within the age range of 50-80 years (74%). Although Adj-RT was omitted for 30% of BCS patients, the utilization was higher compared to MS (OR=26, p-value=0.001). The predictors of Adj-RT use were – African American race, higher stage, higher grade, presence of lymphovascular invasion and ER/Her-2 positivity for the entire cohort and higher age, urban location and higher income for BCS. Adj-RT was associated with lower mortality in the propensity matched model (overall HR for BCS=0.28, p-value<0.001; overall HR for MS=0.62,p-value=0.001) and is shown in the table. Conclusions: This study demonstrates there may be an association between decreased mortality and Adj-RT in MBC undergoing BCS. Although this implies that Adj-RT should be routinely delivered, it appears to be omitted frequently and its use requires further investigation. The study also suggests a benefit to Adj-Rt after MS for stage-III MBC. [Table: see text]

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