Management of Hereditary Breast Cancer: American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Guideline.

Management of Hereditary Breast Cancer: American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Guideline. J Clin Oncol. 2020 Apr 03;:JCO2000299 Authors: Tung NM, Boughey JC, Pierce LJ, Robson ME, Bedrosian I, Dietz JR, Dragun A, Gelpi JB, Hofstatter EW, Isaacs CJ, Jatoi I, Kennedy E, Litton JK, Mayr NA, Qamar RD, Trombetta MG, Harvey BE, Somerfield MR, Zakalik D Abstract PURPOSE: To develop recommendations for management of patients with breast cancer (BC) with germline mutations in BC susceptibility genes. METHODS: The American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology convened an Expert Panel to develop recommendations based on a systematic review of the literature and a formal consensus process. RESULTS: Fifty-eight articles met eligibility criteria and formed the evidentiary basis for the local therapy recommendations; six randomized controlled trials of systemic therapy met eligibility criteria. RECOMMENDATIONS: Patients with newly diagnosed BC and BRCA1/2 mutations may be considered for breast-conserving therapy (BCT), with local control of the index cancer similar to that of noncarriers. The significant risk of a contralateral BC (CBC), especially in young women, and the higher risk of new cancers in the ipsilateral breast warrant discussion of bilateral mastectomy. Patients with mutations in moderate-risk genes sh...
Source: Clinical Genitourinary Cancer - Category: Cancer & Oncology Authors: Tags: J Clin Oncol Source Type: research

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Conclusions: This study is the first to demonstrate a dose-response relationship between risk of complications and near Dmax, where hypofractionated regimen or boost RT can play an important role. Rigorous RT-quality assurance program and modification of dose constraints could be considered as a critically important component for ongoing trials of hypofractionation. Based on our findings, we initiated a multi-center retrospective study (KROG 18-04) and a prospective study (NCT03523078) to validate our findings. Introduction Breast reconstruction provides important psychosocial, cosmetic, and quality of life benefits ...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsAfter NAC, most patients received irradiation of the breast/chest wall and axillary and supraclavicular nodes. In this setting, PORT to breast/chest wall with or without regional nodal irradiation was safe and effective, with acceptable disease-free and overall survival rates reported in this high-risk population.
Source: Reports of Practical Oncology and Radiotherapy - Category: Cancer & Oncology Source Type: research
In conclusion, sufficient evidence is now available to suggest that breast conservation after neoadjuvant chemotherapy is safe and effective for selected patients. Though neoadjuvant chemotherapy may increase the complexity of breast conservative treatment, a close collaboration between a multidisciplinary team and use of oncoplastic surgical techiques permit to optimize oncological and cosmetis outcomes. PMID: 30352955 [PubMed - in process]
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
Authors: Boyages J Abstract Radiation therapy (RT) is an important component of breast cancer treatment. RT reduces local recurrence and breast cancer mortality after breast conservation for all patients and for node-positive patients after a mastectomy. Short courses of RT over 3-4 weeks are generally as effective as longer courses. A patient subgroup where RT can be avoided after conservative surgery has not been consistently identified. A radiation boost reduces the risk of a recurrence in the breast but may be omitted for older patients with good prognosis tumours with clear margins. Axillary recurrences can ta...
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
This article will detail current management approaches to achieving breast conservation in patients with invasive breast cancer, including cases of bulky tumors and/or multiple tumors. PMID: 28516441 [PubMed - in process]
Source: Oncology (Williston Park, N.Y.) - Category: Cancer & Oncology Authors: Tags: Oncology (Williston Park) Source Type: research
Conclusions: The CPS+EG staging system better stratifies patients with respect to LRR after neoadjuvant chemotherapy than presenting clinical stage or final pathologic stage. For CPS+EG scores ≥3, use of postmastectomy radiation therapy decreases the likelihood of LRR after mastectomy.
Source: Annals of Surgery - Category: Surgery Tags: Original Articles Source Type: research
CONCLUSION: Inverting the sequence protocol for BC, requiring both CT and RT, allows more IBR without diminishing pCR and should therefore be considered as an acceptable therapeutic option. PMID: 28033508 [PubMed - as supplied by publisher]
Source: Breast - Category: Cancer & Oncology Authors: Tags: Breast Source Type: research
CONCLUSION:NRT-CHX is safe method and it is not associated with severe grade 3 or 4 acute or late side effects.Citation Format: Matuschek C, Boelke E, Budach W, Audretsch W, Wollandt S, Speer V, Nestle-Krämling C. Neoadjuvant radiochemotherapy in breast cancer- A safe and effect method for patients. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-12-09.
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Poster Session Abstracts Source Type: research
Abstract PURPOSE: American College of Surgeons Oncology Group Z1071 was a prospective trial evaluating the false negative rate of sentinel lymph node (SLN) surgery after neoadjuvant chemotherapy (NAC) in breast cancer patients with initial node-positive disease. Radiation therapy (RT) decisions were made at the discretion of treating physicians, providing an opportunity to evaluate variability in practice patterns following NAC. METHODS AND MATERIALS: Of 756 patients enrolled from July 2009 to June 2011, 685 met all eligibility requirements. Surgical approach, RT, and radiation field design were analyzed...
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Int J Radiat Oncol Biol Phys Source Type: research
Conclusions: In a cohort with stage II to III HER2-overexpressing breast cancer treated predominantly with trastuzumab-containing NACT followed by mastectomy±RT, we identified omission of RT, negative ER status, and residual positive lymph nodes as significant predictors of LRR, with 50% of LRR having a regional component.
Source: American Journal of Clinical Oncology - Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research
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