A prospective comparison of subjective and objective assessments of cosmetic outcomes following breast brachytherapy.

A prospective comparison of subjective and objective assessments of cosmetic outcomes following breast brachytherapy. J Contemp Brachytherapy. 2019 Jun;11(3):207-214 Authors: Wadasadawala T, Sinha S, Verma S, Parmar V, Kannan S, Pathak R, Sarin R, Gaikar M Abstract Purpose: We evaluated agreement between subjective and objective methods of cosmesis scoring in an accelerated partial breast irradiation (APBI) cohort. Material and methods: Consecutive women treated with APBI using interstitial brachytherapy reported for clinical follow-up every 6 months. Single cross-sectional assessment of the breast cosmesis was done by a radiation oncologist (subjective method) using Harvard scale and by photographic assessment using BCCT.core (Breast Cancer Conservative Treatment. Cosmetic results, version 3.1) software (objective method) at 18-36 months post-APBI. The agreement between subjective and objective methods for the overall score as well as individual subjective/objective subdomains was computed using kappa statistics. ANOVA was used to test the correlation between objective indices and subjective subdomains. Results: The agreement between the subjective (physician) and objective assessment was good with a kappa of 0.673. Overall, 77 (98.7%) patients were satisfied with the overall outcomes of breast conservation therapy. The kappa agreement between physician and patient scoring was 0.457 (95% CI: 0.240-0.674). Among the subjective subdomains, location...
Source: Journal of Contemporary Brachytherapy - Category: Cancer & Oncology Tags: J Contemp Brachytherapy Source Type: research

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ute;n JI, Lara PC Abstract Patients with low-risk invasive ductal carcinoma treated with breast-conserving surgery (BCS) were included in a multicatheter brachytherapy APBI protocol. The primary endpoint was ipsilateral breast recurrence. Between December 2008-December 2017, 186 low-risk breast cancer patients were treated with APBI using interstitial multicatheter brachytherapy and followed prospectively. At 5-years of follow-up, cumulative local recurrence (LR) and cause-specific survival was 1.1% (95% CI 0.3-1.9) and 98.3% (95% CI 97.3-99.3%) respectively. No grade 3 adverse effects were observed. Postoperative...
Source: Breast - Category: Cancer & Oncology Authors: Tags: Breast Source Type: research
After breast conserving surgery (BCS) of invasive cancer, whole breast irradiation (WBI) with daily fractions of 2  Gy up to 50 Gy was considered as treatment standard for decades. An additional dose augmentation to the tumor bed further increased local control [1–3]. These boosts are mostly administered by external electrons or brachytherapy [4,5]. As an alternative, intraoperative radiation with electrons (IOERT) was introduced two decades ago [6]. As early as in 1989, Fowler JF et al have proposed that the α/β ratio of breast cancer might be as low as around 4 [7], which prompted randomized tr...
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
Publication date: Available online 5 December 2019Source: The LancetAuthor(s): Frank A Vicini, Reena S Cecchini, Julia R White, Douglas W Arthur, Thomas B Julian, Rachel A Rabinovitch, Robert R Kuske, Patricia A Ganz, David S Parda, Michael F Scheier, Kathryn A Winter, Soonmyung Paik, Henry M Kuerer, Laura A Vallow, Lori J Pierce, Eleftherios P Mamounas, Beryl McCormick, Joseph P Costantino, Harry D Bear, Isabelle GermainSummaryBackgroundWhole-breast irradiation after breast-conserving surgery for patients with early-stage breast cancer decreases ipsilateral breast-tumour recurrence (IBTR), yielding comparable results to m...
Source: The Lancet - Category: General Medicine Source Type: research
ConclusionPRT/PCRT is associated with low grades of fibrosis and a  good to excellent long-term cosmetic outcome.
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
This report details our experience using accelerated partial breast irradiation (APBI) as a component of salvage breast conserving treatment.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research
We present Results of quality of life assessment comparison between APBI and WBI in early breast cancer.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research
ConclusionsThe local recurrence risk reduction of the tumour bed boost in breast-conserving therapy is not influenced by the applied boost technique.
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
In this study, the effect of a subcutaneous spacer injection on the skin dose, late skin toxicity, and cosmetic outcome is tested in patients treated with PBSI in the setting of breast-conserving therapy. Our results will be relevant for most forms of breast brachytherapy as well as robotic radiosurgery, as skin spacers could protect the skin with these other techniques.Trial registrationNetherlands Trial Register,NTR6549. Registered on 27 June 2017.
Source: Trials - Category: Research Source Type: clinical trials
This study aimed to estimate the probability of an unfavourable aesthetic outcome (AO) 2  years after breast-conserving therapy (BCT) and evaluate the possible influence of brachytherapy (BT) and external beam radiotherapy (EBRT) boost on patient-reported outcomes (PROs) and AO.Patients and methodsPatients treated with BCT starting April 2015 were prospectively included. Selection of the boost technique followed an in-house flowchart based on the depth of the tumour bed. An electron boost was performed for a  superficial clinical target volume (maximum 28 mm under the epidermis), a BT boost was proposed in...
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
This report reviews our available data to provide an analysis of patient outcomes over 12 years of use at a single institution. A retrospective review was conducted of records of 150 patients who underwent APBI or attempted APBI after breast-sparing surgeries between 2006 and 2017. These charts were analyzed for documentation of patient age, cancer stage, incidence of recurrence, and posttreatment complications. Of the patients evaluated, 99 per cent (149/150) completed treatment. The median time since treatment completion is now 8.9 years. One hundred eleven patients (74% ) are now greater than five years posttreatment. I...
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
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