Volumetric changes in the lumpectomy cavity during whole breast irradiation after breast conserving surgery

Cho, Heunglae; Kim, Cheoljin

doi:10.3857/roj.2011.29.4.277

Cited by 14 publications

(8 citation statements)

References 28 publications

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“…Therefore, we excluded patients with an increasing seroma from subsequent analyses. The correlation between SV and its reduction has been demonstrated in previous studies [14, 16]. Our data revealed this correlation as well.…”

Section: Discussionsupporting

confidence: 91%

Seroma change during magnetic resonance imaging-guided partial breast irradiation and its clinical implications

et al. 2017

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BackgroundTo investigate the patterns of post-lumpectomy seroma volume (SV) change and related clinical factors to determine the benefits of adaptive planning in magnetic resonance imaging (MRI)-guided partial breast irradiation (PBI).MethodsMRI data obtained from 37 women with early breast cancer acquired at simulation and at the 1st, 6th, and 10th fractions were analyzed. The planning target volume (PTV) was defined as unequal margins of 10–15 mm added according to the directional surgical margin status of each seroma. Treatment was performed using a 0.35 T MRI-guided radiotherapy system. Univariate analysis was performed to assess the correlations between SV change rate and clinical factors. Seroma and PTV for adaptive planning were based on the images obtained at the 6th fraction.ResultsThe average time intervals between surgery-simulation, simulation-1st, 1st-6th, and 6th-10th fractions were 23.1, 8.5, 7.2, and 5.9 days, respectively. Of the 37 patients, 33 exhibited decreased SV over the treatment period. The mean SV of these 33 patients decreased from 100% at simulation to 60, 48, and 40% at each MRI scan. In most cases (26/33), the logarithm of SV was inversely proportional to the elapsed time from surgery (R 2 > 0.90, Pearson’s correlation test). The volume of spared normal tissue from adaptive radiotherapy was proportional to the absolute change in SV (R 2 = 0.89, Pearson’s correlation test).ConclusionSeromas exhibit exponential shrinkage over the course of PBI. In patients receiving PBI, frequent monitoring of SV could be helpful in decision-making regarding adaptive planning, especially those with a large seroma.

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Section: Discussionsupporting

confidence: 91%

Seroma change during magnetic resonance imaging-guided partial breast irradiation and its clinical implications

et al. 2017

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“…Therefore, we excluded patients with an increasing seroma from subsequent analyses. The correlation between SV and its reduction has been demonstrated in previous studies [14,16]. Our data revealed this correlation as well.…”

Section: Discussionsupporting

confidence: 90%

“…After superficial closure of the excision cavity, the tumor bed often appears as a seroma [9,10], which makes target definition more clear and consistent. Seroma volume (SV) is well-known to typically shrink with time [11][12][13][14][15][16][17]. Therefore, an ideal target volume should differ in each PBI fraction.…”

Section: Introductionmentioning

confidence: 99%

Seroma Change during Magnetic Resonance Imaging-Guided Partial Breast Irradiation and Its Clinical Implications

Jeon

Shin

Park

et al. 2017

International Journal of Radiation Oncology*Biology*Physics

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Background: To investigate the patterns of post-lumpectomy seroma volume (SV) change and related clinical factors to determine the benefits of adaptive planning in magnetic resonance imaging (MRI)-guided partial breast irradiation (PBI). Methods: MRI data obtained from 37 women with early breast cancer acquired at simulation and at the 1st, 6th, and 10th fractions were analyzed. The planning target volume (PTV) was defined as unequal margins of 10-15 mm added according to the directional surgical margin status of each seroma. Treatment was performed using a 0.35 T MRI-guided radiotherapy system. Univariate analysis was performed to assess the correlations between SV change rate and clinical factors. Seroma and PTV for adaptive planning were based on the images obtained at the 6th fraction.

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“…Total averaged excised volume was 33 cc. This compares to the reported 40-60 cc average in multiple studies 5,10,11 . Of the 68 cases of invasive cancer, 14 of the lumpectomies were identi ed to have at least 1 positive margin on nal pathology.…”

Section: Resultscontrasting

confidence: 43%

MarginProbe Radiofrequency Spectroscopy with Intraoperative Pathology Assessment: Synergistic, or Redundant?

Qafiti¹,

Layton²,

McDonald³

2021

Preprint

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Background:Published MarginProbe (MP) data reports ≥50% reduction in positive lumpectomy margins. Standard of care (SOC) in our facility uses intraoperative pathologic gross assessment for invasive cancer. We sought to determine if adjunctive use of MP would provide incremental value over gross assessment alone. Methods:This is a single-site, single-surgeon retrospective chart review of 86 consecutive lumpectomies with MP from 12/2018–11/2019. Margins were considered positive using SSO/ASTRO “no ink on tumor” consensus guideline for invasive cancer, and SSO/ASTRO/ASCO consensus guideline of 2mm or greater for pure DCIS. Significance was measured using Fisher’s exact two-tailed test.Results:76 patients (7 bilateral, 3 unilateral/multi-focal) yielded 86 lumpectomies for inclusion. Mean age was 69.8 and mean tumor size was 1.09cm. 68 invasive cancers were assessed using adjunct MP and gross assessment while 18 DCIS cases utilized MP only. Among all cases, gross assessment alone reduced positive margins from 27.9% to 19.8% (29.2% relative reduction, p=0.28). Utilizing both modalities in tandem, positive margins decreased from 27.9% to 9.3% (66.7% relative reduction, p<0.01) representing a 46.9% relative reduction versus gross assessment alone. Main specimen tissue volume was 27.1cc. After gross assessment and MarginProbe evaluation, there was additional excised volume that averaged 2.9 cc. Total averaged excised volume was 33 cc. This compares to the reported 40-60 cc average in multiple studies.Conclusion:Adjunctive use of MP with gross assessment maximizes reduction of positive margins during breast conserving surgery while minimizing impact on specimen volumes.

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Volumetric changes in the lumpectomy cavity during whole breast irradiation after breast conserving surgery

Cited by 14 publications

References 28 publications

Seroma change during magnetic resonance imaging-guided partial breast irradiation and its clinical implications

Seroma change during magnetic resonance imaging-guided partial breast irradiation and its clinical implications

Seroma Change during Magnetic Resonance Imaging-Guided Partial Breast Irradiation and Its Clinical Implications

MarginProbe Radiofrequency Spectroscopy with Intraoperative Pathology Assessment: Synergistic, or Redundant?

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