Minimally invasive tumor bed implant (MITBI) and peri-operative high-dose-rate brachytherapy (PHDRBT) for accelerated minimal breast irradiation (AMBI) or anticipated boost (A-PHDRBT-boost) in breast-conserving surgery for ductal carcinoma in situ

Gimeno, M; Martínez‐Regueira, Fernando; Rodríguez-Spiteri, N.; Olartecoechea, Begoña; Rubio, Isabel T.; Esgueva, Antonio; Pina, Luis; Elizalde, Arlette; Sampedro, Carolina Sobrido; Idoate, Miguel A.; Abengózar, Marta; Ramos, Luís; Manuel, Felipe; Martı́nez-Monge, Rafael; Cambeiro, Mauricio

doi:10.5114/jcb.2020.101684

Cited by 5 publications

(9 citation statements)

References 28 publications

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“…There was a trend for poorer cosmesis in patients with higher absolute, but not relative, MIBT V 29Gy (volume of the breast tissue that received 100% of the prescribed dose in brachytherapy boost, if α/β = 3 Gy was assumed for normal breast late effects), with odds ratio = 1.01, meaning that every centimeter cube increase in MIBT breast V 100% (treated volume) increases the risk of poorer Harvard's score by 1%. This finding is in line with Kulik et al [10], Cambeiro et al [22], Quéro et al [23], and Morales et al [24] studies (Table 6). In univariate analysis, patients treated with irradiation of regional lymphatics (odds ratio ≈ 5), and patients with larger breast volumes presented statistically significant poorer cosmesis scores.…”

Section: Discussionsupporting

confidence: 91%

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Predictors of poor cosmesis in breast cancer patients treated with adjuvant whole breast radiation therapy plus high-dose-rate interstitial brachytherapy boost after breast conservation surgery

Feizi¹,

Arvandi²,

Feli³

et al. 2022

jcb

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To identify patient, tumor, and treatment-related factors, which predict cosmesis in breast cancer survivors treated with adjuvant whole breast irradiation (WBI) plus high-dose-rate (HDR) multicatheter interstitial brachytherapy (MIBT) boost after breast conservation surgery.Material and methods: At least 12 months after completion of radiotherapy, cosmetic outcomes were measured both objectively with BCCT.core software (using a front view digital photograph), and subjectively according to Harvard's criteria. MIBT dose fractionation regimen was 13.6 Gy/4 fractions (bid). To evaluate the correlation between cosmetic scores and dose-volume histogram (DVH) parameters, WBI and MIBT plans were retrospectively analyzed, and ipsilateral skin and breast biologically equivalent dosimetric indices were recorded (α/β = 3 Gy). A multivariate ordinal logistic regression model was used for statistical analysis.Results: Twenty-eight consecutive patients were enrolled into this study. The median time from completion of radiation therapy to cosmesis scoring was 18 months. In evaluation with BCCT.core software, no patient was scored as excellent. Cosmesis was good in 18%, fair in 50%, and poor in 32% of patients. According to Harvard's scale, 10.5% of patients had excellent cosmesis, and 43%, 28.5%, and 18% of patients had good, fair, and poor scores, respectively. In univariate analysis, patients with higher absolute MIBT V 29Gy (cc), those treated with irradiation of regional lymphatics (odds ratio ≈ 5), and patients with larger breast volumes had statistically significant lower Harvard's scores. In the multivariate model, none of the mentioned factors remained statistically significant, except for a trend for poorer cosmesis in patients with higher absolute MIBT V 29Gy (p-value = 0.066).Conclusions: Based on the results of this study, MIBT breast V 29Gy , regional nodal irradiation, and larger breast volumes are the potential factors, which could predict cosmesis.

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Section: Discussionsupporting

confidence: 91%

“…[ 23 ], and Morales et al . [ 24 ] studies ( Table 6 ). In univariate analysis, patients treated with irradiation of regional lymphatics (odds ratio ≈ 5), and patients with larger breast volumes presented statistically significant poorer cosmesis scores.…”

Section: Discussionmentioning

confidence: 99%

Predictors of poor cosmesis in breast cancer patients treated with adjuvant whole breast radiation therapy plus high-dose-rate interstitial brachytherapy boost after breast conservation surgery

Feizi¹,

Arvandi²,

Feli³

et al. 2022

jcb

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“…Esta modalidad de implante evita un segundo procedimiento intervencionista a las pacientes sin mayores complicaciones perioperatorias (104). Además, permite mejorar la precisión del volumen diana, gracias a la visualización directa del lecho tumoral a implantar, y optimizar el uso de la radiación adyuvante a través del diseño de un implante multicatéter mínimamente invasivo que implica una irradiación de mínimo volumen (151).…”

Section: Discussionunclassified

“…El concepto de MITBI puede aportar mayor eficiencia en el procedimiento de braquiterapia. La discriminación topográfica de alta precisión en el reconocimiento del lecho tumoral a implantar, en el seno de la cavidad quirúrgica, es una característica íntrínseca a la propia técnica MITBI (151). Si se tomase todo el lecho quirúrgico como área subsidiaria de implante y de irradiación, se requeriría cubrir la totalidad de un lecho amplio e irregular.…”

Section: A) Eficiencia a Nivel Técnicounclassified

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Estudio de factibilidad, seguridad y eficacia de la irradiación ultra-acelerada de mínimo volumen empleando técnica de braquiterapia perioperatoria en cáncer precoz de mama

Gimeno¹

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Estudio de factibilidad, seguridad y eficacia de la irradiación ultra-acelerada de mínimo volumen empleando técnica de braquiterapia perioperatoria en cáncer precoz de mama.MARTA GIMENO MORALES PAMPLONA, 2021. CLASIFICACIÓN HISTOLÓGICALa clasificación histológica o anatomo-patológica está basada en el tipo de célula y su disposición arquitectural. Una reciente actualización de la OMS del año 2019 (5) reclasifica los diferentes tipos histológicos del cáncer de mama de origen epitelial, tal y como se muestra en la tabla 1: Tabla 1: Clasificación histológica OMS 2019. Carcinoma ductal in situ (CDIS) Carcinoma intraductal, no infiltrante, NOS. -CDIS de bajo grado nuclear. -DCIS de grado nuclear intermedio. -DCIS de alto grado nuclear. Carcinoma de mama invasivo Carcinoma ductal infiltrante, NOS. (CDI) Carcinoma oncocítico. Carcinoma "lipid-rich". Carcinoma "glycogen-rich". Carcinoma sebáceo. Carcinoma lobulillar, NOS. Carcinoma tubular. Carcinoma cribiforme, NOS. Adenocarcinoma mucinoso. Cistoadenocarcinoma mucinoso, NOS Carcinoma micropapilar invasivo. Adenocarcinoma apocrino. Carcinoma metaplásico, NOS.Para el CDIS, tanto el nuevo compendio de la OMS como el colegio de patólogos americanos (CAP) recomiendan el uso de la morfología citonuclear para la graduación (6). De manera que, a través de la evaluación nuclear (pleomorfismo, el tamaño, la orientacion, la presencia o ausencia de cromatina, nucleolos y mitosis), se establecen tres categorías: bajo grado, grado intermedio y alto grado. Además, la presencia o ausencia de necrosis, clasificada como central ("comedo") o focal, debe ser descrita en el informe de anatomía patológica.Para los CDI, el grado histológico se evalúa con la clasificación de Nottingham (7,8) como referencia semi-cuantitativa de la estructura morfológica. Mediante la evaluación de tres características (la diferenciación tubular, el pleomorfismo nuclear y el número de mitosis) que son puntuadas con una escala numérica de 1 a 3, se obtienen tres categorías:

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Four-fraction ultra-accelerated minimal breast irradiation in early breast cancer: The initial feasibility results of an institutional experience

et al. 2022

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Minimally invasive tumor bed implant (MITBI) and peri-operative high-dose-rate brachytherapy (PHDRBT) for accelerated minimal breast irradiation (AMBI) or anticipated boost (A-PHDRBT-boost) in breast-conserving surgery for ductal carcinoma in situ

Cited by 5 publications

References 28 publications

Predictors of poor cosmesis in breast cancer patients treated with adjuvant whole breast radiation therapy plus high-dose-rate interstitial brachytherapy boost after breast conservation surgery

Predictors of poor cosmesis in breast cancer patients treated with adjuvant whole breast radiation therapy plus high-dose-rate interstitial brachytherapy boost after breast conservation surgery

Estudio de factibilidad, seguridad y eficacia de la irradiación ultra-acelerada de mínimo volumen empleando técnica de braquiterapia perioperatoria en cáncer precoz de mama

Four-fraction ultra-accelerated minimal breast irradiation in early breast cancer: The initial feasibility results of an institutional experience

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