Adoption of Hypofractionated Whole-Breast Irradiation for Early-Stage Breast Cancer: A National Cancer Data Base Analysis

Wang, Elyn H.; Mougalian, Sarah Schellhorn; Soulos, Pamela R.; Rutter, C.E.; Evans, Suzanne B.; Haffty, Bruce G.; Gross, Cary P.; Yu, James B.

doi:10.1016/j.ijrobp.2014.06.038

Cited by 75 publications

(66 citation statements)

References 31 publications

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“…As these and other studies mature it is incumbent on the profession of radiation oncology to ensure that these advances are appropriately translated into practice. Considerable recent attention has been devoted within both the Red Journal (27)(28)(29)(30) and other prominent publications (31,32) to the slow uptake of research advances, particularly with regard to hypofractionated whole breast radiation therapydan important example of the "less is more" approach. The lag in adoption of new evidence in clinical practice is an important concern, and initiatives that reduce the aggressiveness of therapy may be particularly difficult to disseminate.…”

Section: Resultsmentioning

confidence: 99%

Breast Radiation Therapy—Sometimes Less May Be More

Jagsi

Woodward

2015

International Journal of Radiation Oncology*Biology*Physics

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Section: Resultsmentioning

confidence: 99%

Breast Radiation Therapy—Sometimes Less May Be More

Jagsi

Woodward

2015

International Journal of Radiation Oncology*Biology*Physics

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“…That variation could be a result of differences in culture and clinical practice between cancer centres 19,20 . Factors influencing practice patterns include physician education, attitudes, and preferences; patient choice or preference; tumour and institutional factors; local treatment capacity; and distance from the radiation treatment centre 15,21,22 . Our findings suggest that, in 5 of 6 provinces, most women with early-stage breast cancer received hypofractionated whole-breast rt, suggesting alignment with guidelines.…”

Section: Discussionmentioning

confidence: 99%

Use of Low-Value Radiotherapy Practices in Canada: An Analysis of Provincial Cancer Registry Data

et al. 2016

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“…Interest and usage of shortened treatment designs have increased, especially in academic settings and when considering patient perspectives (19, 20). The adoption of hypofractionation continues to increase in Canada and the United States (19, 21).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Mammographic Changes Across Three Different Fractionation Schedules for Early-Stage Breast Cancer

Tian

Paster

Kim

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Purpose As the use of hypofractionated breast radiation therapy (RT) increases, so will the need for long-term data on post-RT mammographic changes. The purpose of the present study was to longitudinally compare the incidence of common mammographic sequelae seen after breast conserving surgery and RT in patients treated with accelerated partial breast irradiation (APBI), hypofractionated whole breast irradiation (HWBI), and conventionally fractionated whole breast irradiation (WBI). Methods and Materials Patients treated with either APBI or HWBI after breast conserving therapy and with ≥3 mammograms of the treated breast were identified. They were matched 1:1 by age ±5 years to patients treated with WBI. The mammograms were evaluated for common post-RT breast findings by a mammographer who was unaware of the treatment. The outcomes were analyzed using a cumulative logistic regression model; P<.05 indicated statistically significance. Results Of 89 patients treated with RT from 2006 to 2011, 29 had received APBI, 30 had received HWBI, and 30 had received WBI. Their median age was 60 years (range 33–83). A total of 605 mammograms were evaluated, with a median follow-up of 48 months. The treatment technique did not affect the severity of architectural distortion when the groups were evaluated longitudinally. The likelihood of finding skin thickening decreased with increasing follow-up duration (odds ratio 0.6; P<.001) adjusted for fractionation schemes. No differences were seen with respect to changes in skin thickening, fluid collections, or calcifications among the treatment groups, after adjustment for the follow-up time. The clinical characteristics, including age, race, T stage, and chemotherapy use, were not linked to the likelihood of finding several mammographic phenomena over time. Conclusions Although specific post-treatment imaging findings evolved over time, RT fractionation did not alter the relative incidence or severity of architectural distortion, skin thickening, fluid collections, or calcifications. These findings will be useful to both radiologists and radiation oncologists when counseling patients regarding follow-up studies after RT.

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Adoption of Hypofractionated Whole-Breast Irradiation for Early-Stage Breast Cancer: A National Cancer Data Base Analysis

Cited by 75 publications

References 31 publications

Breast Radiation Therapy—Sometimes Less May Be More

Breast Radiation Therapy—Sometimes Less May Be More

Use of Low-Value Radiotherapy Practices in Canada: An Analysis of Provincial Cancer Registry Data

Comparison of Mammographic Changes Across Three Different Fractionation Schedules for Early-Stage Breast Cancer

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