Postoperative radiotherapy in breast cancer—long-term results from the Oslo study

Høst, Herman; Brennhovd, I. O.; Loeb, Mitchell

doi:10.1016/0360-3016(86)90029-5

Cited by 328 publications

(82 citation statements)

References 11 publications

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“…Lacour et al (1983) and Meier et al (1989) performed randomised studies of extended radical mastectomy vs radical mastectomy and found no survival difference. Randomised trials of post-mastectomy radiation encompassing the internal mammary nodes did not result in an improvement in overall survival either (Fisher et al, 1970;Palmer and Ribeiro, 1985;Høst et al, 1986;Veronesi et al, 1986;Arriagada et al, 1996). Obfuscating factors of such studies can be the use of adjuvant systemic treatment and the fact that internal mammary nodes may be situated in the breast irradiation field (Freedman et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Impact of non-axillary sentinel node biopsy on staging and treatment of breast cancer patients

et al. 2002

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The purpose of this study was to evaluate the occurrence of lymphatic drainage to non-axillary sentinel nodes and to determine the implications of this phenomenon. A total of 549 breast cancer patients underwent lymphoscintigraphy after intratumoural injection of 99m Tc-nanocolloid. The sentinel node was intraoperatively identified with the aid of intratumoural administered patent blue dye and a gamma-ray detection probe. Histopathological examination of sentinel nodes included step-sectioning at six levels and immunohistochemical staining. A sentinel node outside level I or II of the axilla was found in 149 patients (27%): internal mammary sentinel nodes in 86 patients, other non-axillary sentinel nodes in 44 and both internal mammary and other non-axillary sentinel nodes in nineteen patients. The intra-operative identification rate was 80%. Internal mammary metastases were found in seventeen patients and metastases in other non-axillary sentinel nodes in ten patients. Staging improved in 13% of patients with non-axillary sentinel lymph nodes and their treatment strategy was changed in 17%. A small proportion of clinically node negative breast cancer patients can be staged more precisely by biopsy of sentinel nodes outside level I and II of the axilla, resulting in additional decision criteria for postoperative regional or systemic therapy.

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Section: Discussionmentioning

confidence: 99%

Impact of non-axillary sentinel node biopsy on staging and treatment of breast cancer patients

et al. 2002

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“…Increased cardiac mortality risk associated with left side breast patients in the long term was reported by multiple authors. 16,18,19 The advancement in treatment techniques such as IMRT has enabled to reduce cardiac exposure, and steady decline of radiation risk is being noticed. 20 Furthermore, Boivin et al 21 noted that the anteriorly placed coronary arteries were more often affected by radiation therapy (compared with the circumflex artery).…”

Section: Dose Homogeneity and Conformitymentioning

confidence: 99%

Dosimetric study of SIB-IMRT versus SIB-3DCRT for breast cancer with breath-hold gated technique

Moorthy

Sakr

Hasan

et al. 2013

Int J Cancer Ther Oncol

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Background and purpose: 3-dimensional conformal therapy (3DCRT) is widely employed radiation therapy technique for breast cancer, but there is still need to minimize the doses to organ at risk (OAR) using 3DCRT. A few clinical studies have discussed using intensity modulated radiation therapy (IMRT) to address this shortfall. Simultaneous integrated boost (SIB) has been used in head and neck and prostate cancer, and there is a growing interest in using SIB for breast cancer too. This study aimed to compare SIB-IMRT versus SIB-3DCRT for breast cancer patients. Materials and Methods: SIB-3DCRT treatment plans were created for 36 consecutive patients. Dose was prescribed as 45 Gy in 25 fractions to the planning target volume (PTV)-1 and 60 Gy in 25 fractions to PTV-2. Treatment plans were normalized to 95% of PTV volume receiving 95% of the prescription dose. The conformity index (CI), homogeneity index (HI), lung dose, heart dose, left anterior descending artery(LAD) dose, and low dose volume and integral dose of normal healthy tissue were recorded and analyzed. Results: With the use of IMRT technique, there was an improvement in CI (0.14) when compared to CI of 3DCRT (0.18; p = 0.01). However, there was no significant difference in the HI (p = 0.45). On average, the V20Gy of ipsilateral lung was 37.9 % for 3DCRT and 22.4 % (p < 0.01) for IMRT, whereas the V20Gy of total lung (ipsilateral + contralateral) was 21.8% for 3DCRT and 12.14 (p < 0.01) for IMRT. Similarly, average V40Gy of heart was 7.5 % for 3DCRT and 2.13 % (p = 0.01) for IMRT. The LAD maximum dose to left side breast patients, on average, was 39.5 Gy for 3DCRT and 29.17 Gy (p = 0.03) for IMRT. The average number of monitor units was about 180 for 3DCRT and 1441 (p < 0.01) for IMRT. Conclusion: IMRT for breast cancer treatment is feasible. In comparison to 3DCRT, IMRT can reduce the maximum dose to the target volume, and dose to the OAR. However, 3DCRT technique is superior in terms of low dose volume, integral dose, and treatment time. With the use of breath-hold gated technique in IMRT, it can further improve the target coverage and reduction of doses to the heart, lung, and LAD. SIB technique could reduce the overall treatment duration by about one week.

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“…[32][33][34] Part of the heart may be irradiated in patients undergoing adjuvant breast irradiation. Tangential irradiation of the left breast may encompass up to 10% of the left ventricle.…”

Section: Morbidity From Breast Radiotherapymentioning

confidence: 99%

A randomised controlled trial of postoperative radiotherapy following breast-conserving surgery in a minimum-risk older population. The PRIME trial

Prescott¹,

Kunkler²,

Williams³

et al. 2007

Health Technol Assess

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Postoperative radiotherapy in breast cancer—long-term results from the Oslo study

Cited by 328 publications

References 11 publications

Impact of non-axillary sentinel node biopsy on staging and treatment of breast cancer patients

Impact of non-axillary sentinel node biopsy on staging and treatment of breast cancer patients

Dosimetric study of SIB-IMRT versus SIB-3DCRT for breast cancer with breath-hold gated technique

A randomised controlled trial of postoperative radiotherapy following breast-conserving surgery in a minimum-risk older population. The PRIME trial

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