A new method to optimize resection area using a radiation treatment planning system and deformable image registration for breast-conserving surgery after neoadjuvant chemotherapy

Publication date: Available online 10 October 2020Source: European Journal of Surgical OncologyAuthor(s): Tetsutaro Miyoshi, Satoshi Yamaguchi, Hiroshi Fujimoto, Shigeru Yoshioka, Masayuki Shiobara, Kazuo Wakatsuki, Kosuke Suda, Kotaro Miyazawa, Toshiaki Aida, Yoshihiro Watanabe, Masayuki Ohtsuka
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research

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Clin Breast Cancer. 2021 Jun 12:S1526-8209(21)00148-8. doi: 10.1016/j.clbc.2021.06.003. Online ahead of print.ABSTRACTINTRODUCTION: Neoadjuvant chemotherapy (NAC) is increasingly used for operable breast cancer (BC). Appropriate radiation therapy (RT) fields (ie, whole breast [WB] ± regional nodal irradiation [RNI]) in patients who were clinically node positive (cN1) but convert to pathologically node negative (ypN0) after NAC are unknown and the subject of the accruing NSABP B-51 trial. We sought to compare outcomes between WB RT with or without RNI following breast conservation and sentinel lymph node biopsy (SLNB...
Source: Clinical Breast Cancer - Category: Cancer & Oncology Authors: Source Type: research
Regional lymph nodal (LN) involvement is arguably the most important prognostic factor for breast cancer [1]. Involvement of LNs is a near-universal indication to deliver chemotherapy. While historically, chemotherapy was delivered adjuvantly, the contemporary era has seen a sharp rise in the administration of neoadjuvant chemotherapy (NAC), which allows for tumor downstaging, enables a greater proportion of women to undergo breast conserving surgery (BCS), and also provides information regarding tumor biology[2].
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
Am Soc Clin Oncol Educ Book. 2021 Mar;41:1-11. doi: 10.1200/EDBK_320691.ABSTRACTIn the care of patients with operable breast cancer, there has been a shift toward increasing use of neoadjuvant therapy. There are benefits to neoadjuvant therapy, such as monitoring for response, as well as an increased rate of breast conservation and reduction of potential morbidity associated with breast surgery, including axillary management. Among patients with highly proliferative tumors, such as HER2-positive or triple-negative breast cancer, those with residual disease are at higher risk of recurrence, which informs the recommended sys...
Source: Clinical Genitourinary Cancer - Category: Cancer & Oncology Authors: Source Type: research
ConclusionThis investigation provides additional preliminary data supporting the using of IORT in the boost setting and corroborates the existing literature. These encouraging results should be prospectively validated by the eventual publication of randomized studies such as TARGIT ‑B.
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
AbstractPurpose of ReviewAxillary primary breast cancer, also known as occult primary breast cancer, is a rare entity representing less than 1% of all breast cancers. The surgical management of the axilla in breast cancer has changed significantly, with implications for the management of axillary primary breast cancer. Much of the data is limited by era, small cohorts, or large retrospective database studies. The purpose of this review is to reinforce the diagnostic work up of occult breast cancer, review updated management strategies of the axilla and breast, and summarize changes and updates in practice management and ou...
Source: Current Breast Cancer Reports - Category: Cancer & Oncology Source Type: research
This study explores the current role of SLNB in BC patients eligible for BCS, providing a view into future directions in BC care. PMID: 32975389 [PubMed - as supplied by publisher]
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research
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. ...
Source: Clinical Genitourinary Cancer - Category: Cancer & Oncology Authors: Tags: J Clin Oncol Source Type: research
ConclusionsThis survey shows a fairly good use of hRT and a moderate practice of PBI in Italy. Some practices like hRT to the chest wall and regional lymph nodes as well as rRT need further verification. Likewise, the management of post-NAC RT is very heterogeneous. Future national clinical collaborative studies are advocated in order to investigate these controversial topics about breast cancer radiotherapy.
Source: La Radiologia Medica - Category: Radiology Source Type: research
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
We aimed to determine the significance of multifocal regression after neoadjuvant chemotherapy as a predictor of ipsilateral breast tumor recurrence (IBTR) in the modern era. In this retrospective review of 346 patients, multifocal regression, hormone receptor-negative phenotype, and lack of nodal pathologic complete response predicted for increased risk of IBTR on multivariate analysis. Although more common in hormone receptor-positive disease, multifocal regression was associated with worse outcome only in hormone receptor-negative patients.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Clinical Investigation Source Type: research
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