Why Do Physicians Overtreat Elderly Breast Cancer Patients? Why Do Physicians Overtreat Elderly Breast Cancer Patients?
Drs Kathy Miller and Reshma Jagsi on the reasons behind practitioners'reluctance to omit radiation therapy in older patients.Medscape Oncology
Conclusions: This SEER analysis demonstrates that a substantial proportion of women with early stage breast cancer are eligible for HFRT, APBI, or ET alone after breast conserving surgery according to consensus guidelines and prospective trial criteria. With incorporation of additional pathologic, dosimetric, and chemotherapy data, quality assurance pathways may use such data to help ensure patients are receiving appropriate risk stratified treatment recommendations.
Condition: Breast Cancer Female Intervention: Procedure: Breast reconstructive surgery Sponsor: Yonsei University Recruiting
Deep inspiration breath hold (DIBH) reduces cardiac radiation exposure by creating cardiac –chest wall separation in breast cancer radiotherapy. DIBH requires sustaining chest wall expansion for up to 40 s and involves complex co-ordination of thoraco-abdominal muscles, which may not be intuitive to patients. We investigated the effect of in-advance preparatory DIBH coaching and home p ractice on cardiac doses.
In this study, evaluation was made to determine efficiency of gold-silica shell-core NP in megavoltage irradiation of MCF7 breath cancer cells. MATERIALS AND METHODS: Gold-silicon oxide shell-core NPs were obtained by conjugation of gold NP with amine or thiol functionalized silica NPs (AuN@SiO2 and AuS@SiO2). Cellular uptake and cytotoxicity of NPs were examined by fluorescent microscopy and MTT assay, respectively. MCF-7 breast cancer cells were treated with both NPs and irradiation was made with X-ray energies of 6 and 18 MV to the absorbed dose of 2, 4 and 8 Gy using Simense linear accelerator. The ef...
Conclusions: The once-weekly hypofractionated radiotherapy is a feasible and convenient option for elderly patients with breast cancer. It is a safe treatment modality with similar survival and local control results compared to standard fractionation, while the side effects are acceptable. PMID: 29736399 [PubMed - in process]
Conclusions While new advances in plastic surgery may improve on cosmetic outcomes for breast cancer patients, increased discussion with radiation oncologists is needed to appropriately select candidates for these procedures. Prospective trials are necessary to ensure that these new techniques do not compromise oncologic outcomes.
Conclusions: As in the 2017 U.S. National Comprehensive Cancer Network guidelines, we recommend high-risk imaging for women in Ontario who are heterozygous for a pathogenic ATM variant. Currently, ATM carrier status should not influence decisions about systemic or radiation therapy in the setting of an established breast cancer diagnosis. PMID: 29719442 [PubMed - in process]
Authors: Koulis TA, Dang A, Speers C, Olson RA Abstract Background: Radiation therapy (rt) after mastectomy for breast cancer can improve survival outcomes, but has been associated with inferior cosmesis after breast reconstruction. In the literature, rt dose and fractionation schedules are inconsistently reported. We sought to determine the pattern of rt prescribing practices in a provincial rt program for patients treated with mastectomy and reconstruction. Methods: Women diagnosed with stages 0-iii breast cancer between January 2012 and December 2013 and treated with curative-intent rt were identified from a...
AbstractPurpose of ReviewThe treatment of breast cancer in the elderly population requires a tailored approach. We summarize the current best evidence for personalized local-regional therapy in breast cancer patients older than 70.Recent FindingsBreast cancer treatment in older adults incorporates the use of geriatric assessment tools to best evaluate functional status and treatment tolerability while accounting for the biologic profile of the disease. Surgical resection of the primary tumor with lymph node evaluation remains the cornerstone of local-regional control. Recent clinical trials demonstrate that surgery and rad...
Summary: In a randomized trial in patients with left-sided node-positive breast cancer receiving regional nodal radiotherapy, we observed lower doses to the heart and lungs with IMRT and deep inspiration breath-hold (DIBH) as compared to free-breathing three-dimensional conformal therapy. Patients treated with IMRT-DIBH experienced a lesser difference in left ventricular ejection fraction between baseline and one year. This should motivate larger studies evaluating whether such approaches may result in better preservation of cardiac left ventricular function.