Breast Cancer: Intact and Post Mastectomy

Bloom, Elizabeth Stroh; Poortmans, Philip; Aznar, Marianne C.; Buchholz, Thomas A.; Strom, Eric A.

doi:10.1007/174_2011_163

Cited by 1 publication

(1 citation statement)

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“…As an example, the entire chest wall may sometimes be treated with electron-beam fields [57] . With a five-field technique a homogeneous dose to the thoracic wall (and the IMC if indicated) can be delivered with a much lower dose to the underlying lungs and heart compared with tangential photon fields, especially in patients with a markedly curved thoracic wall [74] . Also, a partially wide tangential approach, including the IMC lymph-node region together with the chest wall or breast in a single pair of fields, can be used when a separate IMC field cannot be employed due to the patients’ anatomy.…”

Section: Challengesmentioning

confidence: 99%

Optimal approach in early breast cancer: Radiation therapy

Poortmans

2013

European Journal of Cancer Supplements

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Radiation therapy significantly reduces by at least 70% the relative risk of local and regional recurrences for breast cancer after surgery. A positive influence on overall survival has been clearly demonstrated, especially for patients with a high absolute risk for locoregional recurrences. However, this is partially counterbalanced by late toxicity (dependent upon the radiation dose) especially to cardiac structures. Apart from this toxicity, a clear influence of radiation-therapy-related factors on functional and cosmetic outcome has also been demonstrated. Over time, technical improvements have led to a marked reduction in dose to the neighbouring organs, with a consequent drop in acute and late toxicity. This has also allowed the introduction of shorter radiation schedules, lowering the burden of treatment to the patient and the hospital. Several tools, techniques and guidelines have been developed to optimise the balance between the desired reduction in recurrence rates and side effects.The multidisciplinary team should discuss all available treatment options for every individual breast cancer patient. Individualisation of the selection of the optimal combination of treatments, depending on patient and tumour-related factors, is of utmost importance. Apart from direct tumour-related outcomes, cosmesis and potential side effects have to be taken into account. Counselling should include known risk factors for survival and complications, including comorbidity.

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Section: Challengesmentioning

confidence: 99%