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Sample records for accelerated partial breast

  1. Accelerated partial breast irradiation

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Whole breast radiotherapy afier tumor lumpectomy is based on the premise that that the breast cancer recurrence rate is reduced through the elimination of residual cancer foci in the remaining tissue immediately adjacent to the lumpectomy site and occult multicentric areas of in situ or infiltrating cancer in remote areas of the breast. The relevance of remote foci to ipsilateral breast failure rates after breast conserving treatment is debatable, because 65%~100% of recurrences develop in the same quadrant as the initial tumor. This has led several investigators to question whether radiotherapy must be administered to the entire breast.

  2. Accelerated partial breast irradiation: an advanced form of hypofractionation.

    Science.gov (United States)

    Budrukkar, Ashwini

    2008-01-01

    Altered fractionation schedules are being increasingly investigated in the treatment of breast cancer. Two such schedules that are frequently compared are hypofractionated external beam radiation therapy (HERT) and accelerated partial breast irradiation (APBI). Though these two modalities are considered separately, APBI is an actually an advanced form of hypofractionation, where acceleration of the treatment is possible due to the smaller volume being irradiated. HERT as well as APBI are investigational at present and are being tested in randomized trials. This article looks at the advantages of APBI as a hypofractionation schedule.

  3. Accelerated partial breast irradiation: An advanced form of hypofractionation

    Directory of Open Access Journals (Sweden)

    Budrukkar Ashwini

    2008-01-01

    Full Text Available Altered fractionation schedules are being increasingly investigated in the treatment of breast cancer. Two such schedules that are frequently compared are hypofractionated external beam radiation therapy (HERT and accelerated partial breast irradiation (APBI. Though these two modalities are considered separately, APBI is an actually an advanced form of hypofractionation, where acceleration of the treatment is possible due to the smaller volume being irradiated. HERT as well as APBI are investigational at present and are being tested in randomized trials. This article looks at the advantages of APBI as a hypofractionation schedule.

  4. Accelerated Partial Breast Irradiation (APBI: A review of available techniques

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    Saunders Mark W

    2010-10-01

    Full Text Available Abstract Breast conservation therapy (BCT is the procedure of choice for the management of the early stage breast cancer. However, its utilization has not been maximized because of logistics issues associated with the protracted treatment involved with the radiation treatment. Accelerated Partial Breast Irradiation (APBI is an approach that treats only the lumpectomy bed plus a 1-2 cm margin, rather than the whole breast. Hence because of the small volume of irradiation a higher dose can be delivered in a shorter period of time. There has been growing interest for APBI and various approaches have been developed under phase I-III clinical studies; these include multicatheter interstitial brachytherapy, balloon catheter brachytherapy, conformal external beam radiation therapy and intra-operative radiation therapy (IORT. Balloon-based brachytherapy approaches include Mammosite, Axxent electronic brachytherapy and Contura, Hybrid brachytherapy devices include SAVI and ClearPath. This paper reviews the different techniques, identifying the weaknesses and strength of each approach and proposes a direction for future research and development. It is evident that APBI will play a role in the management of a selected group of early breast cancer. However, the relative role of the different techniques is yet to be clearly identified.

  5. [State of the art and perspectives of accelerated partial breast irradiation in 2014].

    Science.gov (United States)

    Chand-Fouché, M-È; Hannoun-Lévi, J-M

    2014-11-01

    In the frame of treatment de-escalation and personalization, accelerated partial breast irradiation is taking its place in the breast cancer therapeutic options. This study analyzed the results of phase III randomized trials having compared accelerated partial breast irradiation versus whole breast irradiation. Currently, among those trails, six proposed some results regarding efficacy and/or toxicity. Globally, the non-randomized studies confirmed the expected results showing a low rate of local recurrence and toxicity. The first results of the phase III randomized trials showed encouraging data in terms of local control while the toxicity varied mainly according to the accelerated partial breast irradiation technique used. However, the follow-up of the majority of these studies remains insufficient. The strict respect of accelerated partial breast irradiation indications likely represents one of the key factors of the therapeutic success. The next results could allow proposing a better definition of the accelerated partial breast irradiation selection criteria. Copyright © 2014 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  6. Accelerated partial breast irradiation (APBI): are breath-hold and volumetric radiation therapy techniques useful?

    NARCIS (Netherlands)

    Essers, M.; Osman, S.O.; Hol, S.; Donkers, T.; Poortmans, P.M.P.

    2014-01-01

    BACKGROUND: In a selective group of patients accelerated partial breast irradiation (APBI) might be applied after conservative breast surgery to reduce the amount of irradiated healthy tissue. The role of volumetric modulated arc therapy (VMAT) and voluntary moderately deep inspiration breath-hold (

  7. PRONE ACCELERATED PARTIAL BREAST IRRADIATION AFTER BREAST-CONSERVING SURGERY: FIVE YEAR RESULTS OF 100 PATIENTS

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    Formenti, Silvia C.; Hsu, Howard; Fenton-Kerimian, Maria; Roses, Daniel; Guth, Amber; Jozsef, Gabor; Goldberg, Judith D.; DeWyngaert, J. Keith

    2013-01-01

    Purpose To report the 5-year results of a prospective trial of three-dimensional conformal external beam radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation in the prone position (P-APBI). Methods Post-menopausal patients with Stage I breast cancer with non palpable <2 cm tumors, negative margins, and negative nodes, positive hormonal receptors, and no extensive intraductal component (EIC) were eligible. The trial was offered only once eligible patients had refused to undergo standard whole-breast radiotherapy. Patients were simulated and treated on a dedicated table for prone set-up. The 3D-CRT delivered was 30 Gy in five 6 Gy/daily fractions over 10 days with port film verification at each treatment. Ipsilateral breast, ipsilateral nodal, contralateral breast, and distant failure (IBF, INF, CBF, DF) were estimated using the cumulative incidence method. Disease-free, overall, and cancer-specific survival (DFS, OS, CSS) were recorded. Results One hundred patients accrued to this IRB- approved prospective trial, one with bilateral breast cancer. One patient withdrew consent after simulation and another elected to interrupt radiotherapy after receiving two treatments. Ninety-eight patients are evaluable for toxicity and, in one case, both breasts were treated with PBI. Median patient age was 68 years (range 53–88 years); in 55% the tumor size was <1 cm. All patients had hormonal receptor positive cancers: 87% underwent adjuvant anti-hormonal therapy. At a median follow-up of 64 months (range, 2–125 months), there was one local recurrence (1% IBF) and one contralateral breast cancer (1% CBF). There were no deaths due to breast cancer by 5 years. Grade 3 late toxicities occurred in 2 patients (1 breast edema, 1 transient breast pain). Cosmesis was rated good/excellent in 89% of patients with at least 36 months follow-up. Conclusions Five-year efficacy and toxicity of 3D-CRT to deliver prone-PBI are comparable to other experiences with similar

  8. [Accelerated partial breast irradiation with multicatheters during breast conserving surgery for cancer].

    Science.gov (United States)

    Rodríguez-Spiteri Sagredo, Natalia; Martínez Regueira, Fernando; Olartecoechea Linaje, Begoña; Arredondo Chaves, Jorge; Cambeiro Vázquez, Mauricio; Pina Insausti, Luis Javier; Elizalde Pérez, Arlette; y García-Lallana, Amaya; Sola Gallego, Jose Javier

    2013-10-01

    Accelerated partial breast irradiation (APBI) with multicatheters after lumpectomy for breast cancer (BC) may be an alternative to whole breast irradiation in selected patients. The aim is to show our 5 year experience. Between June 2007 and June 2012, 87 BC patients have been evaluated for APBI. Inclusion criteria were: age over 40 years, unifocal tumour, infiltrating ductal or intraductal carcinoma, tumour size smaller than 3 cm and no lymph node involvement. Complications, cosmetic results and local and distant recurrences were evaluated. Treatment was completed in 48 patients and contraindicated in 39. The average age of treated patients was 59 years. Operating time was 123 min with 9 implanted catheters in each patient. No complications were observed during surgery or radiotherapy. Patients were discharged from hospital after 4 days. Tumour size was 11 mm. Of these, 35 were infiltrating ductal and 13 intraductal carcinomas. A total of 44 patients received adjuvant treatment. Mean follow-up was 22 months with no evidence of local or distant recurrence. The cosmetic outcome was good or excellent in 66% of cases. APBI with multicatheter placed after lumpectomy for BC is feasible and safe but requires a strict selection of patients. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  9. MO-E-BRD-02: Accelerated Partial Breast Irradiation in Brachytherapy: Is Shorter Better?

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    Todor, D. [Virginia Commonwealth University (United States)

    2015-06-15

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  10. Accelerated partial breast irradiation using 3D conformal radiotherapy: initial clinical experience

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    Gatti, M.; Madeddu, A.; Malinverni, G.; Delmastro, E.; Bona, C.; Gabriele, P. [IRCC-Radiotherapy, Candiolo, TO (Italy); Baiotto, B.; Stasi, M. [IRCC-Medical Physics, Candiolo, TO (Italy); Ponzone, R.; Siatis, D. [IRCC-Surgery, Candiolo, TO (Italy)

    2006-11-15

    Accelerated partial breast irradiation using 3D-C.R.T. is technically sophisticate but feasible and acute toxicity to date has been minimal. A C.T.V.-to-P.T.V. margin of 10 mm seems to provide coverage for analyzed patients. However, more patients and additional studies will be needed to validate the accuracy of this margin, and longer follow-up will be needed to assess acute and chronic toxicity, tumor control, and cosmetic results. (author)

  11. Radiation recall secondary to adjuvant docetaxel after balloon-catheter based accelerated partial breast irradiation

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    Wong, Nathan W. [Summer Intern, Mayo Clinic Arizona, Scottsdale, AZ (United States); Wong, William W., E-mail: wong.william@mayo.ed [Department of Radiation Oncology, Mayo Clinic Arizona, 13400 E. Shea Boulevard, Scottsdale, AZ 85259 (United States); Karlin, Nina J. [Division of Oncology, Mayo Clinic Arizona, Scottsdale, AZ (United States); Gray, Richard J. [Department of Surgery, Mayo Clinic Arizona, Scottsdale, AZ (United States)

    2010-08-15

    For early stage breast cancer, wide local excision and post-operative whole breast irradiation is a standard treatment. If adjuvant chemotherapy is recommended, radiation is usually given after completion of chemotherapy. In recent years, accelerated partial breast irradiation (APBI) with balloon-cathetered based brachytherapy has become an option for selected patients. For these patients, adjuvant chemotherapy would have to be administered after radiation. The sequence of treatment with radiation followed by chemotherapy results in increased risk of radiation recall reaction (RRD) in these patients. Docetaxel is becoming a more commonly used drug as adjuvant treatment for breast cancer. Here we report a case of docetaxel induced RRD after APBI with balloon-cathetered based brachytherapy. Such reaction would have an adverse impact on the cosmetic outcome and quality of life of the patient. For patients who develop an intense skin reaction after the administration of docetaxel following APBI, RRD should be considered in the differential diagnosis.

  12. Prone Accelerated Partial Breast Irradiation After Breast-Conserving Surgery: Five-year Results of 100 Patients

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    Formenti, Silvia C., E-mail: silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Hsu, Howard; Fenton-Kerimian, Maria [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Roses, Daniel; Guth, Amber [Department of Surgery, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Jozsef, Gabor [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Goldberg, Judith D. [Division of Biostastistics, Department of Environmental Medicine, New York University School of Medicine and Langone Medical Center, New York, New York (United States); DeWyngaert, J. Keith [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States)

    2012-11-01

    Purpose: To report the 5-year results of a prospective trial of three-dimensional conformal external beam radiotherapy (3D-CRT) to deliver accelerated partial breast irradiation in the prone position. Methods and Materials: Postmenopausal patients with Stage I breast cancer with nonpalpable tumors <2 cm, negative margins and negative nodes, positive hormone receptors, and no extensive intraductal component were eligible. The trial was offered only after eligible patients had refused to undergo standard whole-breast radiotherapy. Patients were simulated and treated on a dedicated table for prone setup. 3D-CRT was delivered at a dose of 30 Gy in five 6-Gy/day fractions over 10 days with port film verification at each treatment. Rates of ipsilateral breast failure, ipsilateral nodal failure, contralateral breast failure, and distant failure were estimated using the cumulative incidence method. Rates of disease-free, overall, and cancer-specific survival were recorded. Results: One hundred patients were enrolled in this institutional review board-approved prospective trial, one with bilateral breast cancer. One patient withdrew consent after simulation, and another patient elected to interrupt radiotherapy after receiving two treatments. Ninety-eight patients were evaluable for toxicity, and, in 1 case, both breasts were treated with partial breast irradiation. Median patient age was 68 years (range, 53-88 years); in 55% of patients the tumor size was <1 cm. All patients had hormone receptor-positive cancers: 87% of patients underwent adjuvant antihormone therapy. At a median follow-up of 64 months (range, 2-125 months), there was one local recurrence (1% ipsilateral breast failure) and one contralateral breast cancer (1% contralateral breast failure). There were no deaths due to breast cancer by 5 years. Grade 3 late toxicities occurred in 2 patients (one breast edema, one transient breast pain). Cosmesis was rated good/excellent in 89% of patients with at least 36

  13. Prone Accelerated Partial Breast Irradiation After Breast-Conserving Surgery: Compliance to the Dosimetry Requirements of RTOG-0413

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    Wen Bixiu [Department of Radiation Oncology, New York University Medical Center, New York, New York (United States); Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080 (China); Hsu, Howard; Formenti-Ujlaki, George F.; Lymberis, Stella; Magnolfi, Chiara; Zhao Xuan; Chang Jenghwa; DeWyngaert, J. Keith; Jozsef, Gabor [Department of Radiation Oncology, New York University Medical Center, New York, New York (United States); Formenti, Silvia C., E-mail: silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University Medical Center, New York, New York (United States)

    2012-11-15

    Purpose: The dosimetric results from our institution's trials of prone accelerated partial breast irradiation are compared with the dosimetric requirements of RTOG-0413. Methods and Materials: Trial 1 and Trial 2 are 2 consecutive trials of prone-accelerated partial breast irradiation. Eligible for both trials were stage I breast cancer patients with negative margins after breast-conserving surgery. The planning target tumor volume (PTV) was created by extending the surgical cavity 2.0 cm for Trial 1 and 1.5 cm for Trial 2, respectively. Contralateral breast, heart, lungs, and thyroid were contoured. Thirty Gray was delivered in five daily fractions of 6 Gy by a three-dimensional conformal radiation therapy technique in Trial 1 and were by image-guided radiation therapy/intensity-modulated radiation therapy in Trial 2. Dosimetric results from the trials are reported and compared with RTOG 0413 requirements. Results: One hundred forty-six consecutive plans were analyzed: 67 left and 79 right breast cancers. The plans from the trials complied with the required >90% of prescribed dose covering 90% of PTV{sub E}VAL (=generated from the PTV by cropping 0.5 cm from the skin edge and excluding the chest wall): V90% was 98.1 {+-} 3.0% (with V100% and V95%, 89.4 {+-} 12.8%, 96.4 {+-} 5.1%, respectively). No significant difference between laterality was found (Student's t test). The dose constraints criteria of the RTOG-0413 protocol for ipsilateral and contralateral lung (V30 <15% and Dmax <3%), heart (V5 <40%), and thyroid (Dmax <3%) were satisfied because the plans showed an average V5% of 0.6% (range, 0-13.4) for heart, an average V30% of 0.6% (range, 0-9.1%) for ipsilateral lung, and <2% maximum dose to the thyroid. However, our partial breast irradiation plans demonstrated a higher dose to contralateral breast than that defined by RTOG constraints, with a median value of maximum doses of 4.1% (1.2 Gy), possibly as a result of contouring differences

  14. Toxicity and cosmetic outcome of three-dimensional conformal radiotherapy for accelerated partial breast irradiation

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    Gatti, M.; Bresciani, S.; Ponzone, R.; Panaia, R.; Salatino, A.; Stasi, M.; Gabriele, P. [IRCC, Candiolo (Italy)

    2011-10-15

    Full text of publication follows: Purpose.- To analyse the incidence and severity of acute and late normal tissue toxicity and cosmetic outcome using three - dimensional conformal radiotherapy to deliver accelerated partial breast irradiation. Patients and Methods.- 70 patients with stage I disease were treated with three-dimensional conformal radiotherapy for accelerated partial breast irradiation, in an approved protocol. The prescribed dose was 34 Gy in all patients delivered in 10 fractions over 5 consecutive days. On all CT scans gross tumor volume (GTV ) was defined around surgical clips. A 1.5 cm margin was added in order to account for clinical target volume (CTV) . A margin of 1 cm was added to CTI to define the planning target volume (PTV). The dose-volume constraints were followed in accordance with the specifications as dictated in the NSABP/RTOG protocol. After treatment, patients underwent a clinical and cosmetic evaluation every 3 months. Late toxicity was evaluated according to the RTOG grading schema. The cosmetic assessment was performed by the physicians using the controlateral untreated breast as the reference (Harvard scale). Results.- Median patient age was 66 years (range 51-80). Median follow-up was 15 months (range 6-46). Tumor size was < 10 mm in 33 patients (53%) and > 2 cm in 4(6%). The mean value of the ratio between the PTV and the whole ipsilateral breast volume was 38 % and the median percentage whole breast volume that received 95 % of prescribed dose was 34% (range 16%-55%). The rate of G1 and G2 acute skin toxicity was 28% and 2% respectively and the late toxicity was 17% (G1). G2 or greater toxicities were not observed. The most pronounced G1 late toxicity was subcutaneous fibrosis, developed in 3 patients. The cosmetic outcome was excellent in 83% and good in 17%. Conclusion.- Accelerated partial breast irradiation using three-dimensional conformal radiotherapy is technically feasible with very low acute and late toxicity. Long

  15. Accelerated partial breast irradiation with brachytherapy: patient selection and technique considerations

    Directory of Open Access Journals (Sweden)

    Trifiletti DM

    2015-07-01

    Full Text Available Daniel M Trifiletti,1 Kara D Romano,1 Shayna L Showalter,2 Kelli A Reardon,1 Bruce Libby,1 Timothy N Showalter11Department of Radiation Oncology, 2Division of Surgical Oncology, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USAAbstract: Accelerated partial breast irradiation (APBI through breast brachytherapy is a relatively recent development in breast radiotherapy that has gained international favor because of its reduction in treatment duration and normal tissue irradiation while maintaining favorable cancer-specific and cosmetic outcomes. Despite the fact that several large national trials have not reported final results yet, many providers are currently offering APBI to select patients and APBI is listed as a treatment option for selecting patients in the National Comprehensive Cancer Network guidelines. Multiple consensus guidelines exist in selecting patients for APBI, some with conflicting recommendations. In this review, the existing patient selection guidelines are reported, compared, and critiqued, grouping them in helpful subcategories. Unique patient and technical selection factors for APBI with brachytherapy are explored.Keywords: breast cancer, APBI, breast brachytherapy

  16. Accelerated partial-breast irradiation with interstitial implants. Analysis of factors affecting cosmetic outcome

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    Ott, Oliver J.; Lotter, Michael; Fietkau, Rainer; Strnad, Vratislav [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2009-03-15

    Purpose: To analyze patient-, disease-, and treatment-related factors for their impact on cosmetic outcome (CO) after interstitial multicatheter accelerated partial-breast irradiation (APBI). Patients and Methods: Between April 2001 and January 2005, 171 patients with early breast cancer were recruited in Erlangen for this subanalysis of the German-Austrian APBI phase II-trial. 58% (99/171) of the patients received pulsed-dose-rate (PDR), and 42% (72/171) high-dose-rate (HDR) brachytherapy. Prescribed reference dose for HDR brachytherapy was 32 Gy in eight fractions of 4 Gy, twice daily. Prescribed reference dose in PDR brachytherapy was 49.8 Gy in 83 consecutive fractions of 0.6 Gy each hour. Total treatment time was 3-4 days. Endpoint of this evaluation was the CO, graded as excellent, good, fair, or poor. Patients were divided in two groups with an excellent (n = 102) or nonexcellent (n = 69) cosmetic result. Various factors were analyzed for their impact on excellent CO. Results: The median follow-up time was 52 months (range: 21-91 months). Cosmetic results were rated as excellent in 59.6% (102/171), good in 29.8% (51/171), fair in 9.9% (17/171), and poor in 0.6% (1/171). The initial cosmetic status was significantly worse for the nonexcellent CO group (p = 0.000). The percentage of patients who received PDR brachytherapy APBI was higher in the nonexcellent CO group (68.1% vs. 51%; p = 0.026). Acute toxicity was higher in the nonexcellent CO group (24.6% vs. 12.7%; p = 0.045). Furthermore, the presence of any late toxicity was found to be associated with a worse cosmetic result (65.2% vs. 18.6%; p = 0.000). In detail, the appearance of skin hyperpigmentation (p = 0.034), breast tissue fibrosis (p = 0.000), and telangiectasia (p = 0.000) had a negative impact on CO. Conclusion: The initial, surgery-associated cosmetic status, brachytherapy modality, and the presence of acute and late toxicities were found to have an impact on overall CO. Our data have proven

  17. Using corrected Cone-Beam CT image for accelerated partial breast irradiation treatment dose verification: the preliminary experience

    OpenAIRE

    Wang, Jiazhou; Hu, Weigang; Cai, Gang; Peng, Jiayuan; Pan, Ziqiang; Guo, Xiaomao; Chen, Jiayi

    2013-01-01

    Background Accurate target localization is mandatory in the accelerated partial breast irradiation (APBI) delivery. Dosimetric verification for positional error will further guarantee the accuracy of treatment delivery. The purpose of this study is to evaluate the clinical feasibility of a cone beam computer tomographic (CBCT) image correction method in APBI. Methods A CBCT image correction method was developed. First, rigid image registration was proceeded for CTs and CBCTs; second, these im...

  18. Accelerated partial breast irradiation with external beam radiotherapy. First results of the German phase 2 trial

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    Ott, Oliver J.; Strnad, Vratislav; Stillkrieg, Wilhelm; Fietkau, Rainer [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany); Uter, Wolfgang [University Erlangen-Nuremberg, Dept. of Medical Informatics, Biometry and Epidemiology, Erlangen (Germany); Beckmann, Matthias W. [University Hospital Erlangen, Dept. of Gynecology, Erlangen (Germany)

    2017-01-15

    To evaluate the feasibility and efficacy of external beam three-dimensional (3D) conformal accelerated partial breast irradiation (APBI) for selected patients with early breast cancer. Between 2011 and 2016, 72 patients were recruited for this prospective phase 2 trial. Patients were eligible for APBI if they had histologically confirmed breast cancer or pure ductal carcinoma in situ (DCIS), a tumor diameter ≤3 cm, clear resection margins ≥2 mm, no axillary lymph node involvement, no distant metastases, tumor bed clips, and were aged ≥50 years. Patients were excluded if mammography showed a multicentric invasive growth pattern, or if they had residual diffuse microcalcifications postoperatively, an extensive intraductal component, or vessel invasion. Patients received 3D conformal external beam APBI with a total dose of 38 Gy in 10 fractions in 1-2 weeks. The trial had been registered at the German Clinical Trials Register, DRKS-ID: DRKS00004417. Median follow-up was 25.5 months (range 1-61 months). Local control was maintained in 71 of 72 patients. The 3-year local recurrence rate was 2.1% (95% confidence interval, CI: 0-6.1%). Early toxicity (grade 1 radiodermatitis) was seen in 34.7% (25/72). Late side effects ≥ grade 3 did not occur. Cosmetic results were rated as excellent/good in 96.7% (59/61). APBI with external beam radiotherapy techniques is feasible with low toxicity and, according to the results of the present and other studies, on the way to becoming a standard treatment option for a selected subgroup of patients. (orig.) [German] Untersuchung der Vertraeglichkeit und Sicherheit der externen, 3-D-konformalen akzelerierten Teilbrustbestrahlung (APBI) fuer ausgewaehlte Patientinnen mit einem fruehen Mammakarzinom. Von 2011 bis 2016 wurden 72 Patientinnen in diese prospektive Phase-2-Studie eingebracht. Einschlusskriterien waren ein histologisch gesichertes Mammakarzinom oder DCIS, ein Tumordurchmesser ≤ 3 cm, tumorfreie Resektionsraender ≥ 2

  19. Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: A case-control study of disease control, cosmesis, and complications

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    Wadasadawala Tabassum

    2009-01-01

    Full Text Available Context: Accelerated partial-breast irradiation (APBI using various approaches is being increasingly employed for selected women with early breast cancer (EBC. Aims: To conduct a case-control study comparing disease control, cosmesis, and complications in patients with EBC undergoing APBI using multicatheter interstitial brachytherapy vs those receiving conventional whole breast radiotherapy (WBRT. Settings and Design: Women with EBC fulfilling the American Brachytherapy Society (ABS criteria were selected as ′cases′ if treated with APBI or as ′controls′ if offered WBRT during the period from May 2000 to December 2004. Materials and Methods: APBI patients were treated with high-dose-rate brachytherapy (HDR to a dose of 34 Gy/10#/6-8 days. WBRT was delivered to the whole breast to a dose of 45 Gy/25# followed by tumor bed boost, either with electrons (15 Gy/6# or interstitial brachytherapy (HDR 10 Gy/1#. Results: At the median follow-up of 43.05 months in APBI and 51.08 months in WBRT there was no difference in overall survival (OS, disease-free survival (DFS, late arm edema, and symptomatic fat necrosis between the two groups. However, APBI resulted in increase in mild breast fibrosis at the tumor bed. Telangiectasias were observed in three patients of the APBI group. The cosmetic outcome was significantly better in the APBI group as compared to the WBRT group (P = 0.003. Conclusions: This study revealed equivalent locoregional and distant disease control in the two groups. APBI offered better overall cosmetic outcome, though at the cost of a slight increase in mild breast fibrosis and telangiectasias.

  20. Validating Fiducial Markers for Image-Guided Radiation Therapy for Accelerated Partial Breast Irradiation in Early-Stage Breast Cancer

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    Park, Catherine K. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States); Pritz, Jakub [Department of Physics, University of South Florida, Tampa, FL (United States); Zhang, Geoffrey G.; Forster, Kenneth M. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States); Harris, Eleanor E.R., E-mail: Eleanor.Harris@Moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States)

    2012-03-01

    Purpose: Image-guided radiation therapy (IGRT) may be beneficial for accelerated partial breast irradiation (APBI). The goal was to validate the use of intraparenchymal textured gold fiducials in patients receiving APBI. Methods and Materials: Twenty-six patients were enrolled on this prospective study that had three or four textured gold intraparenchymal fiducials placed at the periphery of the lumpectomy cavity and were treated with three-dimensional (3D) conformal APBI. Free-breathing four-dimensional computed tomography image sets were obtained pre- and posttreatment, as were daily online megavoltage (MV) orthogonal images. Intrafraction motion, variations in respiratory motion, and fiducial marker migration were calculated using the 3D coordinates of individual fiducials and a calculated center of mass (COM) of the fiducials. We also compared the relative position of the fiducial COM with the geometric center of the seroma. Results: There was less than 1 mm of intrafraction respiratory motion, variation in respiratory motion, or fiducial marker migration. The change in seroma position relative to the fiducial COM was 1 mm {+-} 1 mm. The average position of the geometric seroma relative to the fiducial COM pretreatment compared with posttreatment was 1 mm {+-} 1 mm. The largest daily variation in displacement when using bony landmark was in the anteroposterior direction and two standard deviations (SD) of this variation was 10 mm. The average variation in daily separation between the fiducial pairs from daily MV images was 3 mm {+-} 3 mm therefore 2 SD is 6 mm. Conclusion: Fiducial markers are stable throughout the course of APBI. Planning target volume margins when using bony landmarks should be 10 mm and can be reduced to 6 mm if using fiducials.

  1. Study of the seroma volume changes in the patients who underwent Accelerated Partial Breast Irradiation

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    Kim, Dae Ho; Son, Sang Jun; Mun, Jun Ki; Seo, Seok Jin; Lee, Je Hee [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-06-15

    By analyzing seroma volume changes in the patients who underwent Partial breast radiation therapy after breast conserving surgery, we try to contribute to the improvement of radiotherapy effect. Enrolled 20 patients who underwent partial breast radiation therapy by ViewRay MRIdian System were subject. After seeking for the size of the removed sample in the patients during surgery and obtained seroma volume changes on a weekly basis. On the Basis of acquired volume, it was compared with age, term from start of the first treatment after surgery, BMI (body mass index) and the extracted sample size during surgery. And using the ViewRay MRIdian RTP System, the figure was analyzed by PTV(=seroma volume + margin) to obtain a specific volume of the Partial breast radiation therapy. The changes of seroma volume from MR simulation to the first treatment (a week) is 0~5% in 8, 5~10% in 3, 10 to 15% in 2, and 20% or more in 5 people. Two patients(A, B patient) among subjects showed the biggest change. The A patient's 100% of the prescribed dose volume is 213.08 cc, PTV is 181.93 cc, seroma volume is 15.3 cc in initial plan. However, while seroma volume decreased 65.36% to 5.3 cc, 100% of the prescribed dose volume was reduced to 3.4% to 102.43 cc and PTV also did 43.6% to 102.54 cc. In the case of the B patient, seroma volume decreased 42.57% from 20.2 cc to 11.6 cc. Because of that, 100% of the prescribed dose volume decreased 8.1% and PTV also did to 40%. As the period between the first therapy and surgery is shorter, the patient is elder and the size of sample is smaller than 100 cc, the change grow bigger. It is desirable to establish an adaptive plan according to each patient's changes of seroma volume through continuous observation. Because partial breast patients is more sensitive than WBRT patients about dose conformity in accordance with the volume change.

  2. Intensity Modulated Accelerated Partial Breast Irradiation Before Surgery in Treating Older Patients With Hormone Responsive Stage 0-I Breast Cancer

    Science.gov (United States)

    2016-05-04

    Ductal Breast Carcinoma in Situ; Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Ductal Breast Carcinoma With Predominant Intraductal Component; Lobular Breast Carcinoma in Situ; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Progesterone Receptor-positive Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Tubular Ductal Breast Carcinoma

  3. Three-Year Outcomes of a Canadian Multicenter Study of Accelerated Partial Breast Irradiation Using Conformal Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Berrang, Tanya S., E-mail: tberrang@bccancer.bc.ca [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Olivotto, Ivo [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Kim, Do-Hoon [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Nichol, Alan [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Cho, B.C. John [Princess Margaret Hospital, Ontario (Canada); University of Toronto, Ontario (Canada); Mohamed, Islam G. [British Columbia Cancer Agency-Southern Interior, BC (Canada); University of British Columbia, BC (Canada); Parhar, Tarnjit [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Wright, J.R. [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Truong, Pauline [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Tyldesley, Scott [British Columbia Cancer Agency-Vancouver Centre, BC (Canada); University of British Columbia, BC (Canada); Sussman, Jonathan [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada); Wai, Elaine [British Columbia Cancer Agency-Vancouver Island, BC (Canada); University of British Columbia, BC (Canada); Whelan, Tim [Juravinski Cancer Centre, Ontario (Canada); McMaster University, Ontario (Canada)

    2011-12-01

    Purpose: To report 3-year toxicity, cosmesis, and efficacy of a multicenter study of external beam, accelerated partial breast irradiation (APBI) for early-stage breast cancer. Methods and Materials: Between March 2005 and August 2006, 127 women aged {>=}40 years with ductal carcinoma in situ or node-negative invasive breast cancer {<=}3 cm in diameter, treated with breast-conserving surgery achieving negative margins, were accrued to a prospective study involving five Canadian cancer centers. Women meeting predefined dose constraints were treated with APBI using 3 to 5 photon beams, delivering 35 to 38.5 Gy in 10 fractions, twice a day, over 1 week. Patients were assessed for treatment-related toxicities, cosmesis, and efficacy before APBI and at specified time points for as long as 3 years after APBI. Results: 104 women had planning computed tomography scans showing visible seromas, met dosimetric constraints, and were treated with APBI to doses of 35 Gy (n = 9), 36 Gy (n = 33), or 38.5 Gy (n = 62). Eighty-seven patients were evaluated with minimum 3-year follow-up after APBI. Radiation dermatitis, breast edema, breast induration, and fatigue decreased from baseline levels or stabilized by the 3-year follow-up. Hypopigmentation, hyperpigmentation, breast pain, and telangiectasia slightly increased from baseline levels. Most toxicities at 3 years were Grade 1. Only 1 patient had a Grade 3 toxicity with telangiectasia in a skin fold inside the 95% isodose. Cosmesis was good to excellent in 86% (89/104) of women at baseline and 82% (70/85) at 3 years. The 3-year disease-free survival was 97%, with only one local recurrence that occurred in a different quadrant away from the treated site and two distant recurrences. Conclusions: At 3 years, toxicity and cosmesis were acceptable, and local control and disease-free survival were excellent, supporting continued accrual to randomized APBI trials.

  4. Clinical outcomes, toxicity, and cosmesis in breast cancer patients with close skin spacing treated with accelerated partial breast irradiation (APBI) using multi-lumen/catheter applicators.

    Science.gov (United States)

    Akhtari, Mani; Abboud, Mirna; Szeja, Sean; Pino, Ramiro; Lewis, Gary D; Bass, Barbara L; Miltenburg, Darlene M; Butler, E Brian; Teh, Bin S

    2016-12-01

    Accelerated partial breast irradiation (APBI) using a single-lumen device is associated with better cosmetic outcomes if the spacing between the applicator and skin is > 7 mm. However, there are no reports addressing the late toxicity and clinical outcomes in patients treated with single-entry multi-lumen/catheter applicators who had close skin spacing (7 mm or less). We undertook this study to report clinical outcome, acute and late toxicity as well as cosmesis of early stage breast cancer patients with close skin spacing treated with APBI using multi-lumen or multi-catheter devices. This is a retrospective study of all breast cancer patients who had undergone APBI using single-entry multi-lumen/catheter devices in a single institution between 2008 to 2012. The study was limited to those with ≤ 7 mm spacing between the device and skin. We identified 37 patients and 38 lesions with skin spacing of ≤ 7 mm. Seven lesions (18%) had spacing of ≤ 3 mm. Median follow-up was 47.5 months. There was one case of ipsilateral breast recurrence and one ipsilateral axillary recurrence. Based on RTOG criteria, 22 treated lesions experienced grade 1 and 9 lesions experienced grade 2 toxicity. Twenty-one lesions experienced late grade 1 toxicity. One patient had to undergo mastectomy due to mastitis. Twenty-four treated breasts showed excellent and 11 had good cosmetic outcome. Overall cosmesis trended towards a significant correlation with skin spacing. However, all patients with ≤ 3 mm skin spacing experienced acute and late toxicities. Accelerated partial breast irradiation can be safely performed in patients with skin spacing of ≤ 7 mm using single-entry multi-lumen/catheter applicators with excellent cosmetic outcomes and an acceptable toxicity profile. However, skin spacing of ≤ 3 mm is associated with acute and late toxicity and should be avoided if possible.

  5. Nomogram for Predicting the Risk of Locoregional Recurrence in Patients Treated With Accelerated Partial-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Wobb, Jessica L. [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan (United States); Chen, Peter Y., E-mail: PChen@beaumont.edu [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan (United States); Shah, Chirag [Department of Radiation Oncology, Summa Health System, Akron, Ohio (United States); Moran, Meena S. [Department of Therapeutic Radiology, Yale School of Medicine, Norwich, Connecticut (United States); Shaitelman, Simona F. [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Vicini, Frank A. [Department of Radiation Oncology, Michigan Healthcare Professionals/21st Century Oncology, Farmington, Michigan (United States); Mbah, Alfred K.; Lyden, Maureen [Biostat International Inc, Tampa, Florida (United States); Beitsch, Peter [Department of Surgery, Dallas Breast Center, Dallas, Texas (United States)

    2015-02-01

    Purpose: To develop a nomogram taking into account clinicopathologic features to predict locoregional recurrence (LRR) in patients treated with accelerated partial-breast irradiation (APBI) for early-stage breast cancer. Methods and Materials: A total of 2000 breasts (1990 women) were treated with APBI at William Beaumont Hospital (n=551) or on the American Society of Breast Surgeons MammoSite Registry Trial (n=1449). Techniques included multiplanar interstitial catheters (n=98), balloon-based brachytherapy (n=1689), and 3-dimensional conformal radiation therapy (n=213). Clinicopathologic variables were gathered prospectively. A nomogram was formulated utilizing the Cox proportional hazards regression model to predict for LRR. This was validated by generating a bias-corrected index and cross-validated with a concordance index. Results: Median follow-up was 5.5 years (range, 0.9-18.3 years). Of the 2000 cases, 435 were excluded because of missing data. Univariate analysis found that age <50 years, pre-/perimenopausal status, close/positive margins, estrogen receptor negativity, and high grade were associated with a higher frequency of LRR. These 5 independent covariates were used to create adjusted estimates, weighting each on a scale of 0-100. The total score is identified on a points scale to obtain the probability of an LRR over the study period. The model demonstrated good concordance for predicting LRR, with a concordance index of 0.641. Conclusions: The formulation of a practical, easy-to-use nomogram for calculating the risk of LRR in patients undergoing APBI will help guide the appropriate selection of patients for off-protocol utilization of APBI.

  6. Accelerated partial breast irradiation in an Asian population: dosimetric findings and preliminary results of a multicatheter interstitial program

    Directory of Open Access Journals (Sweden)

    Koh YV

    2016-09-01

    Full Text Available Yaling Vicky Koh,1 Poh Wee Tan,1 Shaik Ahmad Buhari,2 Philip Iau,2 Ching Wan Chan,2 Liang Shen,3 Sing Huang Tan,4 Johann I-Hsiung Tang1 1Department of Radiation Oncology, National University Cancer Institute Singapore, 2Department of Surgery, National University Hospital, 3Department of Medicine, Biostatistics Unit, National University of Singapore, 4Department of Medical Oncology, National University Cancer Institute Singapore, Singapore Introduction: Accelerated partial breast irradiation (APBI using the multicatheter method has excellent cosmesis and low rates of long-term toxicity. However, there are few studies looking at the feasibility of this procedure and the outcomes in an Asian population. This study aims to look at outcomes at our hospital.Methods: We identified 121 patients treated with APBI at our center between 2008 and 2014. The median follow-up for our patient group was 30 months (range 3.7–66.5. The prescribed dose per fraction was 3.4 Gy in 10 fractions. In this study population, 71% of the patients were Chinese while 15% (n=19 were of other Asian ethnicity.Results: In this study, the median breast volume was 850 cc (range 216–2,108 with 59.5% (n=72 patients with a breast volume of <1,000 cc. The average planning target volume was 134 cc (range 28–324. The number of catheters used ranged from 8 to 25 with an average of 18 catheters used per patient. We achieved an average dose homogeneity index of 0.76 in our patients. The average D90(% was 105% and the average D90(Gy was 3.6 Gy per fraction. The median volume receiving 100% of the prescribed dose (V100 was 161.7 cc (range 33.9–330.1, 150% of the prescribed dose (V150 and 200% of the prescribed dose (V200 was 39.4 cc (range 14.6–69.6 and 14.72 cc (range 6.48–22.25, respectively. Our dosimetric outcomes were excellent even in patients with breast volume under 1,000 cc. There were no cases of grade 3 skin toxicity or acute pneumonitis. Two patients had a

  7. Implementation of the technique of partial irradiation accelerated the breast with high doses (HDR) brachytherapy; Puesta en marcha de la tecnica de irradiacion parcial acelerada de la mama con braquterapia de alta tasa de dosis (HDR)

    Energy Technology Data Exchange (ETDEWEB)

    Molina Lopez, M. Y.; Pardo Perez, E.; Castro Novais, J.; Martinez Ortega, J.; Ruiz Maqueda, S.; Cerro Penalver, E. del

    2013-07-01

    The objective of this work is presents procedure carried out in our Centre for the implementation of the accelerated partial breast irradiation (APBI, accelerated partial-breast irradiation) with high-rate brachytherapy (HDR), using plastic tubes as applicators. Carried out measures, the evaluation of the dosimetric parameters analyzing and presenting the results. (Author)

  8. Identifying Patients Who May Be Candidates for a Clinical Trial of Salvage Accelerated Partial Breast Irradiation after Previous Whole Breast Irradiation

    Directory of Open Access Journals (Sweden)

    Linna Li

    2012-01-01

    Full Text Available Background and Objectives. Accelerated partial breast irradiation (APBI has been proposed as an alternative to salvage mastectomy for patients with ipsilateral breast tumor recurrence (IBTR after prior breast conservation. We studied factors that are associated with a more favorable local recurrence profile that could make certain patients eligible for APBI. Methods. Between 1980 and 2005, 157 Stage 0–II breast cancer patients had an IBTR treated by mastectomy. Clinical and pathological features were analyzed to identify factors associated with favorable IBTR defined as unifocal DCIS or T1 ≤ 2 cm, without skin involvement, and >2 year interval from initial treatment. Results. Median followup was 140 months and time to recurrence was 73 months. Clinical stage distribution at recurrence was DCIS in 32 pts (20%, T1 in 90 pts (57%, T2 in 14 pts (9%, T3 in 4 pts (3%, and T4 in 9 pts (6%. IBTR was classified as favorable in 71%. Clinical stage of IBTR predicted for pathologic stage –95% of patients with clinical T1 IBTR had pathologic T1 disease at salvage mastectomy . Conclusions. Clinical stage at presentation strongly correlated with pathologic stage at mastectomy. More than 70% of recurrences were favorable and may be appropriate candidates for salvage APBI trials.

  9. Impact of the Number of Cautionary and/or Unsuitable Risk Factors on Outcomes After Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Wobb, Jessica; Wilkinson, J. Ben [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Shah, Chirag [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Mitchell, Christina; Wallace, Michelle; Ye, Hong; Stromberg, Jannifer; Grills, Inga [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Chen, Peter Y., E-mail: PChen@beaumont.edu [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)

    2013-09-01

    Purpose: To examine clinical outcomes of accelerated partial-breast irradiation (APBI) stratified by the number of American Society for Radiation Oncology consensus statement cautionary/unsuitable risk factors (RFs) present. Methods and Materials: A total of 692 patients were treated with APBI at a single institution between April 1993 and January 2012 using interstitial (n=195), balloon (n=292), and 3-dimensional conformal radiation therapy (n=205) techniques. Clinical outcomes were evaluated by risk group and number of RFs. Results: Median follow-up was 5.2 years (range, 0-18.3 years). Most patients were classified as suitable (n=240, 34%) or cautionary (n=343, 50%) risk, whereas 16% (n=109) were unsuitable. In patients with increasing total RFs (1 RF, 2 RF, 3+ RF), higher rates of grade 3 histology (10% vs 18% vs 32%, P<.001), estrogen receptor negativity (0 vs 12% vs 29%, P<.001), close/positive margins (0 vs 6% vs 17%, P<.001), and use of adjuvant chemotherapy (3% vs 12% vs 33%, P<.001) were noted. When pooling cautionary and unsuitable patients, increased ipsilateral breast tumor recurrence/regional recurrence was most notable for patients with 3 or more combined RFs versus 2 or fewer combined RFs (P<.001). Conclusions: Patients with 3 or more cautionary or unsuitable RFs may be at risk for higher local, regional, and distant recurrence after breast-conserving therapy using APBI. Patients with 2 or fewer total RFs have 98% locoregional control at 5 years. Inclusion of total number of RFs in future risk stratification schemes for APBI may be warranted.

  10. Vertical mammaplasty associated with accelerated partial breast radiotherapy: how oncoplastic surgery techniques associated with modern techniques of radiotherapy can improve the aesthetic outcome in selected patients

    Energy Technology Data Exchange (ETDEWEB)

    Couto, Henrique Lima, E-mail: enriquecouto@hotmail.com [Santa Fe Women' s and Maternity Hospital, Belo Horizonte, MG (Brazil); Amorim, Washington Cancado; Guimaraes, Rodrigo [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital Geral; Ramires, Leandro Cruz; Castilho, Marcus Simoes [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Fac. de Medicina; Dominguez, Lorena Lima Coto [Universidade Estacio de Sa (UNESA), Rio de Janeiro, EJ (Brazil)

    2014-07-15

    Breast cancer is the second most common type of cancer in the world, being the most common among women, responsible for 22% of new cases each year. It's surgical and radiation treatment evolved from radical procedures (Halsted radical mastectomy and total external breast radiotherapy) to less radical and more conservative procedures. With the use of modern oncoplastic surgery techniques and accelerated partial breast radiotherapy, selected patients can benefit with better aesthetic results, fewer side effects, and more comfortable and brief treatments. (author)

  11. Accelerated partial breast irradiation using once-daily fractionation: analysis of 312 cases with four years median follow-up

    Directory of Open Access Journals (Sweden)

    Shaikh Arif Y

    2012-02-01

    Full Text Available Abstract Background There are limited data on accelerated partial breast irradiation (APBI using external beam techniques. Moreover, there are recent reports of increased fibrosis and unacceptable cosmesis with APBI using external beam with BID fractionation. We adopted a once daily regimen of APBI with fractionation similar to that shown to be effective in a Canadian randomized trial of whole breast irradiation. It is unclear whether patients with DCIS or invasive lobular carcinoma (ILC are suitable for APBI. Methods The retrospective cohort included 310 patients with 312 tumors of T1-T2N0-N1micM0 invasive ductal carcinoma (IDC, ILC, or Tis (DCIS treated with APBI via external beam. Most patients were treated using IMRT with 16 daily fractions of 270 cGy to a dose of 4320 cGy. The target volume included the lumpectomy cavity plus 1.0 cm to account for microscopic disease and an additional 0.5 to 1.0 cm for setup uncertainty and breathing motion. Ipsilateral breast failure (IBF was pathologically confirmed as a local failure (LF or an elsewhere failure (EF. Results Median follow-up was 49 months. Among the 312 cases, 213 were IDC, 31 ILC, and 68 DCIS. Median tumor size was 1.0 cm. There were 9 IBFs (2.9% including 5 LFs and 4 EFs. The IBF rates among patients with IDC, ILC, and DCIS were 2.4%, 3.2%, and 4.4%, respectively, with no significant difference between histologies. When patients were analyzed by the ASTRO APBI consensus statement risk groups, 32% of treated cases were considered suitable, 50% cautionary, and 18% unsuitable. The IBF rates among suitable, cautionary, and unsuitable patients were 4.0%, 2.6%, and 1.8%, respectively, with no significant difference between risk groups. Acute skin reactions were rare and long-term cosmetic outcome was very good to excellent. Conclusions External beam APBI with once daily fractionation has a low rate of IBF consistent with other published APBI studies. The ASTRO risk stratification did not

  12. Accelerated Partial Breast Irradiation Is Safe and Effective Using Intensity-Modulated Radiation Therapy in Selected Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lewin, Alan A., E-mail: alanl@baptisthealth.net [Department of Radiation Oncology, Baptist Hospital of Miami, Miami, FL (United States); Derhagopian, Robert [Department of Surgery, Baptist Hospital of Miami, Miami, FL (United States); Saigal, Kunal; Panoff, Joseph E. [Department of Radiation Oncology, University of Miami, Miami, FL (United States); Abitbol, Andre; Wieczorek, D. Jay; Mishra, Vivek [Department of Radiation Oncology, Baptist Hospital of Miami, Miami, FL (United States); Reis, Isildinha; Ferrell, Annapoorna [Division of Biostatistics, University of Miami, Miami, FL (United States); Moreno, Lourdes [Department of Radiation Oncology, Baptist Hospital of Miami, Miami, FL (United States); Takita, Cristiane [Department of Radiation Oncology, University of Miami, Miami, FL (United States)

    2012-04-01

    Purpose: To report the feasibility, toxicity, cosmesis, and efficacy of using intensity-modulated radiation therapy (IMRT) with respiratory gating to deliver accelerated partial breast irradiation (APBI) in selected Stage I/II breast cancer after breast-conserving surgery. Methods and Materials: Eligible patients with node-negative Stage I/II breast cancer were prospectively enrolled in an institutional review board approved protocol to receive APBI using IMRT after breast-conserving surgery. The target volume was treated at 3.8 Gy/fraction twice daily for 5 days, to a total dose of 38 Gy. Results: Thirty-six patients were enrolled for a median follow-up time of 44.8 months. The median tumor size was 0.98 cm (range, 0.08-3 cm). The median clinical target volume (CTV) treated was 71.4 cc (range, 19-231 cc), with the mean dose to the CTV being 38.96 Gy. Acute toxicities included Grade 1 erythema in 44% of patients and Grade 2 in 6%, Grade 1 hyperpigmentation in 31% of patients and Grade 2 in 3%, and Grade 1 breast/chest wall tenderness in 14% of patients. No Grade 3/4 acute toxicities were observed. Grade 1 and 2 late toxicities as edema, fibrosis, and residual hyperpigmentation occurred in 14% and 11% of patients, respectively; Grade 3 telangiectasis was observed in 3% of patients. The overall cosmetic outcome was considered 'excellent' or 'good' by 94% of patients and 97% when rated by the physician, respectively. The local control rate was 97%; 1 patient died of a non-cancer-related cause. Conclusions: APBI can be safely and effectively administered using IMRT. In retrospective analysis, IMRT enabled the achievement of normal tissue dose constraints as outlined by Radiation Therapy Oncology Group 04-13/NSABP B-13 while providing excellent conformality for the CTV. Local control and cosmesis have remained excellent at current follow-up, with acceptable rates of acute/late toxicities. Our data suggest that cosmesis is dependent on target volume

  13. Local Control, Toxicity, and Cosmesis in Women >70 Years Enrolled in the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Atif J., E-mail: atif_khan@rwjuh.edu [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Vicini, Frank A.; Beitsch, Peter [American Society of Breast Surgeons, Columbia, MD (United States); Goyal, Sharad [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Kuerer, Henry M.; Keisch, Martin; Quiet, Coral; Zannis, Victor; Keleher, Angela; Snyder, Howard; Gittleman, Mark; Whitworth, Pat; Fine, Richard [American Society of Breast Surgeons, Columbia, MD (United States); Lyden, Maureen [BioStat International, Inc., Tampa, FL (United States); Haffty, Bruce G. [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); American Society of Breast Surgeons, Columbia, MD (United States)

    2012-10-01

    Purpose: The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial. Methods and Materials: A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher's exact test was performed to correlate age ({<=}70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model. Results: Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors {<=}2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients. Conclusions: Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.

  14. Accelerated partial breast irradiation using intensity-modulated radiotherapy versus whole breast irradiation: 5-year survival analysis of a phase 3 randomised controlled trial.

    Science.gov (United States)

    Livi, Lorenzo; Meattini, Icro; Marrazzo, Livia; Simontacchi, Gabriele; Pallotta, Stefania; Saieva, Calogero; Paiar, Fabiola; Scotti, Vieri; De Luca Cardillo, Carla; Bastiani, Paolo; Orzalesi, Lorenzo; Casella, Donato; Sanchez, Luis; Nori, Jacopo; Fambrini, Massimiliano; Bianchi, Simonetta

    2015-03-01

    Accelerated partial breast irradiation (APBI) has been introduced as an alternative treatment method for selected patients with early stage breast cancer (BC). Intensity-modulated radiotherapy (IMRT) has the theoretical advantage of a further increase in dose conformity compared with three-dimensional techniques, with more normal tissue sparing. The aim of this randomised trial is to compare the local recurrence and survival of APBI using the IMRT technique after breast-conserving surgery to conventional whole-breast irradiation (WBI) in early stage BC. This study was performed at the University of Florence (Florence, Italy). Women aged more than 40years affected by early BC, with a maximum pathological tumour size of 25mm, were randomly assigned in a 1:1 ratio to receive either WBI or APBI using IMRT. Patients in the APBI arm received a total dose of 30 Gy to the tumour bed in five daily fractions. The WBI arm received 50Gy in 25 fractions, followed by a boost on the tumour bed of 10Gy in five fractions. The primary end-point was occurrence of ipsilateral breast tumour recurrences (IBTRs); the main analysis was by intention-to-treat. This trial is registered with ClinicalTrials.gov, number NCT02104895. A total of 520 patients were randomised (260 to external WBI and 260 to APBI with IMRT) between March 2005 and June 2013. At a median follow-up of 5.0 years (Interquartile Range (IQR) 3.4-7.0), the IBTR rate was 1.5% (three cases) in the APBI group (95% confidence interval (CI) 0.1-3.0) and in the WBI group (three cases; 95% CI 0.0-2.8). No significant difference emerged between the two groups (log rank test p=0.86). We identified seven deaths in the WBI group and only one in the APBI group (p=0.057). The 5-year overall survival was 96.6% for the WBI group and 99.4% for the APBI group. The APBI group presented significantly better results considering acute (p=0.0001), late (p=0.004), and cosmetic outcome (p=0.045). To our knowledge, this is the first randomised

  15. Accelerated partial breast irradiation: Using the CyberKnife as the radiation delivery platform in the treatment of early breast cancer

    Directory of Open Access Journals (Sweden)

    Sandra eVermeulen

    2011-11-01

    Full Text Available We evaluate the CyberKnife (Accuray, Incorporated, Sunnyvale, CA for non-invasive delivery of accelerated partial breast irradiation (APBI in early breast cancer patients. Between 6/2009 and 5/2011, 9 patients were treated with CyberKnife APBI. Normal tissue constraints were imposed as outlined in the National Surgical Adjuvant Breast and Bowel Project B-39/Radiation Therapy Oncology Group 0413 (NSABP/RTOG Protocol (Vicini and White, 2007. Patients received a total dose of 30 Gy in 5 fractions (group 1, n=2 or 34 Gy in 10 fractions (group 2, n=7 delivered to the planning treatment volume (PTV defined as the clinical target volume (CTV + 2 mm. The CTV was defined as either the lumpectomy cavity plus 10 mm (n=2 or 15 mm (n=7. The cavity was defined by a T2-weighted non-contrast breast MRI fused to a planning non-contrast thoracic CT. The CyberKnife Synchrony system tracked gold fiducials sutured into the cavity wall during lumpectomy. Treatments started 4-5 weeks after lumpectomy. The mean PTV was 100 cm3 (range, 92-108 cm3 and 105 cm3 (range, 49-241 cm3 and the mean PTV isodose prescription line was 70% for groups 1 and 2, respectively. The mean percent of whole breast reference volume receiving 100% and 50% of the dose (V100 and V50 for group 1 was 11% (range, 8-13% and 23% (range, 16-30% and for group 2 was 11% (range, 7-14% and 26% (range, 21- 35.0% , respectively. At a median 7 months follow-up (range, 4-26 months, no acute toxicities were seen. Acute cosmetic outcomes were excellent or good in all patients; for those patients with more than 12 months follow-up the late cosmesis outcomes were excellent or good. In conclusion, the lack of observable acute side effects and current excellent/good cosmetic outcomes is promising. We believe this suggests the CyberKnife is a suitable non-invasive radiation platform for delivering APBI with achievable normal tissue constraints.

  16. Factors Associated With Chest Wall Toxicity After Accelerated Partial Breast Irradiation Using High-Dose-Rate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Sheree, E-mail: shereedst32@hotmail.com [Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, Georgia (United States); Vicini, Frank [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Vanapalli, Jyotsna R.; Whitaker, Thomas J.; Pope, D. Keith [Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, Georgia (United States); Lyden, Maureen [BioStat International, Inc., Tampa, Florida (United States); Bruggeman, Lisa; Haile, Kenneth L.; McLaughlin, Mark P. [Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, Georgia (United States)

    2012-07-01

    Purpose: The purpose of this analysis was to evaluate dose-volume relationships associated with a higher probability for developing chest wall toxicity (pain) after accelerated partial breast irradiation (APBI) by using both single-lumen and multilumen brachytherapy. Methods and Materials: Rib dose data were available for 89 patients treated with APBI and were correlated with the development of chest wall/rib pain at any point after treatment. Ribs were contoured on computed tomography planning scans, and rib dose-volume histograms (DVH) along with histograms for other structures were constructed. Rib DVH data for all patients were sampled at all volumes {>=}0.008 cubic centimeter (cc) (for maximum dose related to pain) and at volumes of 0.5, 1, 2, and 3 cc for analysis. Rib pain was evaluated at each follow-up visit. Patient responses were marked as yes or no. No attempt was made to grade responses. Eighty-nine responses were available for this analysis. Results: Nineteen patients (21.3%) complained of transient chest wall/rib pain at any point in follow-up. Analysis showed a direct correlation between total dose received and volume of rib irradiated with the probability of developing rib/chest wall pain at any point after follow-up. The median maximum dose at volumes {>=}0.008 cc of rib in patients who experienced chest wall pain was 132% of the prescribed dose versus 95% of the prescribed dose in those patients who did not experience pain (p = 0.0035). Conclusions: Although the incidence of chest wall/rib pain is quite low with APBI brachytherapy, attempts should be made to keep the volume of rib irradiated at a minimum and the maximum dose received by the chest wall as low as reasonably achievable.

  17. Contralateral breast dose from partial breast brachytherapy.

    Science.gov (United States)

    Robinson, R Cole; Nelson, Christopher L; Bloom, Elizabeth S; Kisling, Kelly D; Mason, Bryan E; Fisher, Gary D; Kirsner, Steven M

    2015-11-08

    The purpose of this study was to determine the dose to the contralateral breast during accelerated partial breast irradiation (APBI) and to compare it to external beam-published values. Thermoluminescent dosimeter (TLD) packets were used to measure the dose to the most medial aspect of the contralateral breast during APBI simulation, daily quality assurance (QA), and treatment. All patients in this study were treated with a single-entry, multicatheter device for 10 fractions to a total dose of 34 Gy. A mark was placed on the patient's skin on the medial aspect of the opposite breast. Three TLD packets were taped to this mark during the pretreatment simulation. Simulations consisted of an AP and Lateral scout and a limited axial scan encompassing the lumpectomy cavity (miniscan), if rotation was a concern. After the simulation the TLD packets were removed and the patients were moved to the high-dose-rate (HDR) vault where three new TLD packets were taped onto the patients at the skin mark. Treatment was administered with a Nucletron HDR afterloader using Iridium-192 as the treatment source. Post-treatment, TLDs were read (along with the simulation and QA TLD and a set of standards exposed to a known dose of 6 MV photons). Measurements indicate an average total dose to the contralateral breast of 70 cGy for outer quadrant implants and 181 cGy for inner quadrant implants. Compared to external beam breast tangents, these results point to less dose being delivered to the contralateral breast when using APBI.

  18. Accelerated Partial Breast Irradiation With Low-Dose-Rate Interstitial Implant Brachytherapy After Wide Local Excision: 12-Year Outcomes From a Prospective Trial

    Energy Technology Data Exchange (ETDEWEB)

    Hattangadi, Jona A. [Harvard Radiation Oncology Program, Boston, MA (United States); Powell, Simon N. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); MacDonald, Shannon M.; Mauceri, Thomas; Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Freer, Phoebe [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Lawenda, Brian [21st Century Oncology, Las Vegas, NV (United States); Alm El-Din, Mohamed A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Department of Clinical Oncology, Tanta University Hospital, Tanta (Egypt); Gadd, Michele A.; Smith, Barbara L. [Department of Surgical Oncology, Massachusetts General Hospital, Boston, MA (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)

    2012-07-01

    Purpose: To evaluate the long-term toxicity, cosmesis, and local control of accelerated partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0 breast cancer (BCa). Materials and Methods: Between 1997 and 2001, 50 patients with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate accelerated partial breast irradiation with implant brachytherapy after wide local excision and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n = 20), 55 Gy (n = 17), and 60 Gy (n = 13). Patient- and physician-assessed breast cosmesis, patient satisfaction, toxicity, mammographic abnormalities, repeat biopsies, and disease status were prospectively evaluated at each visit. Kendall's tau ({tau}{sub {beta}}) and logistic regression analyses were used to correlate outcomes with dose, implant volume, patient age, and systemic therapy. Results: The median follow-up period was 11.2 years (range, 4-14). The patient satisfaction rate was 67%, 67% reported good-excellent cosmesis, and 54% had moderate-severe fibrosis. Higher dose was correlated with worse cosmetic outcome ({tau}{sub {beta}} 0.6, p < .0001), lower patient satisfaction ({tau}{sub {beta}} 0.5, p < .001), and worse fibrosis ({tau}{sub {beta}} 0.4, p = .0024). Of the 50 patients, 35% had fat necrosis and 34% developed telangiectasias {>=}1 cm{sup 2}. Grade 3-4 late skin and subcutaneous toxicities were seen in 4 patients (9%) and 6 patients (13%), respectively, and both correlated with higher dose ({tau}{sub {beta}} 0.3-0.5, p {<=} .01). One patient had Grade 4 skin ulceration and fat necrosis requiring surgery. Mammographic abnormalities were seen in 32% of the patients, and 30% underwent repeat biopsy, of which 73% were benign. Six patients had ipsilateral breast recurrence: five elsewhere in the breast, and one at the implant site. One patient died of metastatic BCa after recurrence. The 12-year actuarial local control, recurrence

  19. MO-DE-210-06: Development of a Supercompounded 3D Volumetric Ultrasound Image Guidance System for Prone Accelerated Partial Breast Irradiation (APBI)

    Energy Technology Data Exchange (ETDEWEB)

    Chiu, T; Hrycushko, B; Zhao, B; Jiang, S; Gu, X [UT Southwestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: For early-stage breast cancer, accelerated partial breast irradiation (APBI) is a cost-effective breast-conserving treatment. Irradiation in a prone position can mitigate respiratory induced breast movement and achieve maximal sparing of heart and lung tissues. However, accurate dose delivery is challenging due to breast deformation and lumpectomy cavity shrinkage. We propose a 3D volumetric ultrasound (US) image guidance system for accurate prone APBI Methods: The designed system, set beneath the prone breast board, consists of a water container, an US scanner, and a two-layer breast immobilization cup. The outer layer of the breast cup forms the inner wall of water container while the inner layer is attached to patient breast directly to immobilization. The US transducer scans is attached to the outer-layer of breast cup at the dent of water container. Rotational US scans in a transverse plane are achieved by simultaneously rotating water container and transducer, and multiple transverse scanning forms a 3D scan. A supercompounding-technique-based volumetric US reconstruction algorithm is developed for 3D image reconstruction. The performance of the designed system is evaluated with two custom-made gelatin phantoms containing several cylindrical inserts filled in with water (11% reflection coefficient between materials). One phantom is designed for positioning evaluation while the other is for scaling assessment. Results: In the positioning evaluation phantom, the central distances between the inserts are 15, 20, 30 and 40 mm. The distances on reconstructed images differ by −0.19, −0.65, −0.11 and −1.67 mm, respectively. In the scaling evaluation phantom, inserts are 12.7, 19.05, 25.40 and 31.75 mm in diameter. Measured inserts’ sizes on images differed by 0.23, 0.19, −0.1 and 0.22 mm, respectively. Conclusion: The phantom evaluation results show that the developed 3D volumetric US system can accurately localize target position and determine

  20. External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Pashtan, Itai M. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Recht, Abram [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Brachtel, Elena [Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts (United States); Abi-Raad, Rita F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); D' Alessandro, Helen A. [Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts (United States); Levy, Antonin; Wo, Jennifer Y. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Hirsch, Ariel E. [Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts (United States); Kachnic, Lisa A. [Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Goldberg, Saveli [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle; Gadd, Michelle; Smith, Barbara L. [Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Powell, Simon N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2012-11-01

    Purpose: External beam accelerated partial breast irradiation (APBI) is an increasingly popular technique for treatment of patients with early stage breast cancer following breast-conserving surgery. Here we present 5-year results of a prospective trial. Methods and Materials: From October 2003 through November 2005, 98 evaluable patients with stage I breast cancer were enrolled in the first dose step (32 Gy delivered in 8 twice-daily fractions) of a prospective, multi-institutional, dose escalation clinical trial of 3-dimensional conformal external beam APBI (3D-APBI). Median age was 61 years; median tumor size was 0.8 cm; 89% of tumors were estrogen receptor positive; 10% had a triple-negative phenotype; and 1% had a HER-2-positive subtype. Median follow-up was 71 months (range, 2-88 months; interquartile range, 64-75 months). Results: Five patients developed ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial IBTR rate of 5% (95% confidence interval [CI], 1%-10%). Three of these cases occurred in patients with triple-negative disease and 2 in non-triple-negative patients, for 5-year actuarial IBTR rates of 33% (95% CI, 0%-57%) and 2% (95% CI, 0%-6%; P<.0001), respectively. On multivariable analysis, triple-negative phenotype was the only predictor of IBTR, with borderline statistical significance after adjusting for tumor grade (P=.0537). Conclusions: Overall outcomes were excellent, particularly for patients with estrogen receptor-positive disease. Patients in this study with triple-negative breast cancer had a significantly higher IBTR rate than patients with other receptor phenotypes when treated with 3D-APBI. Larger, prospective 3D-APBI clinical trials should continue to evaluate the effect of hormone receptor phenotype on IBTR rates.

  1. SU-E-T-217: Comprehensive Dosimetric Evaluation On 3D-CRT, IMRT and Non-Coplanar Arc Treatment for Prone Accelerated Partial Breast Irradiation (APBI)

    Energy Technology Data Exchange (ETDEWEB)

    Chiu, T; Yan, Y; Ramirez, E; Lee, P; Jiang, S; Gu, X [UT Southwestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: Accelerated partial breast irradiation (APBI) is an effective treatment for early stage breast-cancer. Irradiation in a prone position can mitigate breast motion and spare heart and lung. In this study, a comprehensive study is performed to evaluate various treatment techniques for prone APBI treatment including: 3D-CRT, IMRT, co-planar and non-coplanar partial arcs treatment. Methods: In this treatment planning study, a left breast patient treated in prone position in our clinic was imported into Varian Eclipse TPS. Six beams tangential to chest wall were used in both 3D-CRT and IMRT plans. These six beams were coplanar in a transactional plane achieved by both gantry and couch rotation. A 60-beam IMRT plan was also created to explore the maximum benefit of co-planar IMRT. Within deliverable couch rotation range (±30°), partial arc treatment plans with one and up to ten couch positions were generated for comparison. For each plan, 30Gy in 6 fractions was prescribed to 95% PTV volume. Critical dosimetric parameters, such as conformity index, mean, maximum, and volume dose of organ at risk, are evaluated. Results: The conformity indexes (CI) are 3.53, 3.17, 2.21 and 1.08 respectively to 3D-CRT, 6-beam IMRT, 60-beam IMRT, and two-partial-arcs coplanar plans. However, arc plans increase heart dose. CI for non-coplanar arc plans decreases from 1.19 to 1.10 when increases couch positions. Maximum dose in ipsilateral lung (1.98 to 1.13 Gy), and heart (0.62 to 0.43 Gy) are steadily decreased with the increased number of non-coplanar arcs. Conclusions: The dosimetric evaluation results show that partial arc plans have improved CIs compared to conventional 3D-CRT and IMRT plans. Increasing number of partial arcs decreases lung and heart dose. The dosimetric benefit obtained from non-coplanar arcs should be considered with treatment delivery time.

  2. Feasibility and acute toxicity of 3-dimensional conformal external-beam accelerated partial-breast irradiation for early-stage breast cancer after breast-conserving surgery in Chinese female patients

    Institute of Scientific and Technical Information of China (English)

    LI Feng-yan; HE Zhen-yu; XUE Ming; CHEN Li-xin; WU San-gang; GUAN Xun-xing

    2011-01-01

    Background A growing number of studies worldwide have advocated the replacement of whole-breast irradiation with accelerated partial breast irradiation using three-dimensional conformal external-beam radiation (APBI-3DCRr) for early-stage breast cancer. But APBI can be only used in selected population of patients with early-staged breast cancer. It is not replacing the whole breast radiotherapy. This study aimed to examine the feasibility and acute normal tissue toxicity of the APBI-3DCRT technique in Chinese female patients who generally have smaller breasts compared to their Western counterparts.Methods From May 2006 to December 2009, a total of 48 Chinese female patients (with early-stage breast cancer who met the inclusion criteria) received APBI-3DCRT after breast-conserving surgery at Sun Yat-sen University Cancer Center. The total dosage from APBI-3DCRT was 34 Gy, delivered in 3.4 Gy per fractions, twice per day at intervals of at least six hours. The radiation dose, volume of the target area and volume of irradiated normal tissues were calculated.Acute toxicity was evaluated according to the Common Toxicity Criteria (CTC) 3.0.Results Among the 48 patients, the planning target volume for evaluation (PTVE) was (90.42±9.26) cm3, the ipsilateral breast volume (IBV) was (421.74±28.53) cm3, and the ratio between the two was (20.74±5.86)%. Evaluation of the dosimetric characteristics of the PTVE revealed excellent dosimetric results in 14 patients and acceptable results in 34 patients. The dose delivered to the PTVE ranged from 93% to 110% of the prescribed dose. The average ratio of the volume of PTVE receiving 95% of the prescription dose (V95) was (99.26±0.37)%. The habituation index (HI) and the conformity index (CI) were 1.08±0.01 and 0.72±0.02, respectively, suggesting good homogeneity and conformity of the dose delivered to the target field. The radiation dose to normal tissues and organs was within the dose limitation.Subjects experienced mild acute

  3. Five-Year Outcomes, Cosmesis, and Toxicity With 3-Dimensional Conformal External Beam Radiation Therapy to Deliver Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Rodríguez, Núria, E-mail: nrodriguez@parcdesalutmar.cat [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Universidad Pompeu Fabra, Barcelona (Spain); Sanz, Xavier [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Universidad Pompeu Fabra, Barcelona (Spain); Dengra, Josefa [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Foro, Palmira [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Universidad Pompeu Fabra, Barcelona (Spain); Membrive, Ismael; Reig, Anna [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Quera, Jaume [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Universidad Pompeu Fabra, Barcelona (Spain); Fernández-Velilla, Enric; Pera, Óscar; Lio, Jackson; Lozano, Joan [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Algara, Manuel [Department of Radiation Oncology, Hospital de la Esperanza, Parc de Salut MAR, Barcelona (Spain); Universidad Pompeu Fabra, Barcelona (Spain)

    2013-12-01

    Purpose: To report the interim results from a study comparing the efficacy, toxicity, and cosmesis of breast-conserving treatment with accelerated partial breast irradiation (APBI) or whole breast irradiation (WBI) using 3-dimensional conformal external beam radiation therapy (3D-CRT). Methods and Materials: 102 patients with early-stage breast cancer who underwent breast-conserving surgery were randomized to receive either WBI (n=51) or APBI (n=51). In the WBI arm, 48 Gy was delivered to the whole breast in daily fractions of 2 Gy, with or without additional 10 Gy to the tumor bed. In the APBI arm, patients received 37.5 Gy in 3.75 Gy per fraction delivered twice daily. Toxicity results were scored according to the Radiation Therapy Oncology Group Common Toxicity Criteria. Skin elasticity was measured using a dedicated device (Multi-Skin-Test-Center MC-750-B2, CKelectronic-GmbH). Cosmetic results were assessed by the physician and the patients as good/excellent, regular, or poor. Results: The median follow-up time was 5 years. No local recurrences were observed. No significant differences in survival rates were found. APBI reduced acute side effects and radiation doses to healthy tissues compared with WBI (P<.01). Late skin toxicity was no worse than grade 2 in either group, without significant differences between the 2 groups. In the ipsilateral breast, the areas that received the highest doses (ie, the boost or quadrant) showed the greatest loss of elasticity. WBI resulted in a greater loss of elasticity in the high-dose area compared with APBI (P<.05). Physician assessment showed that >75% of patients in the APBI arm had excellent or good cosmesis, and these outcomes appear to be stable over time. The percentage of patients with excellent/good cosmetic results was similar in both groups. Conclusions: APBI delivered by 3D-CRT to the tumor bed for a selected group of early-stage breast cancer patients produces 5-year results similar to those achieved with

  4. Extended (5-year) Outcomes of Accelerated Partial Breast Irradiation Using MammoSite Balloon Brachytherapy: Patterns of Failure, Patient Selection, and Dosimetric Correlates for Late Toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Vargo, John A.; Verma, Vivek; Kim, Hayeon; Kalash, Ronny; Heron, Dwight E.; Johnson, Ronald; Beriwal, Sushil, E-mail: beriwals@upmc.edu

    2014-02-01

    Purpose: Accelerated partial breast irradiation (APBI) with balloon and catheter-based brachytherapy has gained increasing popularity in recent years and is the subject of ongoing phase III trials. Initial data suggest promising local control and cosmetic results in appropriately selected patients. Long-term data continue to evolve but are limited outside of the context of the American Society of Breast Surgeons Registry Trial. Methods and Materials: A retrospective review of 157 patients completing APBI after breast-conserving surgery and axillary staging via high-dose-rate {sup 192}Ir brachytherapy from June 2002 to December 2007 was made. APBI was delivered with a single-lumen MammoSite balloon-based applicator to a median dose of 34 Gy in 10 fractions over a 5-day period. Tumor coverage and critical organ dosimetry were retrospectively collected on the basis of computed tomography completed for conformance and symmetry. Results: At a median follow-up time of 5.5 years (range, 0-10.0 years), the 5-year and 7-year actuarial incidences of ipsilateral breast control were 98%/98%, of nodal control 99%/98%, and of distant control 99%/99%, respectively. The crude rate of ipsilateral breast recurrence was 2.5% (n=4); of nodal failure, 1.9% (n=3); and of distant failure, 0.6% (n=1). The 5-year and 7-year actuarial overall survival rates were 89%/86%, with breast cancer–specific survival of 100%/99%, respectively. Good to excellent cosmetic outcomes were achieved in 93.4% of patients. Telangiectasia developed in 27% of patients, with 1-year, 3-year, and 5-year actuarial incidence of 7%/24%/33%; skin dose >100% significantly predicted for the development of telangiectasia (50% vs 14%, P<.0001). Conclusions: Long-term single-institution outcomes suggest excellent tumor control, breast cosmesis, and minimal late toxicity. Skin toxicity is a function of skin dose, which may be ameliorated with dosimetric optimization afforded by newer multicatheter brachytherapy

  5. Factors Associated With Optimal Long-Term Cosmetic Results in Patients Treated With Accelerated Partial Breast Irradiation Using Balloon-Based Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Keisch, Martin [Miami Brachytherapy Center, Cancer Healthcare Associates, Miami, FL (United States); Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Goyal, Sharad; Khan, Atif J. [Department of Radiation Oncology, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Beitsch, Peter D. [Dallas Breast Center, Dallas, TX (United States); Lyden, Maureen [BioStat International Inc, Tampa, FL (United States); Haffty, Bruce G. [Department of Radiation Oncology, Cancer Institute of New Jersey, New Brunswick, NJ (United States)

    2012-06-01

    Purpose: To evaluate factors associated with optimal cosmetic results at 72 months for early-stage breast cancer patients treated with Mammosite balloon-based accelerated partial breast irradiation (APBI). Methods and Materials: A total of 1,440 patients (1,449 cases) with early-stage breast cancer undergoing breast-conserving therapy were treated with balloon-based brachytherapy to deliver APBI (34 Gy in 3.4-Gy fractions). Cosmetic outcome was evaluated at each follow-up visit and dichotomized as excellent/good (E/G) or fair/poor (F/P). Follow-up was evaluated at 36 and 72 months to establish long-term cosmesis, stability of cosmesis, and factors associated with optimal results. Results: The percentage of evaluable patients with excellent/good (E/G) cosmetic results at 36 months and more than 72 months were 93.3% (n = 708/759) and 90.4% (n = 235/260). Factors associated with optimal cosmetic results at 72 months included: larger skin spacing (p = 0.04) and T1 tumors (p = 0.02). Using multiple regression analysis, the only factors predictive of worse cosmetic outcome at 72 months were smaller skin spacing (odds ratio [OR], 0.89; confidence interval [CI], 0.80-0.99) and tumors greater than 2 cm (OR, 4.96, CI, 1.53-16.07). In all, 227 patients had both a 36-month and a 72-month cosmetic evaluation. The number of patients with E/G cosmetic results decreased only slightly from 93.4% at 3 years to 90.8% (p = 0.13) at 6 years, respectively. Conclusions: APBI delivered with balloon-based brachytherapy produced E/G cosmetic results in 90.4% of cases at 6 years. Larger tumors (T2) and smaller skin spacing were found to be the two most important independent predictors of cosmesis.

  6. Long-term Cosmetic Outcomes and Toxicities of Proton Beam Therapy Compared With Photon-Based 3-Dimensional Conformal Accelerated Partial-Breast Irradiation: A Phase 1 Trial

    Energy Technology Data Exchange (ETDEWEB)

    Galland-Girodet, Sigolène; Pashtan, Itai; MacDonald, Shannon M.; Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Hirsch, Ariel E.; Kachnic, Lisa A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts (United States); Specht, Michelle; Gadd, Michele; Smith, Barbara L. [Department of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Powell, Simon N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Recht, Abram [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-11-01

    Purpose: To present long-term outcomes of a prospective feasibility trial using either protons or 3-dimensional conformal photon-based (accelerated partial-breast irradiation [APBI]) techniques. Methods and Materials: From October 2003 to April 2006, 98 evaluable patients with stage I breast cancer were treated with APBI (32 Gy in 8 fractions given twice daily) on a prospective clinical trial: 19 with proton beam therapy (PBT) and 79 with photons or mixed photons/electrons. Median follow-up was 82.5 months (range, 2-104 months). Toxicity and patient satisfaction evaluations were performed at each visit. Results: At 7 years, the physician rating of overall cosmesis was good or excellent for 62% of PBT patients, compared with 94% for photon patients (P=.03). Skin toxicities were more common for the PBT group: telangiectasia, 69% and 16% (P=.0013); pigmentation changes, 54% and 22% (P=.02); and other late skin toxicities, 62% and 18% (P=.029) for PBT and photons, respectively. There were no significant differences between the groups in the incidences of breast pain, edema, fibrosis, fat necrosis, skin desquamation, and rib pain or fracture. Patient-reported cosmetic outcomes at 7 years were good or excellent for 92% and 96% of PBT and photon patients, respectively (P=.95). Overall patient satisfaction was 93% for the entire cohort. The 7-year local failure rate for all patients was 6%, with 3 local recurrences in the PBT group (7-year rate, 11%) and 2 in photon-treated patients (4%) (P=.22). Conclusions: Local failure rates of 3-dimensional APBI and PBT were similar in this study. However, PBT, as delivered in this study, led to higher rates of long-term telangiectasia, skin color changes, and skin toxicities. We recommend the use of multiple fields and treatment of all fields per treatment session or the use of scanning techniques to minimize skin toxicity.

  7. A novel schedule of accelerated partial breast radiation using intensity-modulated radiation therapy in elderly patients: survival and toxicity analysis of a prospective clinical trial

    Energy Technology Data Exchange (ETDEWEB)

    Sayan, Mutlay; Nelson, Carl; Gagne, Havaleh; Rubin, Deborah; Heimann, Ruth [Dept. of Radiation Oncology, University of Vermont Medical Center, Burlington (United States); Wilson, Karen [University of Vermont Cancer Center, Burlington (United States)

    2017-03-15

    Several accelerated partial breast radiation (APBR) techniques have been investigated in patients with early-stage breast cancer (BC); however, the optimal treatment delivery techniques remain unclear. We evaluated the feasibility and toxicity of APBR delivered using intensity-modulated radiation therapy (IMRT) in elderly patients with stage I BC, using a novel fractionation schedule. Forty-two patients aged ≥65 years, with stage I BC who underwent breast conserving surgery were enrolled in a phase I/II study evaluating APBR using IMRT. Forty eligible patients received 40 Gy in 4 Gy daily fractions. Patients were assessed for treatment related toxicities, and cosmesis, before APBR, during, and after completion of the treatment. The median age was 73 years, median tumor size 0.8 cm and the median follow-up was 54 months. The 5-year locoregional control was 97.5% and overall survival 90%. Erythema and skin pigmentation was the most common acute adverse event, reported by 27 patients (69%). Twenty-six patients (65%) reported mild pain, rated 1-4/10. This improved at last follow-up to only 2 (15%). Overall the patient and physician reported worst late toxicities were lower than the baseline and at last follow-up, patients and physicians rated cosmesis as excellent/good in 93% and 86 %, respectively. In this prospective trial, we observed an excellent rate of tumor control with daily APBR. The acceptable toxicity profile and cosmetic results of this study support the use of IMRT planned APBR with daily schedule in elderly patients with early stage BC.

  8. Late Toxicity and Patient Self-Assessment of Breast Appearance/Satisfaction on RTOG 0319: A Phase 2 Trial of 3-Dimensional Conformal Radiation Therapy-Accelerated Partial Breast Irradiation Following Lumpectomy for Stages I and II Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chafe, Susan, E-mail: susan.chafe@albertahealthservices.ca [Department of Radiation Oncology, Cross Cancer Institute-University of Alberta, Edmonton, Alberta (Canada); Moughan, Jennifer [Department of Radiation Oncology, RTOG Statistical Center, Philadelphia, Pennsylvania (United States); McCormick, Beryl [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Wong, John [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland (United States); Pass, Helen [Womens' Breast Center, Stamford Hospital, Stamford, Connecticut (United States); Rabinovitch, Rachel [Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado (United States); Arthur, Douglas W. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Petersen, Ivy [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); White, Julia [Department of Radiation Oncology, Ohio State University, Columbus, Ohio (United States); Vicini, Frank A. [Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, Michigan (United States)

    2013-08-01

    Purpose: Late toxicities and cosmetic analyses of patients treated with accelerated partial breast irradiation (APBI) on RTOG 0319 are presented. Methods and Materials: Patients with stages I to II breast cancer ≤3 cm, negative margins, and ≤3 positive nodes were eligible. Patients received three-dimensional conformal external beam radiation therapy (3D-CRT; 38.5 Gy in 10 fractions twice daily over 5 days). Toxicity and cosmesis were assessed by the patient (P), the radiation oncologist (RO), and the surgical oncologist (SO) at 3, 6, and 12 months from the completion of treatment and then annually. National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0, was used to grade toxicity. Results: Fifty-two patients were evaluable. Median follow-up was 5.3 years (range, 1.7-6.4 years). Eighty-two percent of patients rated their cosmesis as good/excellent at 1 year, with rates of 64% at 3 years. At 3 years, 31 patients were satisfied with the treatment, 5 were not satisfied but would choose 3D-CRT again, and none would choose standard radiation therapy. The worst adverse event (AE) per patient reported as definitely, probably, or possibly related to radiation therapy was 36.5% grade 1, 50% grade 2, and 5.8% grade 3 events. Grade 3 AEs were all skin or musculoskeletal-related. Treatment-related factors were evaluated to potentially establish an association with observed toxicity. Surgical bed volume, target volume, the number of beams used, and the use of bolus were not associated with late cosmesis. Conclusions: Most patients enrolled in RTOG 0319 were satisfied with their treatment, and all would choose to have the 3D-CRT APBI again.

  9. TH-C-12A-09: Planning and Delivery of the Fully Dynamic Trajectory Modulated Arc Therapy: Application to Accelerated Partial Breast Irradiation

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    Liang, J; Atwood, T; Fahimian, B; Chin, E; Hristov, D [Department of Radiation Oncology, Stanford University, CA (United States); Otto, K [Department of Physics, University of British Columbia, BC (Canada)

    2014-06-15

    Purpose: A novel trajectory modulated arc therapy (TMAT) system was developed that uses source motion trajectory involving synchronized gantry rotation with translational and rotational couch movement. MLC motion and dose rate were fully optimized for dynamic beam delivery. This work presents a platform for planning deliverable TMAT on a collision free coronal trajectory and evaluates its benefit for accelerated partial breast irradiation (APBI) in a prone position. Methods: The TMAT algorithm was built on VMAT with modifications (physical properties on couch movement were defined) and enhancements (pencil beam dose calculation engine to support extended SSDs) to make it feasible for TMAT delivery. A Matlab software environment for TMAT optimization and dose calculation was created to allow any user specified motion axis. TMAT delivery was implemented on Varian TrueBeamTM STx via XML scripts. 10 prone breast irradiation cases were evaluated in VMAT and compared with a 6- field non-coplanar IMRT plan. Patient selection/exclusion criteria and structure contouring followed the guidelines of NSABP B-39/RTOG 0413 protocol. Results: TMAT delivery time was ∼4.5 minutes. 251.5°±7.88° of non-isocentric couch arc was achieved by the optimized trajectory with 180– 210 control points at 1°–2° couch increments. The improved dose distribution by TMAT was most clearly observed by the marked reduction in the volume of irradiated normal breast tissue in the high dose region. The ratios of the normal breast tissue volume receiving more than 50%, 80% and 100% of the prescription dose for TMAT versus IMRT were: V50%(TMAT/IMRT) = 78.38%±13.03%, V80%(TMAT/IMRT) = 44.19%±9.04% and V100% (TMAT/IMRT) = 9.96%±7.55%, all p≤0.01. Conclusion: The study is the first demonstration of planning and delivery implementation of a fully dynamic APBI TMAT system with continuous couch motion. TMAT achieved significantly improved dosimetry over noncoplanar IMRT on dose volume parameters

  10. Dosimetric Improvements in Balloon Based Brachytherapy Using the Contura® Multi-Lumen Balloon (MLB Catheter to Deliver Accelerated Partial Breast Irradiation

    Directory of Open Access Journals (Sweden)

    Thomas Julian

    2010-04-01

    Full Text Available Purpose: Preliminary dosimetric findings in patients managed with the Contura® Multi-Lumen Balloon (MLB breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI on a multi-institutional phase IV registry trial were reviewed. Material and methods: CT-based 3D planning with dose optimization was performed for all patients. For the study, new ideal dosimetric goals were developed: 1 ≥ 95% of the prescribed dose (PD covering ≥ 90% of the target volume (TV, 2 a maximum skin dose ≤ 125% of the PD, 3 maximum rib dose ≤ 145% of the PD, and 4 the V150 ≤ 50 cc and V200 ≤ 10 cc. The frequency of concurrently achieving these dosimetric goals using the Contura® MLB was investigated.Results: 194 cases were evaluable. Employing the MLB, all ideal dosimetric criteria were achieved in 76% of cases.Evaluating dosimetric criteria separately, 90% and 89% of cases met the new ideal skin and rib dose criteria, respectively. In 96%, ideal TV coverage goals were achieved and in 96%, dose homogeneity criteria (V150 and V200 were met. For skin spacing ≥ 5-7 mm, the median skin dose was 121% of the PD and when < 5 mm, the median skin dose was 124.4%. For rib distancees < 5 mm, the median rib dose was reduced to 136.4% of the PD. For skin spacing < 7 mm and distance to rib < 5 mm, the median skin and rib doses were concurrently limited to 121% and 142.8% of thePD, respectively. Conclusions: The Contura® MLB catheter provides potential improvements in dosimetric capabilities (i.e., reduced skin and rib doses and improved TV coverage in many clinical scenarios.

  11. The Effect of Dose-Volume Parameters and Interfraction Interval on Cosmetic Outcome and Toxicity After 3-Dimensional Conformal Accelerated Partial Breast Irradiation

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    Leonard, Kara Lynne, E-mail: karalynne.kerr@gmail.com [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts (United States); Hepel, Jaroslaw T. [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts (United States); Department of Radiation Oncology, Rhode Island Hospital, Warren Alpert School of Medicine of Brown University, Providence, Rhode Island (United States); Hiatt, Jessica R. [Department of Radiation Oncology, Rhode Island Hospital, Warren Alpert School of Medicine of Brown University, Providence, Rhode Island (United States); Dipetrillo, Thomas A. [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts (United States); Department of Radiation Oncology, Rhode Island Hospital, Warren Alpert School of Medicine of Brown University, Providence, Rhode Island (United States); Price, Lori Lyn [Department of Biostatistics Research Center, Institute of Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts (United States); Wazer, David E. [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts (United States); Department of Radiation Oncology, Rhode Island Hospital, Warren Alpert School of Medicine of Brown University, Providence, Rhode Island (United States)

    2013-03-01

    Purpose: To evaluate dose-volume parameters and the interfraction interval (IFI) as they relate to cosmetic outcome and normal tissue effects of 3-dimensional conformal radiation therapy (3D-CRT) for accelerated partial breast irradiation (APBI). Methods and Materials: Eighty patients were treated by the use of 3D-CRT to deliver APBI at our institutions from 2003-2010 in strict accordance with the specified dose-volume constraints outlined in the National Surgical Adjuvant Breast and Bowel Project B39/Radiation Therapy Oncology Group 0413 (NSABP-B39/RTOG 0413) protocol. The prescribed dose was 38.5 Gy in 10 fractions delivered twice daily. Patients underwent follow-up with assessment for recurrence, late toxicity, and overall cosmetic outcome. Tests for association between toxicity endpoints and dosimetric parameters were performed with the chi-square test. Univariate logistic regression was used to evaluate the association of interfraction interval (IFI) with these outcomes. Results: At a median follow-up time of 32 months, grade 2-4 and grade 3-4 subcutaneous fibrosis occurred in 31% and 7.5% of patients, respectively. Subcutaneous fibrosis improved in 5 patients (6%) with extended follow-up. Fat necrosis developed in 11% of women, and cosmetic outcome was fair/poor in 19%. The relative volume of breast tissue receiving 5%, 20%, 50%, 80%, and 100% (V5-V100) of the prescribed dose was associated with risk of subcutaneous fibrosis, and the volume receiving 50%, 80%, and 100% (V50-V100) was associated with fair/poor cosmesis. The mean IFI was 6.9 hours, and the minimum IFI was 6.2 hours. The mean and minimum IFI values were not significantly associated with late toxicity. Conclusions: The incidence of moderate to severe late toxicity, particularly subcutaneous fibrosis and fat necrosis and resulting fair/poor cosmesis, remains high with continued follow-up. These toxicity endpoints are associated with several dose-volume parameters. Minimum and mean IFI values were

  12. Decline of Cosmetic Outcomes Following Accelerated Partial Breast Irradiation Using Intensity Modulated Radiation Therapy: Results of a Single-Institution Prospective Clinical Trial

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    Liss, Adam L. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Ben-David, Merav A. [Department of Radiation Oncology, The Sheba Medical Center, Ramat Gan (Israel); Jagsi, Reshma; Hayman, James A. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Griffith, Kent A. [Biostatistics Unit, University of Michigan, Ann Arbor, Michigan (United States); Moran, Jean M.; Marsh, Robin B. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Pierce, Lori J., E-mail: ljpierce@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2014-05-01

    Purpose: To report the final cosmetic results from a single-arm prospective clinical trial evaluating accelerated partial breast irradiation (APBI) using intensity modulated radiation therapy (IMRT) with active-breathing control (ABC). Methods and Materials: Women older than 40 with breast cancer stages 0-I who received breast-conserving surgery were enrolled in an institutional review board-approved prospective study evaluating APBI using IMRT administered with deep inspiration breath-hold. Patients received 38.5 Gy in 3.85-Gy fractions given twice daily over 5 consecutive days. The planning target volume was defined as the lumpectomy cavity with a 1.5-cm margin. Cosmesis was scored on a 4-category scale by the treating physician. Toxicity was scored according to National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE version 3.0). We report the cosmetic and toxicity results at a median follow-up of 5 years. Results: A total of 34 patients were enrolled. Two patients were excluded because of fair baseline cosmesis. The trial was terminated early because fair/poor cosmesis developed in 7 of 32 women at a median follow-up of 2.5 years. At a median follow-up of 5 years, further decline in the cosmetic outcome was observed in 5 women. Cosmesis at the time of last assessment was 43.3% excellent, 30% good, 20% fair, and 6.7% poor. Fibrosis according to CTCAE at last assessment was 3.3% grade 2 toxicity and 0% grade 3 toxicity. There was no correlation of CTCAE grade 2 or greater fibrosis with cosmesis. The 5-year rate of local control was 97% for all 34 patients initially enrolled. Conclusions: In this prospective trial with 5-year median follow-up, we observed an excellent rate of tumor control using IMRT-planned APBI. Cosmetic outcomes, however, continued to decline, with 26.7% of women having a fair to poor cosmetic result. These results underscore the need for continued cosmetic assessment for patients treated with APBI by technique.

  13. Accelerated partial breast irradiation with iridium-192 multicatheter PDR/HDR brachytherapy. Preliminary results of the German-Austrian multicenter trial

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    Ott, O.J.; Lotter, M.; Sauer, R.; Strnad, V. [Dept. of Radiation Oncology, Univ. Hospital Erlangen, Erlangen (Germany); Poetter, R.; Resch, A. [Dept. of Radiotherapy and Radiobiology, Univ. Hospital AKH Wien, Vienna (Austria); Hammer, J. [Dept. of Radiation Oncology, Barmherzige Schwestern Hospital Linz, Linz (Austria); Hildebrandt, G. [Dept. of Radiation Oncology, Univ. Hospital Leipzig, Leipzig (Germany); Poehls, U.; Beckmann, M.W. [Dept. of Gynecology, Univ. Hospital Erlangen, Erlangen (Germany)

    2004-10-01

    : this analysis indicates that accelerated partial breast irradiation with iridium-192 interstitial multicatheter PDR/HDR implants is feasible with low perioperative morbidity, low acute and mild late toxicity, and does not significantly affect cosmetic results at a median follow-up of 24 months. (orig.)

  14. Preliminary simulation of implants breast through the accelerated partial irradiation technique: coverage rates and homogeneity; Simulacion previa de implates de mama mediante la tecnica de irradiacion parcial acelerada: indices de cubrimiento y homegeneidad

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    Moral Sanchez, S. C.; Paula Carranza, B. de; Erzibengoa, M.; Bragado Alvarez, L.; Guisasola Berasetegui, A.

    2013-07-01

    In this work we present and evaluate the process of pre-simulation we have drawn up when it comes to treatments of accelerated partial irradiation of breast. Previous simulation that we will allow you to have greater control over the location of catheters with respect to the area to radiate. The goodness of this procedure is evaluated through representative quality indexes of the implant. (Author)

  15. Early Side Effects of Three-Dimensional Conformal External Beam Accelerated Partial Breast Irradiation to a Total Dose of 40 Gy in One Week (A Phase II Trial)

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    Bourgier, Celine, E-mail: bourgier@igr.fr [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Pichenot, Charlotte; Verstraet, Rodolfe [Department of Physics, Institut Gustave Roussy, Villejuif (France); El Nemr, Mohamed; Heymann, Steve [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Biron, Bruno [Department of Physics, Institut Gustave Roussy, Villejuif (France); Delaloge, Suzette [Department of Breast Oncology, Institut Gustave Roussy, Villejuif (France); Mathieu, Marie-Christine [Department of Pathology, Institut Gustave Roussy, Villejuif (France); Garbay, Jean-Remy [Department of Breast Surgery, Institut Gustave Roussy, Villejuif (France); Bourhis, Jean [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Taghian, Alphonse G. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Marsiglia, Hugo [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Radiotherapy Unit, University of Florence, Florence (Italy)

    2011-12-01

    Purpose: Several accelerated partial breast irradiation (APBI) techniques are described in the literature, and apparently, the three-dimensional (3D)-conformal technique is being used increasingly. Nonetheless, the optimal radiation dose is not yet known. Here, we report feasibility and early toxicities of APBI delivering 40 Gy over 5 days, in a phase II trial. Methods and Materials: From October 2007 to September 2008, 25 patients with pT1N0 cancer received 3D-conformal APBI. The prescribed radiation dose was 40 Gy in 4-Gy fractions given twice daily. This technique used two minitangents and an 'en face' electron field. Toxicities were systematically assessed at 1, 2, and 6 months and then once every 6 months. Results: The planning tumor volume for evaluation (PTV{sub E}VAL) coverage was adequate: the mean dose to the PTV{sub E}VAL was 41.8 Gy (range, 41-42.4 Gy). Mean doses to the ipsilateral lung and heart were 1.6 Gy (range, 1.0-2.3 Gy) and 1.2 Gy (range, 1.0-1.6 Gy), respectively. One and two months after completion of APBI, most patients had no or mild erythema (n = 16 patients at 1 month; n = 25 patients at 2 months); none of these patients developed moist desquamation. After a median follow-up of 12 months, only 1 patient had a significant moderate field contracture (grade 2). Other reported late toxicities were grade 1. Conclusions: 3D-conformal APBI (with two minitangents and an 'en face' electron field) using a total dose of 40 Gy in 10 fractions twice daily over 5 days achieved appropriate PTV{sub E}VAL coverage and offered significant sparing of normal tissue. Early tolerance was excellent.

  16. Improvement of registration accuracy in accelerated partial breast irradiation using the point-based rigid-body registration algorithm for patients with implanted fiducial markers

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    Inoue, Minoru; Yoshimura, Michio, E-mail: myossy@kuhp.kyoto-u.ac.jp; Sato, Sayaka; Nakamura, Mitsuhiro; Yamada, Masahiro; Hirata, Kimiko; Ogura, Masakazu; Hiraoka, Masahiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto 606-8507 (Japan); Sasaki, Makoto; Fujimoto, Takahiro [Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto 606-8507 (Japan)

    2015-04-15

    Purpose: To investigate image-registration errors when using fiducial markers with a manual method and the point-based rigid-body registration (PRBR) algorithm in accelerated partial breast irradiation (APBI) patients, with accompanying fiducial deviations. Methods: Twenty-two consecutive patients were enrolled in a prospective trial examining 10-fraction APBI. Titanium clips were implanted intraoperatively around the seroma in all patients. For image-registration, the positions of the clips in daily kV x-ray images were matched to those in the planning digitally reconstructed radiographs. Fiducial and gravity registration errors (FREs and GREs, respectively), representing resulting misalignments of the edge and center of the target, respectively, were compared between the manual and algorithm-based methods. Results: In total, 218 fractions were evaluated. Although the mean FRE/GRE values for the manual and algorithm-based methods were within 3 mm (2.3/1.7 and 1.3/0.4 mm, respectively), the percentages of fractions where FRE/GRE exceeded 3 mm using the manual and algorithm-based methods were 18.8%/7.3% and 0%/0%, respectively. Manual registration resulted in 18.6% of patients with fractions of FRE/GRE exceeding 5 mm. The patients with larger clip deviation had significantly more fractions showing large FRE/GRE using manual registration. Conclusions: For image-registration using fiducial markers in APBI, the manual registration results in more fractions with considerable registration error due to loss of fiducial objectivity resulting from their deviation. The authors recommend the PRBR algorithm as a safe and effective strategy for accurate, image-guided registration and PTV margin reduction.

  17. Applications of tissue heterogeneity corrections and biologically effective dose volume histograms in assessing the doses for accelerated partial breast irradiation using an electronic brachytherapy source

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    Shi Chengyu; Guo Bingqi; Eng, Tony; Papanikolaou, Nikos [Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, TX 78229 (United States); Cheng, Chih-Yao, E-mail: shic@uthscsa.ed [Radiation Oncology Department, Oklahoma University Health Science Center, Oklahoma, OK 73104 (United States)

    2010-09-21

    A low-energy electronic brachytherapy source (EBS), the model S700 Axxent(TM) x-ray device developed by Xoft Inc., has been used in high dose rate (HDR) intracavitary accelerated partial breast irradiation (APBI) as an alternative to an Ir-192 source. The prescription dose and delivery schema of the electronic brachytherapy APBI plan are the same as the Ir-192 plan. However, due to its lower mean energy than the Ir-192 source, an EBS plan has dosimetric and biological features different from an Ir-192 source plan. Current brachytherapy treatment planning methods may have large errors in treatment outcome prediction for an EBS plan. Two main factors contribute to the errors: the dosimetric influence of tissue heterogeneities and the enhancement of relative biological effectiveness (RBE) of electronic brachytherapy. This study quantified the effects of these two factors and revisited the plan quality of electronic brachytherapy APBI. The influence of tissue heterogeneities is studied by a Monte Carlo method and heterogeneous 'virtual patient' phantoms created from CT images and structure contours; the effect of RBE enhancement in the treatment outcome was estimated by biologically effective dose (BED) distribution. Ten electronic brachytherapy APBI cases were studied. The results showed that, for electronic brachytherapy cases, tissue heterogeneities and patient boundary effect decreased dose to the target and skin but increased dose to the bones. On average, the target dose coverage PTV V{sub 100} reduced from 95.0% in water phantoms (planned) to only 66.7% in virtual patient phantoms (actual). The actual maximum dose to the ribs is 3.3 times higher than the planned dose; the actual mean dose to the ipsilateral breast and maximum dose to the skin were reduced by 22% and 17%, respectively. Combining the effect of tissue heterogeneities and RBE enhancement, BED coverage of the target was 89.9% in virtual patient phantoms with RBE enhancement (actual BED) as

  18. SU-E-T-401: Evaluation of TG-43 Dose Calculation Accuracy for SAVI-Based Accelerated Partial Breast Irradiation (APBI) Via Monte Carlo Simulations

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    Xu, Y [UT Southwestern Medical Center, Dallas, TX (United States); Southern Medical University, Guangzhou, Guangdong (China); Tian, Z; Jiang, S; Jia, X [UT Southwestern Medical Center, Dallas, TX (United States); Scanderbeg, D; Yashar, C [UCSD Medical Center, La Jolla, CA (United States); Zhang, M [Rutgers University, New Brunswick, NJ (United States)

    2015-06-15

    Purpose: The current standard TG-43 dose calculation method for SAVI-based Accelerated Partial Breast Irradiation (APBI) assumes an ideal geometry of infinite homogeneous water. However, in SAVI treatments, the air cavity inside the device and the short source-to-skin distance raise concerns about the dose accuracy of the TG-43 method. This study is to evaluate TG-43 dose calculation accuracy in SAVI treatments using Monte Carlo (MC) simulations. Methods: We recalculated the dose distributions of 15 APBI patients treated with SAVI devices, including five cases with a size of 6–1, five with 8−1 and five with 10−1, using our in-house developed fast MC dose package for HDR brachytherapy (gBMC). A phase-space file was used to model the Ir-192 HDR source. For each case, the patient CT was converted into a voxelized phantom and the dwell positions and times were extracted from treatment plans for MC dose calculations. Clinically relevant dosimetric parameters of the recalculated dose were compared to those computed via the TG-43 approach. Results: A systematic overestimation of doses was found for the 15 cases in TG-43 results, with D90, V150, and V200 for PTV-eval 2.8±1.8%, 2.0±2.2%, and 1.8±3.5% higher than MC results. TG-43 also overestimated the dose to skin with the maximum dose 4.4±8.4% higher on average. The relatively large standard deviation seen in the difference of maximum skin dose is partially ascribed to the statistical uncertainty of MC simulations when computing the maximum dose. It took gBMC ∼1 minute to compute dose for a SAVI plan. Conclusion: The high efficiency of our gBMC package facilitated the studies with a relatively large number of cases. An overestimation of TG-43 doses was found when using this MC package to recompute doses in SAVI cases. Clinical utilization of TG-43 dose calculation method in this scenario should be aware of this fact.

  19. Implementation of image-guided intensity-modulated accelerated partial breast irradiation. Three-year results of a phase II clinical study

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    Meszaros, Norbert; Major, Tibor; Stelczer, Gabor; Zaka, Zoltan; Takacsi-Nagy, Zoltan; Fodor, Janos; Polgar, Csaba [National Institute of Oncology, Center of Radiotherapy, Budapest (Hungary); Mozsa, Emoke [National Institute of Oncology, Center of Radiotherapy, Budapest (Hungary); Landesklinikum, Department of Radiooncology and Radiotherapy, Wiener Neustadt (Austria); Pukancsik, David [National Institute of Oncology, Department of Breast and Sarcoma Surgery, Budapest (Hungary)

    2017-01-15

    To report 3-year results of accelerated partial breast irradiation (APBI) using image-guided intensity-modulated radiotherapy (IG-IMRT) following breast conserving surgery (BCS) for low-risk early invasive breast cancer. Between July 2011 and March 2014, 60 patients with low-risk early invasive breast cancer underwent BCS and were enrolled in this phase II prospective study. The total dose was 36.9 Gy (9 fractions of 4.1 Gy, two fractions/day). Patient setup errors were detected in LAT, LONG and VERT directions. Local tumour control, survival results, early and late side effects and cosmetic outcome were assessed. At a median follow-up of 39 months, all patients were alive and neither locoregional nor distant failure occurred. One contralateral breast cancer and two new primary malignancies outside the breast were observed. No grade (G) 3-4 acute toxicity was detected. G1 and G2 erythema occurred in 21 (35%) and 2 (3.3%) patients, respectively; while G1 oedema was observed in 23 (38.8%) cases. G1 and G2 pain was reported by 6 (10%) and 2 (3.3%) patients, respectively. Among the late radiation side effects, G1 pigmentation or telangiectasia, G1 fibrosis and G1 asymptomatic fat necrosis occurred in 10 (16.7%), 7 (11.7%) and 3 (5%) patients, respectively. No ≥ G2 late toxicity was detected. Cosmetic outcome was excellent in 43 (71.7%) and good in 17 (28.3%) patients. IG-IMRT is a reproducible and feasible technique for delivery of external beam APBI following BCS for treatment of low-risk, early-stage invasive breast carcinoma. In order to avoid toxicity, image guidance performed before each radiation fraction is necessary to minimize the PTV. Three-year results are promising, early and late radiation side-effects are minimal, and cosmetic results are excellent to good. (orig.) [German] Evaluierung der 3-Jahres-Ergebnisse der Teilbrustbestrahlung (APBI) mittels bildgefuehrter intensitaetsmodulierter Strahlentherapie (IG-IMRT) nach brusterhaltender Operation (BCS

  20. Accelerated partial breast irradiation with external beam three-dimensional conformal radiotherapy. Five-year results of a prospective phase II clinical study

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    Mozsa, Emoeke [National Institute of Oncology, Centre of Radiotherapy, Budapest (Hungary); Landesklinikum Wiener Neustadt, Department of Radiooncology and Radiotherapy, Wiener Neustadt (Austria); Meszaros, Norbert; Major, Tibor; Froehlich, Georgina; Stelczer, Gabor; Fodor, Janos; Polgar, Csaba [National Institute of Oncology, Centre of Radiotherapy, Budapest (Hungary); Sulyok, Zoltan [National Institute of Oncology, Centre of Surgery, Budapest (Hungary)

    2014-05-15

    The aim of this study was to report the 5-year results of accelerated partial breast irradiation (APBI) using external beam three-dimensional conformal radiotherapy (3D-CRT). Between 2006 and 2011, 44 patients with low-risk, stage I-II breast cancer underwent breast-conserving surgery. Postoperative APBI was given by means of 3D-CRT using three to five non-coplanar fields. The total dose of APBI was 36.9 Gy (nine fractions of 4.1 Gy b.i.d.). The mean follow-up time was 58.2 months for surviving patients. Survival results, side effects, and cosmetic results were assessed. One (2.3 %) local recurrence was observed, for a 5-year actuarial rate of 3.7 %. Neither regional nor distant failure was observed. Two patients died of internal disease. The 5-year disease-free, cancer-specific, and overall survival rates were 96.3, 100, and 95.1 %, respectively. Acute side effects included grade 1 (G1) erythema in 75 %, G1 parenchymal induration in 46 %, and G1 pain in 46 % of patients. No G2 or higher acute side effect occurred. Late side effects included G1, G2, and G3 fibrosis in 44, 7, and 2 % of patients, respectively, G1 skin pigmentation in 12 %, and G1 pain in 2 %. Asymptomatic fat necrosis occurred in 14 %. Cosmetic results were rated excellent or good in 86 % of cases by the patients themselves and 84 % by the physicians. The 5-year local tumor control, toxicity profile, and cosmetic results of APBI delivered with external beam 3D-CRT are encouraging and comparable to other APBI series. (orig.) [German] Evaluation der 5-Jahres-Ergebnisse bezueglich Ueberleben, Tumorkontrolle, Nebenwirkungen und Kosmetik nach Teilbrustbestrahlung (APBI) mittels 3-D-konformaler, akzelerierter Radiotherapie (3D-CRT). Zwischen 2006 und 2011 wurden 44 Patienten mit Brustkrebs im Stadium I-II und niedrigem Risikoprofil brusterhaltend operiert. Die adjuvante, 3-D-konformale APBI wurde mittels 3-5 nonkoplanarer Feldern durchgefuehrt. Die Gesamtdosis betrug 36,9 Gy bei 9 -mal 4,1 Gy b.i.d.. Nach

  1. Evaluation of Current Consensus Statement Recommendations for Accelerated Partial Breast Irradiation: A Pooled Analysis of William Beaumont Hospital and American Society of Breast Surgeon MammoSite Registry Trial Data

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    Wilkinson, J. Ben [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Beitsch, Peter D. [Dallas Surgical Group, Dallas, Texas (United States); Shah, Chirag [Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri (United States); Arthur, Doug [Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia (United States); Haffty, Bruce G. [Department of Radiation Oncology, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Camden, New Jersey (United States); Wazer, David E. [Department of Radiation Oncology, Tufts Medical Center, Boston, Massachusetts and Rhode Island Hospital/Brown University, Providence, Rhode Island (United States); Keisch, Martin [Department of Radiation Oncology, Cancer Healthcare Associates, Miami, Florida (United States); Shaitelman, Simona F. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lyden, Maureen [Biostat International, Inc, Tampa, Florida (United States); Chen, Peter Y. [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Vicini, Frank A., E-mail: fvicini@pol.net [Department of Radiation Oncology, Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, Michigan (United States)

    2013-04-01

    Purpose: To determine whether the American Society for Radiation Oncology (ASTRO) Consensus Statement (CS) recommendations for accelerated partial breast irradiation (APBI) are associated with significantly different outcomes in a pooled analysis from William Beaumont Hospital (WBH) and the American Society of Breast Surgeons (ASBrS) MammoSite® Registry Trial. Methods and Materials: APBI was used to treat 2127 cases of early-stage breast cancer (WBH, n=678; ASBrS, n=1449). Three forms of APBI were used at WBH (interstitial, n=221; balloon-based, n=255; or 3-dimensional conformal radiation therapy, n=206), whereas all Registry Trial patients received balloon-based brachytherapy. Patients were divided according to the ASTRO CS into suitable (n=661, 36.5%), cautionary (n=850, 46.9%), and unsuitable (n=302, 16.7%) categories. Tumor characteristics and clinical outcomes were analyzed according to CS group. Results: The median age was 65 years (range, 32-94 years), and the median tumor size was 10.0 mm (range, 0-45 mm). The median follow-up time was 60.6 months. The WBH cohort had more node-positive disease (6.9% vs 2.6%, P<.01) and cautionary patients (49.5% vs 41.8%, P=.06). The 5-year actuarial ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), and distant metastasis (DM) for the whole cohort were 2.8%, 0.6%, 1.6%. The rate of IBTR was not statistically higher between suitable (2.5%), cautionary (3.3%), or unsuitable (4.6%) patients (P=.20). The nonsignificant increase in IBTR for the cautionary and unsuitable categories was due to increased elsewhere failures and new primaries (P=.04), not tumor bed recurrence (P=.93). Conclusions: Excellent outcomes after breast-conserving surgery and APBI were seen in our pooled analysis. The current ASTRO CS guidelines did not adequately differentiate patients at an increased risk of IBTR or tumor bed failure in this large patient cohort.

  2. Trajectory Modulated Arc Therapy: A Fully Dynamic Delivery With Synchronized Couch and Gantry Motion Significantly Improves Dosimetric Indices Correlated With Poor Cosmesis in Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Jieming; Atwood, Todd; Eyben, Rie von; Fahimian, Benjamin; Chin, Erika; Horst, Kathleen [Department of Radiation Oncology, Stanford University, California (United States); Otto, Karl [Department of Physics, University of British Columbia, British Columbia (Canada); Hristov, Dimitre, E-mail: dimitre.hristov@stanford.edu [Department of Radiation Oncology, Stanford University, California (United States)

    2015-08-01

    Purpose: To develop planning and delivery capabilities for linear accelerator–based nonisocentric trajectory modulated arc therapy (TMAT) and to evaluate the benefit of TMAT for accelerated partial breast irradiation (APBI) with the patient in prone position. Methods and Materials: An optimization algorithm for volumetrically modulated arc therapy (VMAT) was generalized to allow for user-defined nonisocentric TMAT trajectories combining couch rotations and translations. After optimization, XML scripts were automatically generated to program and subsequently deliver the TMAT plans. For 10 breast patients in the prone position, TMAT and 6-field noncoplanar intensity modulated radiation therapy (IMRT) plans were generated under equivalent objectives and constraints. These plans were compared with regard to whole breast tissue volume receiving more than 100%, 80%, 50%, and 20% of the prescription dose. Results: For TMAT APBI, nonisocentric collision-free horizontal arcs with large angular span (251.5 ± 7.9°) were optimized and delivered with delivery time of ∼4.5 minutes. Percentage changes of whole breast tissue volume receiving more than 100%, 80%, 50%, and 20% of the prescription dose for TMAT relative to IMRT were −10.81% ± 6.91%, −27.81% ± 7.39%, −14.82% ± 9.67%, and 39.40% ± 10.53% (P≤.01). Conclusions: This is a first demonstration of end-to-end planning and delivery implementation of a fully dynamic APBI TMAT. Compared with IMRT, TMAT resulted in marked reduction of the breast tissue volume irradiated at high doses.

  3. Shock acceleration in partially neutral plasmas

    CERN Document Server

    Morlino, G; Blasi, P; Caprioli, D

    2010-01-01

    We present the non-linear theory of shock acceleration applied to SNRs expanding into partially neutral plasma. Using this theory we show how the Balmer lines detected from young SNRs can be used to test the efficiency of shocks in the production of cosmic rays. In particular we investigate the effect of charge-exchange between protons and neutral hydrogen occurring in the precursor formed ahead of the shock. In this precursor the CR pressure accelerate the ionized component of the plasma and a relative velocity between protons and neutral hydrogen is established. On the other hand the charge-exchange process tends to equilibrate ions and neutrals resulting in the heating of both components. We show that even when the shock converts only a few per cent of the total bulk kinetic energy into CRs, the heating is efficient enough to produce a detectable broadening of the narrow Balmer lines emitted by the neutral hydrogen.

  4. The therapy of gefitinib towards breast cancer partially through ...

    African Journals Online (AJOL)

    The therapy of gefitinib towards breast cancer partially through reversing breast cancer biomarker arginine. ... Background: Breast cancer remains the leading reason of cancer death among women worldwide, and gefitinib is ... Article Metrics.

  5. Silymarin Accelerates Liver Regeneration after Partial Hepatectomy

    Directory of Open Access Journals (Sweden)

    Jia-Ping Wu

    2015-01-01

    Full Text Available Partial hepatectomy (PHx is a liver regeneration physiological response induced to maintain homeostasis. Liver regeneration evolved presumably to protect wild animals from catastrophic liver loss caused by toxins or tissue injury. Silymarin (Sm ability to stimulate liver regeneration has been an object of curiosity for many years. Silymarin has been investigated for use as an antioxidant and anticarcinogen. However, its use as a supportive treatment for liver damage is elusive. In this study, we fed silymarin (Sm, 25 mg/kg to male Sprague-Dawley rats for 7 weeks. Surgical 2/3 PHx was then conducted on the rats at 6 hrs, 24 hrs, and 72 hrs. Western blot and RT-PCR were conducted to detect the cell cycle activities and silymarin effects on hepatic regeneration. The results showed that silymarin enhanced liver regeneration by accelerating the cell cycle in PHx liver. Silymarin led to increased G1 phase (cyclin D1/pRb, S phase (cyclin E/E2F, G2 phase (cyclin B, and M phase (cyclin A protein and mRNA at 6 hrs, 24 hrs, and 72 hrs PHx. HGF, TGFα, and TGFβ1 growth factor expressions were also enhanced. We suggest that silymarin plays a crucial role in accelerated liver regeneration after PHx.

  6. Transforming Growth Factor β-1 (TGF-β1) Is a Serum Biomarker of Radiation Induced Fibrosis in Patients Treated With Intracavitary Accelerated Partial Breast Irradiation: Preliminary Results of a Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Boothe, Dustin L. [Weill Cornell Medical College of Cornell University, New York, New York (United States); Coplowitz, Shana [Department of Radiation Oncology, Stich Radiation Center, Weill Cornell Medical College of Cornell University, New York, New York (United States); Greenwood, Eleni [Weill Cornell Medical College of Cornell University, New York, New York (United States); Barney, Christian L. [Department of Radiation Oncology, Ohio State University, Columbus, Ohio (United States); Christos, Paul J. [Division of Biostatistics and Epidemiology, Department of Public Health, Weill Cornell Medical College of Cornell University, New York, New York (United States); Parashar, Bhupesh; Nori, Dattatreyudu; Chao, K. S. Clifford [Department of Radiation Oncology, Stich Radiation Center, Weill Cornell Medical College of Cornell University, New York, New York (United States); Wernicke, A. Gabriella, E-mail: gaw9008@med.cornell.edu [Department of Radiation Oncology, Stich Radiation Center, Weill Cornell Medical College of Cornell University, New York, New York (United States)

    2013-12-01

    Purpose: To examine a relationship between serum transforming growth factor β -1 (TGF-β1) values and radiation-induced fibrosis (RIF). Methods and Materials: We conducted a prospective analysis of the development of RIF in 39 women with American Joint Committee on Cancer stage 0-I breast cancer treated with lumpectomy and accelerated partial breast irradiation via intracavitary brachytherapy (IBAPBI). An enzyme-linked immunoassay (Quantikine, R and D, Minneapolis, MN) was used to measure serum TGF-β1 before surgery, before IBAPBI, and during IBAPBI. Blood samples for TGF-β1 were also collected from 15 healthy, nontreated women (controls). The previously validated tissue compliance meter (TCM) was used to objectively assess RIF. Results: The median time to follow-up for 39 patients was 44 months (range, 5-59 months). RIF was graded by the TCM scale as 0, 1, 2, and 3 in 5 of 20 patients (25%), 6 of 20 patients (30%), 5 of 20 patients (25%), and 4 of 20 patients (20%), respectively. The mean serum TGF-β1 values were significantly higher in patients before surgery than in disease-free controls, as follows: all cancer patients (30,201 ± 5889 pg/mL, P=.02); patients with any type of RIF (32,273 ± 5016 pg/mL, P<.0001); and women with moderate to severe RIF (34,462 ± 4713 pg/mL, P<0.0001). Patients with moderate to severe RIF had significantly elevated TGF-β1 levels when compared with those with none to mild RIF before surgery (P=.0014) during IBAPBI (P≤0001), and the elevation persisted at 6 months (P≤.001), 12 months (P≤.001), 18 months (P≤.001), and 24 months (P=.12). A receiver operating characteristic (ROC) curve of TGF-β1 values predicting moderate to severe RIF was generated with an area under the curve (AUC){sub ROC} of 0.867 (95% confidence interval 0.700-1.000). The TGF-β1 threshold cutoff was determined to be 31,000 pg/mL, with associated sensitivity and specificity of 77.8% and 90.0%, respectively. Conclusions: TGF-β1 levels correlate with

  7. Partial breast radiation therapy - external beam

    Science.gov (United States)

    ... include: Breast redness, tenderness, sensitivity Breast swelling or edema Breast infection (rare) Long-term side effects may begin months or years after treatment and may include: Decreased breast size Increased firmness ...

  8. Partial breast radiotherapy with simple teletherapy techniques

    Energy Technology Data Exchange (ETDEWEB)

    Fekete, Gábor; Újhidy, Dóra; Együd, Zsófia; Kiscsatári, Laura; Marosi, Gusztáv; Kahán, Zsuzsanna; Varga, Zoltán, E-mail: varga.zoltan@med.u-szeged.hu

    2015-01-01

    A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3 Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0 cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p < 0.001) with >90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.

  9. Partial breast radiotherapy with simple teletherapy techniques.

    Science.gov (United States)

    Fekete, Gábor; Újhidy, Dóra; Együd, Zsófia; Kiscsatári, Laura; Marosi, Gusztáv; Kahán, Zsuzsanna; Varga, Zoltán

    2015-01-01

    A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p 90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.

  10. Dosimetric comparison of three techniques in treatment of accelerated partial breast irradiation%乳腺癌保乳术后部分乳腺三种放疗计划的剂量学比较

    Institute of Scientific and Technical Information of China (English)

    姚晖; 邱健健; 王芸; 徐志勇

    2014-01-01

    Objective To dosimetrically compare three delivery techniques of VMAT,IMRT and 3D-CRT in the treatment of accelerated partial breast irradiation (APBI).Methods Twenty patients with T1/2N0M0breast cancer were treated with VMAT.These cases were subsequently re-planned using static gantry IMRT and 3D-CRT technology to evaluate dosimetric differences.Dosimetric parameters including dose conformity index (CI),dose volume histogram (DVH) analysis of normal tissue coverage,dose parameters of PTV and normal tissues were evaluated,the delivery parameters including MU and delivery time were also analyzed.Results The IMRT and VMAT plans provided lower maximum dose,better mean dose and more conformal target dose distributions than the 3D-CRT plans (F =14.86,8.57,18.23,P <0.05).The volume of ipsilateral breast receiving 5 Gy for VMAT technique was significantly less than that of3D-CRTor IMRT(F=5.83,P<0.05).The ipsilateral lung volume receiving 20 Gy (V20),5 Gy(V5) and the 5% volume dose (D5) of IMRT were superior to those of 3D-CRT and VMAT(F =16.39,3.62,4.81,P < 0.05).The low volume dose distributions of D5 in contralateral lung for IMRT was better than that of VMAT and 3D-CRT(F =3.99,3.43,P < 0.05).The total mean MUs for VMAT,3D-CRT and IMRT were 621.0 ± 111.9,707.3 ± 130.9 and 1161.4 ± 315.6,respectively (F =31.30,P < 0.05).The average machine delivery time was(1.5 ± 0.2)min for the VMAT plans,(7.0 ± 1.6)min for the 3D-CRT plans and (11.5 ± 1.9)min for the IMRT plans.Conclusions VMAT and IMRT techniques offer improved dose conformity as compared with 3D-CRT techniques without increasing dose to the ipsilateral lung.In terms of MU and delivery time,VMAT is more efficient for APBI than conventional 3D-CRT and static beam IMRT.%目的 比较容积弧形调强(VMAT)、固定野动态调强(IMRT)及三维适形放疗(3D-CRT)技术对乳腺癌保乳术后采用部分乳腺放疗的剂量学差异.方法 选取20例临床分期为T1-2N0M0的早期乳腺癌保乳

  11. ACCELERATION OF POLARIZED BEAMS USING MULTIPLE STRONG PARTIAL SIBERIAN SNAKES.

    Energy Technology Data Exchange (ETDEWEB)

    ROSER,T.AHRENS,L.BAI,M.ET AL.

    2004-07-05

    Acceleration of polarized protons in the energy range of 5 to 25 GeV is particularly difficult since depolarizing spin resonances are strong enough to cause significant depolarization but full Siberian snakes cause intolerably large orbit excursions. Using a 20-30% partial Siberian snake both imperfection and intrinsic resonances can be overcome. Such a strong partial Siberian snake was designed for the Brookhaven AGS using a dual pitch helical superconducting dipole. Multiple strong partial snakes are also discussed for spin matching at beam injection and extraction.

  12. ACCELERATION OF POLARIZED BEAMS USING MULTIPLE STRONG PARTIAL SIBERIAN SNAKES.

    Energy Technology Data Exchange (ETDEWEB)

    ROSER,T.; AHRENS,L.; BAI,M.; COURANT,E.; GLENN,J.W.; GUPTA,R.C.; HUANG,H.; LUCCIO,A.U.; MACKAY,W.W.; TSOUPAS,N.; WILLEN,E.; OKAMURA,M.; TAKANO,J.

    2004-10-10

    Acceleration of polarized protons in the energy range of 5 to 25 GeV is particularly difficult since depolarizing spin resonances are strong enough to cause significant depolarization but full Siberian snakes cause intolerably large orbit excursions. Using a 20-30% partial Siberian snake both imperfection and intrinsic resonances can be overcome. Such a strong partial Siberian snake was designed for the Brookhaven AGS using a dual pitch helical superconducting dipole. Multiple strong partial snakes are also discussed for spin matching at beam injection and extraction.

  13. Acceleration of Polarized Beams Using Multiple Strong Partial Siberian Snakes

    Science.gov (United States)

    Roser, T.; Ahrens, L. A.; Bai, M.; Courant, E. D.; Glenn, J. W.; Gupta, R. C.; Huang, H.; Luccio, A. U.; Mackay, W. W.; Tsoupas, N.; Willen, E.; Okamura, M.; Takano, J.

    2005-08-01

    Acceleration of polarized protons in the energy range of 5 to 25 GeV is particularly difficult since depolarizing spin resonances are strong enough to cause significant depolarization, but full Siberian snakes cause intolerably large orbit excursions. Using a 20 - 30 % partial Siberian snake, both imperfection and intrinsic resonances can be overcome. Such a strong partial Siberian snake was designed for the Brookhaven AGS using a dual pitch helical super-conducting dipole. Multiple strong partial snakes are also discussed for spin matching at beam injection and extraction.

  14. The therapy of gefitinib towards breast cancer partially through ...

    African Journals Online (AJOL)

    The therapy of gefitinib towards breast cancer partially through reversing ... Department of Medical Oncology, Affiliated Yuhuangding Hospital, Medical College of Qingdao University, ... solution containing isotope labeled amino acid internal.

  15. SU-E-T-797: Variations of Cardiac Dose at Different Respiratory Status in CyberKnife M6â„¢ Treatment Plans for Accelerated Partial Breast Irradiation (APBI)

    Energy Technology Data Exchange (ETDEWEB)

    Long, S [Florida Atlantic University, Boca Raton, FL (United States); Shang, C [Boca Raton Regional Hospital, Boca Raton, FL (United States); Evans, G [Boca Raton, FL (United States); Leventouri, T [FAU, Boca Raton, FL (United States)

    2015-06-15

    Purpose: Cyberknife robotic assisted radiation delivery has become a choice for accelerated breast RT, while a slightly increased cardiac dose has been reported. The dose dynamics throughout the respiration cycle has scarcely been explored. This study was designed to investigate the dose changes at each respiratory phase or status during respiration cycle. Methods: Six patients with 4DCT studies and six patients with a pair of free-breathing and deep breath-hold CT sets were used for dosimetry comparisons. 4DCT sets were obtained by Siemens™ CT and its respiratory gating system, comprising of 8 phases. Standard APBI plan at 340 cGy was done per fraction per NSABP B-39/RTOG 0413 and modulated with Cyberknife M6™ on MultiPlan™5.1.2. For the purpose of this study, the tumor volume was outlined in the media-lower quadrant of the left breast. Results: Except for D5cc in plans with 4DCT, cardiac doses are significantly different between respiratory phases in well inhaled breathing phases, and more significantly in plans with BH CT. Mean cardiac doses in 100% inhalation phase were often found to be 5–15% (p< 0.02) less than those in other phases. Conclusion: Although ineligible cardiac doses are noted in APBI plans using 4D free-breathing CT and instantaneous free breathing CT series, a reduction in cardiac dose was seen for the well-inhaled phases. This provides practical guidance for cardiac dose reduction applicable with CK M6 APBR.

  16. Preoperative Single Fraction Partial Breast Radiotherapy for Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Palta, Manisha; Yoo, Sua; Adamson, Justus D.; Prosnitz, Leonard R. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Horton, Janet K., E-mail: janet.horton@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)

    2012-01-01

    Purpose: Several recent series evaluating external beam accelerated partial breast irradiation (PBI) have reported adverse cosmetic outcomes, possibly related to large volumes of normal tissue receiving near-prescription doses. We hypothesized that delivery of external beam PBI in a single fraction to the preoperative tumor volume would be feasible and result in a decreased dose to the uninvolved breast compared with institutional postoperative PBI historical controls. Methods and Materials: A total of 17 patients with unifocal Stage T1 breast cancer were identified. Contrast-enhanced subtraction magnetic resonance images were loaded into an Eclipse treatment planning system and used to define the target volumes. A 'virtual plan' was created using four photon beams in a noncoplanar beam arrangement and optimized to deliver 15 Gy to the planning target volume. Results: The median breast volume was 1,713 cm{sup 3} (range: 1,014-2,140), and the median clinical target volume was 44 cm{sup 3} (range: 26-73). In all cases, 100% of the prescription dose covered 95% of the clinical target volume. The median conformity index was 0.86 (range: 0.70-1.12). The median percentage of the ipsilateral breast volume receiving 100% and 50% of the prescribed dose was 3.8% (range: 2.2-6.9) and 13.3% (range: 7.5-20.8) compared with 18% (range: 3-42) and 53% (range: 24-65) in the institutional historical controls treated with postoperative external beam PBI (p = .002). The median maximum skin dose was 9 Gy. The median dose to 1 and 10 cm{sup 3} of skin was 6.7 and 4.9 Gy. The doses to the heart and ipsilateral lung were negligible. Conclusion: Preoperative PBI resulted in a substantial reduction in ipsilateral breast tissue dose compared with postoperative PBI. The skin dose appeared reasonable, given the small volumes. A prospective Phase I trial evaluating this technique is ongoing.

  17. Prospective Multicenter Trial Evaluating Balloon-Catheter Partial-Breast Irradiation for Ductal Carcinoma in Situ

    Energy Technology Data Exchange (ETDEWEB)

    Abbott, Andrea M.; Portschy, Pamela R. [Division of Surgical Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Lee, Chung [Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Le, Chap T. [Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota (United States); Han, Linda K. [Department of Surgery, Indiana University, Indianapolis, Indiana (United States); Washington, Tara [Vantage Oncology, Redhawk and Wildomar Centers California, Wildomar, California (United States); Kinney, Michael [Center for Advanced Breast Care, Arlington Heights, Illinois (United States); Bretzke, Margit [Surgical Specialists of Minnesota, Minneapolis, Minnesota (United States); Tuttle, Todd M., E-mail: tuttl006@umn.edu [Division of Surgical Oncology, University of Minnesota, Minneapolis, Minnesota (United States)

    2013-11-01

    Purpose: To determine outcomes of accelerated partial-breast irradiation (APBI) with MammoSite in the treatment of ductal carcinoma in situ (DCIS) after breast-conserving surgery. Methods and Materials: We conducted a prospective, multicenter trial between 2003 and 2009. Inclusion criteria included age >18 years, core needle biopsy diagnosis of DCIS, and no prior breast cancer history. Patients underwent breast-conserving surgery plus MammoSite placement. Radiation was given twice daily for 5 days for a total of 34 Gy. Patients were evaluated for development of toxicities, cosmetic outcome, and ipsilateral breast tumor recurrence (IBTR). Results: A total of 41 patients (42 breasts) completed treatment in the study, with a median follow up of 5.3 years. Overall, 28 patients (68.3%) experienced an adverse event. Skin changes and pain were the most common adverse events. Cosmetic outcome at 6 months was judged excellent/good by 100% of physicians and by 96.8% of patients. At 12 months, 86.7% of physicians and 92.3% of patients rated the cosmetic outcome as excellent/good. Overall, 4 patients (9.8%) developed an IBTR (all DCIS), with a 5-year actuarial rate of 11.3%. All IBTRs were outside the treatment field. Among patients with IBTRs, the mean time to recurrence was 3.2 years. Conclusions: Accelerated partial-breast irradiation using MammoSite seems to provide a safe and cosmetically acceptable outcome; however, the 9.8% IBTR rate with median follow-up of 5.3 years is concerning. Prospective randomized trials are necessary before routine use of APBI for DCIS can be recommended.

  18. ["SOS SEIN 84" accelerated breast disease management: Patients satisfaction survey].

    Science.gov (United States)

    Arnaud, Antoine; Dumuids, Magali; Mège, Alice; de Rauglaudre, Gaëtan; Regis Arnaud, Anne; Martin, Nicole; Dupuy Meurat, Françoise; Dolle, Sabine; Gallon, Elise; Serin, Daniel

    2016-05-01

    In case of a new breast symptom or an abnormal result of breast imaging, some women have a problem finding a quick answer to allay their anxiety. The Institut Sainte-Catherine in Avignon has set up a new form of accelerated disease management through the opening of a new dedicated consultation called SOS SEIN 84. We present the result of a prospective quality study of our first new patients.

  19. Radiation exposure of the heart, lung and skin by radiation therapy for breast cancer: a dosimetric comparison between partial breast irradiation using multicatheter brachytherapy and whole breast teletherapy.

    Science.gov (United States)

    Lettmaier, Sebastian; Kreppner, Stephan; Lotter, Michael; Walser, Marc; Ott, Oliver J; Fietkau, Rainer; Strnad, Vratislav

    2011-08-01

    Accelerated partial breast irradiation by means of multicatheter brachytherapy shows great promise in the modern treatment of early breast cancer combining high efficacy in preventing tumour recurrence with low levels of toxicity. The present work attempts a dosimetric comparison between this treatment modality and conventional whole breast external beam radiotherapy by looking at differences in risk organ exposure to radiation. The planning CT data sets of 16 consecutive patients with left-sided breast cancer who received external beam radiotherapy to the whole breast followed by a boost to the tumour bed using multicatheter interstitial brachytherapy after breast conserving surgery were used to create two independent physical treatment plans - one for an external radiotherapy, one for sole partial breast brachytherapy in each case assuming a total reference dose of 50Gy for each patient. Dose-volume parameters D(0.1cc), D(0.5cc), D(1cc,)D(2cc), D(5cc,)D(10cc), D(25cc), D(50cc), V(100), V(90), V(50), V(10), V(5) for the ipsilateral lung, the heart and the adjacent skin were calculated and compared between the two treatment modalities. All organs at risk showed a substantially lower radiation exposure in the brachytherapy plan. This was most pronounced for the heart with values differing by a factor of four. Although somewhat less marked this was also true for the ipsilateral lung and the adjacent skin with exposure ratios of three and two, respectively. With the use of multicatheter interstitial brachytherapy substantial reductions in the radiation exposure of risk organs can be achieved in comparison to whole breast external beam radiotherapy. These are likely to translate into profound clinical benefits. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Lateral thoracic artery perforator (LTAP) flap in partial breast reconstruction.

    Science.gov (United States)

    McCulley, Stephen J; Schaverien, Mark V; Tan, Veronique K M; Macmillan, R Douglas

    2015-05-01

    Partial breast reconstruction using pedicled perforator flaps from the thoracodorsal (TDAP) and lateral intercostal arteries (LICAP) is well described. The article introduces the lateral thoracic artery perforator (LTAP) flap as an additional valuable option from the lateral chest wall and reports clinical experience and outcomes. The anatomy of the LTAP flap is reviewed and the results of a consecutive series are reported. In a series of 75 consecutive cases of lateral chest wall perforator flaps used for reconstruction of partial breast defects, 12 (17%) were raised as pure LTAP flaps, and a further 19 (27%) as combined LTAP/LICAP flaps. The LTAP was therefore used in 44% of flaps overall. One LTAP flap (delayed case) had early venous compromise that settled spontaneously. The LTAP flap is a reliable option for partial breast reconstruction from the lateral chest wall, particularly in the immediate setting. It allows comparable flap size to be harvested compared to LICAP flaps. The LTAP flap can be raised on its own pedicle allowing greater mobilization or it can be incorporated into the more commonly used LICAP flap to augment perfusion. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Partial Breast Reconstruction with Goldilocks Technique After Excision of Giant Fibroadenoma: A Case Report

    Science.gov (United States)

    Ter Louw, Ryan P.; Bruce, Sara B.

    2017-01-01

    Summary: Giant juvenile fibroadenomas are relatively rare, accounting for less than 1% fibroadenomas. Large breast tumors create significant asymmetry and provide unique reconstructive challenges after removal. In this case, we describe a 21-year-old female with delayed presentation of a giant fibroadenoma of the right breast. This represents an unusual presentation of benign breast disease requiring reduction of the skin envelope, extensive glandular resection, lower pole reconstruction, and free nipple grafting to achieve symmetry with the opposite breast. A novel modification of the Goldilocks mastectomy technique is described for partial breast reconstruction. Adaptation of the Goldilocks mastectomy technique provides adequate soft tissue for partial breast reconstruction. Using the lower pole deepithelialization breast skin flap provides autologous vascularized tissue to supplement volume loss after tumor and glandular excision. Benign breast disease can create significant breast deformities. Application and combination of the Goldilocks mastectomy technique allow for partial breast reconstruction without the need for an additional donor site or prosthetic devices. PMID:28203501

  2. First test of a partial Siberian snake for acceleration of polarized protons

    Science.gov (United States)

    Caussyn, D. D.; Baiod, R.; Blinov, B. B.; Chu, C. M.; Courant, E. D.; Crandell, D. A.; Derbenev, Ya. S.; Ellison, T. J. P.; Kaufman, W. A.; Krisch, A. D.; Lee, S. Y.; Minty, M. G.; Nurushev, T. S.; Ohmori, C.; Phelps, R. A.; Raczkowski, D. B.; Ratner, L. G.; Schwandt, P.; Stephenson, E. J.; Sperisen, F.; Przewoski, B. von; Wienands, U.; Wong, V. K.

    1995-09-01

    We recently studied the first acceleration of a spin-polarized proton beam through a depolarizing resonance using a partial Siberian snake. We accelerated polarized protons from 95 to 140 MeV with a constant 10% partial Siberian snake obtained using rampable solenoids. The 10% partial snake suppressed all observable depolarization during acceleration due to the Gγ=2 imperfection depolarizing resonance which occurred near 108 MeV. However, 20% and 30% partial Siberian snakes apparently moved an intrinsic depolarizing resonance, normally near 177 MeV, into our energy range; this caused some interesting, although not-yet-fully understood, depolarization.

  3. Realistic respiratory motion margins for external beam partial breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Conroy, Leigh; Quirk, Sarah [Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta T2N 4N2 (Canada); Department of Physics and Astronomy, University of Calgary, Calgary, Alberta T2N 1N4 (Canada); Smith, Wendy L., E-mail: wendy.smith@albertahealthservices.ca [Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta T2N 4N2 (Canada); Department of Physics and Astronomy, University of Calgary, Calgary, Alberta T2N 1N4 (Canada); Department of Oncology, University of Calgary, Calgary, Alberta T2N 1N4 (Canada)

    2015-09-15

    Purpose: Respiratory margins for partial breast irradiation (PBI) have been largely based on geometric observations, which may overestimate the margin required for dosimetric coverage. In this study, dosimetric population-based respiratory margins and margin formulas for external beam partial breast irradiation are determined. Methods: Volunteer respiratory data and anterior–posterior (AP) dose profiles from clinical treatment plans of 28 3D conformal radiotherapy (3DCRT) PBI patient plans were used to determine population-based respiratory margins. The peak-to-peak amplitudes (A) of realistic respiratory motion data from healthy volunteers were scaled from A = 1 to 10 mm to create respiratory motion probability density functions. Dose profiles were convolved with the respiratory probability density functions to produce blurred dose profiles accounting for respiratory motion. The required margins were found by measuring the distance between the simulated treatment and original dose profiles at the 95% isodose level. Results: The symmetric dosimetric respiratory margins to cover 90%, 95%, and 100% of the simulated treatment population were 1.5, 2, and 4 mm, respectively. With patient set up at end exhale, the required margins were larger in the anterior direction than the posterior. For respiratory amplitudes less than 5 mm, the population-based margins can be expressed as a fraction of the extent of respiratory motion. The derived formulas in the anterior/posterior directions for 90%, 95%, and 100% simulated population coverage were 0.45A/0.25A, 0.50A/0.30A, and 0.70A/0.40A. The differences in formulas for different population coverage criteria demonstrate that respiratory trace shape and baseline drift characteristics affect individual respiratory margins even for the same average peak-to-peak amplitude. Conclusions: A methodology for determining population-based respiratory margins using real respiratory motion patterns and dose profiles in the AP direction was

  4. Detecting Partial Energy Modulation in a Dielectric Laser Accelerator - Oral Presentation

    Energy Technology Data Exchange (ETDEWEB)

    Lukaczyk, Louis [SLAC National Accelerator Lab., Menlo Park, CA (United States)

    2015-08-24

    The Dielectric Laser Acceleration group at SLAC uses micro-fabricated dielectric grating structures and conventional infrared lasers to accelerator electrons. These structures have been estimated to produce an accelerating gradient up to 2 orders of magnitude greater than that produced by conventional RF accelerators. The success of the experiment depends on both the laser damage threshold of the structure and the timing overlap of femtosecond duration laser pulses with the electron bunch. In recent dielectric laser acceleration experiments, the laser pulse was shorter both temporally and spatially than the electron bunch. As a result, the laser is theorized to have interacted with only a small portion of the electron bunch. The detection of this phenomenon, referred to as partial population modulation, required a new approach to the data analysis of the electron energy spectra. A fitting function was designed to separate the accelerated electron population from the unaccelerated electron population. The approach was unsuccessful in detecting acceleration in the partial population modulation data. However, the fitting functions provide an excellent figure of merit for previous data known to contain signatures of acceleration.

  5. Dosimetry evaluation of SAVI-based HDR brachytherapy for partial breast irradiation

    Directory of Open Access Journals (Sweden)

    Manoharan Sivasubramanian

    2010-01-01

    Full Text Available Accelerated partial breast irradiation (APBI with high dose rate (HDR brachytherapy offers an excellent compact course of radiation due to its limited number of fractions for early-stage carcinoma of breast. One of the recent devices is SAVI (strut-adjusted volume implant, which has 6, 8 or 10 peripheral source channels with one center channel. Each channel can be differentially loaded. This paper focuses on the treatment planning, dosimetry and quality assurance aspects of HDR brachytherapy implant with GammaMed Plus HDR afterloader unit. The accelerated PBI balloon devices normally inflate above 35 cc range, and hence these balloon type devices cannot be accommodated in small lumpectomy cavity sizes. CT images were obtained and 3-D dosimetric plans were done with Brachyvision planning system. The 3-D treatment planning and dosimetric data were evaluated with planning target volume (PTV_eval V90, V95, V150, V200 skin dose and minimum distance to skin. With the use of the SAVI 6-1 mini device, we were able to accomplish an excellent coverage - V90, V95, V150 and V200 to 98%, 95%, 37 cc (<50 cc volume and 16 cc (<20 cc volume, respectively. Maximum skin dose was between 73% and 90%, much below the prescribed dose of 34 Gy. The minimum skin distance achieved was 5 to 11 mm. The volume that received 50% of the prescribed radiation dose was found to be lower with SAVI. The multi-channel SAVI-based implants reduced the maximum skin dose to markedly lower levels as compared to other modalities, simultaneously achieving best dose coverage to target volume. Differential-source dwell-loading allows modulation of the radiation dose distribution in symmetric or asymmetric opening of the catheter shapes and is also advantageous in cavities close to chest wall.

  6. ACCELERATION OF POLARIZED PROTONS IN THE AGS WITH TWO HELICAL PARTIAL SNAKES.

    Energy Technology Data Exchange (ETDEWEB)

    HUANG, H.; AHRENS, L.A.; BAI, M.; BRAVAR, A.; BROWN, K.; COURANT, E.D.; GARDNER, C.; GLENN, J.W.; LUCCIO, A.U.; MACKAY, W.W.; PTITSYN, V.; ROSER, T.; TEPIKIAN, S.; TSOUPAS, N.; WOOD, J.; YIP, K.; ZELENSKI, A.; ZENO, K.

    2006-06-26

    Acceleration of polarized protons in the energy range of 5 to 25 GeV is particularly difficult: the depolarizing resonances are strong enough to cause significant depolarization but full Siberian snakes cause intolerably large orbit excursions and are not feasible in the AGS since straight sections are too short. Recently, two helical partial snakes with double pitch design have been built and installed in the AGS. With careful setup of optics at injection and along the ramp, this combination can eliminate the intrinsic and imperfection depolarizing resonances encountered during acceleration. This paper presents the accelerator setup and preliminary results.

  7. Polarized Proton Acceleration in the AGS with Two Helical Partial Snakes

    Science.gov (United States)

    Huang, H.; Ahrens, L. A.; Bai, M.; Bravar, A.; Brown, K.; Courant, E. D.; Gardner, C.; Glenn, J. W.; Lin, F.; Luccio, A. U.; MacKay, W. W.; Okamura, M.; Ptitsyn, V.; Roser, T.; Takano, J.; Tepikian, S.; Tsoupas, N.; Wood, J.; Yip, K.; Zelenski, A.; Zeno, K.

    2007-06-01

    Acceleration of polarized protons in the energy range of 5 to 25 GeV is particularly difficult: the depolarizing resonances are strong enough to cause significant depolarization but full Siberian snakes cause intolerably large orbit excursions and are not feasible in the AGS since straight sections are too short. Recently, two helical partial snakes have been built and installed in the AGS. With careful setup of optics at injection and along the ramp, this combination can eliminate the intrinsic and imperfection depolarizing resonances encountered during acceleration. This paper presents the accelerator setup and preliminary results.

  8. Injection to rapid diffusive shock acceleration at perpendicular shocks in partially ionized plasmas

    CERN Document Server

    Ohira, Yutaka

    2016-01-01

    We present a three-dimensional hybrid simulation of a collisionless perpendicular shock in a partially ionized plasma for the first time. In this simulation, the shock velocity and the upstream ionization fraction are Vsh ~ 1333 km/s and fi ~ 0.5, that are typical values for isolated young supernova remnants in the interstellar medium. We confirm previous two-dimensional simulation results that downstream hydrogen atoms leak into the upstream region, they are accelerated by the pickup process in the upstream region, and large magnetic field fluctuations are generated both in the upstream and downstream regions. In addition, we find that the magnetic field fluctuations have three-dimensional structures and the leaking hydrogen atoms are injected to the diffusive shock acceleration at the perpendicular shock after the pickup process. The observed diffusive shock acceleration can be interpreted as the shock drift acceleration with scattering. Particles are accelerated to v ~ 100 Vsh ~ 0.3c within ~ 100 gyroperio...

  9. Partial breast reconstruction with mini superficial inferior epigastric artery and mini deep inferior epigastric perforator flaps.

    Science.gov (United States)

    Spiegel, Aldona J; Eldor, Liron

    2010-08-01

    In this study, partial breast reconstruction was undertaken after breast conservation therapy using mini abdominal free flaps on both an immediate and delayed basis.Patient demographics, oncologic status, reconstructive data, and complications were collected from medical records.Twelve patients (age range 39-60) were included in this study with a mean follow-up time of 5 years. Ten mini superficial inferior epigastric artery flaps and 2 mini deep inferior epigastric perforator flaps were used (7 immediate and 5 delayed reconstructions). No flap lost, 1 minor abdominal wound dehiscence, and no local or distant recurrences were noted. Good to excellent results were reported by 91% of the women.In properly selected patients with high motivation toward breast conservation, tailored abdominal mini-free flaps can safely and satisfactorily be implemented for the reconstruction of partial mastectomy defects. Patients should be comprehensively educated on the potential future implications of using the abdominal donor site for partial breast reconstruction.

  10. Partial breast irradiation for early breast cancer: 3-year results of the German-Austrian phase II-trial; Teilbrustbestrahlung beim Mammakarzinom mit guenstigen prognostischen Faktoren: 3-Jahres-Ergebnisse der deutschoesterreichischen Phase II-Studie

    Energy Technology Data Exchange (ETDEWEB)

    Ott, O.J.; Lotter, M.; Sauer, R.; Strnad, V. [Strahlenklinik, Universitaetsklinikum Erlangen (Germany); Poetter, R. [Universitaetsklinik fuer Strahlentherapie und Strahlenbiologie, AKH Wien (Austria); Hildebrandt, G. [Strahlenklinik, Universitaetsklinikum Leipzig (Germany); Hammer, J. [Abt. fuer Strahlentherapie, KH Barmherzige Schwestern Linz (Austria); Beckmann, M.W. [Frauenklinik, Universitaetsklinikum Erlangen (Germany)

    2005-07-01

    Purpose: to evaluate perioperative morbidity, toxicity and cosmetic outcome in patients treated with interstitial brachytherapy to the tumor bed as the sole radiation modality after breast conserving surgery. Materials and methods: from 11/2000 to 11/2004, 240 women with early stage breast cancer participated in a protocol of tumor bed irradiation alone using pulsed dose rate (PDR) or high dose rate (HDR) interstitial multi-catheter implants (partial breast irradiation). Perioperative morbidity, acute and late toxicity as well as cosmetic outcome were assessed. Of the first 51 patients treated in this multicenter trial, we present interim findings after a median follow-up of 36 months. Results: perioperative Morbidity: Bacterial infection of the implant: 2% (1/51). Acute toxicity: radiodermatitis grade 1: 4% (2/51). Late toxicity: breast pain grade 1: 8% (4/51), grade 2: 2% (1/51); dyspigmentation grade 1: 8% (4/51); fibrosis grade 1: 4% (2/51), grade 2: 8% (4/51); telangiectasia grade 1: 10% (5/51), grade 2: 4% (2/51). Cosmetic results: Excellent and good in 94% (48/51) of the patients. Conclusion: this analysis indicates that accelerated partial breast irradiation with 192-iridium interstitial multicatheter PDR-/HDR-implants (partial breast irradiation) is feasible with low perioperative morbidity, low acute and mild late toxicity at a median follow-up of 36 months. The cosmetic result is not significantly affected. (orig.)

  11. Immediate Partial Breast Reconstruction with Endoscopic Latissimus Dorsi Muscle Flap Harvest

    OpenAIRE

    Chae Eun Yang; Tai Suk Roh; In Sik Yun; Young Seok Kim; Dae Hyun Lew

    2014-01-01

    Background Currently, breast conservation therapy is commonly performed for the treatment of early breast cancer. Depending on the volume excised, patients may require volume replacement, even in cases of partial mastectomy. The use of the latissimus dorsi muscle is the standard method, but this procedure leaves an unfavorable scar on the donor site. We used an endoscope for latissimus dorsi harvesting to minimize the incision, thus reducing postoperative scars. Methods Ten patients who under...

  12. Breast; Sein

    Energy Technology Data Exchange (ETDEWEB)

    Bourgier, C.; Garbay, J.R.; Pichenot, C.; Uzan, C.; Delaloge, S.; Andre, F.; Spielmann, M.; Arriagada, R.; Lefkopoulos, D.; Marsigli, H.; Bondiau, P.Y.; Courdi, A.; Lallemand, M.; Peyrotte, I.; Chapellier, C.; Ferrero, J.M.; Chiovati, P.; Baldissera, A.; Frezza, G.; Vicenzi, L.; Palombarini, M.; Martelli, O.; Degli Esposti, C.; Donini, E.; Romagna CDR, E.; Romagna CDF, E.; Benmensour, M.; Bouchbika, Z.; Benchakroun, N.; Jouhadi, H.; Tawfiq, N.; Sahraoui, S.; Benider, A.; Gilliot, O.; Achard, J.L.; Auvray, H.; Toledano, I.; Bourry, N.; Kwiatkowski, F.; Verrelle, P.; Lapeyre, M.; Tebra Mrad, S.; Braham, I.; Chaouache, K.; Bouaouin, N.; Ghorbel, L.; Siala, W.; Sallemi, T.; Guermazi, M.; Frikha, M.; Daou, J.; El Omrani, A.; Chekrine, T.; Mangoni, M.; Castaing, M.; Folino, E.; Livi, L.; Dunant, A.; Mathieu, M.C.; Bitib, G.P.; Arriagada, R.; Marsigli, H

    2007-11-15

    Nine articles treat the question of breast cancer. Three-dimensional conformal accelerated partial breast irradiation: dosimetric feasibility study; test of dose escalation neo-adjuvant radiotherapy focused by Cyberknife in breast cancer; Three dimensional conformal partial irradiation with the technique by the Irma protocol ( dummy run multi centers of the Emilie Romagne area Italy); Contribution of the neo-adjuvant chemotherapy in the treatment of locally evolved cancers of the uterine cervix; Post operative radiotherapy of breast cancers (N0, pN) after neo-adjuvant chemotherapy. Radiotherapy of one or two mammary glands and ganglions areas,The breast cancer at man; breast conservative treatment; breast cancers without histological ganglions invasion; the breast cancer at 70 years old and more women; borderline mammary phyllod tumors and malignant. (N.C.)

  13. Immediate Partial Breast Reconstruction with Endoscopic Latissimus Dorsi Muscle Flap Harvest

    Directory of Open Access Journals (Sweden)

    Chae Eun Yang

    2014-09-01

    Full Text Available BackgroundCurrently, breast conservation therapy is commonly performed for the treatment of early breast cancer. Depending on the volume excised, patients may require volume replacement, even in cases of partial mastectomy. The use of the latissimus dorsi muscle is the standard method, but this procedure leaves an unfavorable scar on the donor site. We used an endoscope for latissimus dorsi harvesting to minimize the incision, thus reducing postoperative scars.MethodsTen patients who underwent partial mastectomy and immediate partial breast reconstruction with endoscopic latissimus dorsi muscle flap harvest were reviewed retrospectively. The total operation time, hospital stay, and complications were reviewed. Postoperative scarring, overall shape of the reconstructed breast, and donor site deformity were assessed using a 10-point scale.ResultsIn the mean follow-up of 11 weeks, no tumor recurrence was reported. The mean operation time was 294.5 (±38.2 minutes. The postoperative hospital stay was 11.4 days. Donor site seroma was reported in four cases and managed by office aspiration and compressive dressing. Postoperative scarring, donor site deformity, and the overall shape of the neobreast were acceptable, scoring above 7.ConclusionsReplacement of 20% to 40% of breast volume in the upper and the lower outer quadrants with a latissimus dorsi muscle flap by using endoscopic harvesting is a good alternative reconstruction technique after partial mastectomy. Short incision benefits from a very acceptable postoperative scar, less pain, and early upper extremity movement.

  14. Treatment of partial breast irradiation using modulated electron radiotherapy (MERT) in combination with IMRT; Tratamiento de irradiacion parcial de mama usando radioterapia de electrones modulados (MERT) en combinacion con IMRT

    Energy Technology Data Exchange (ETDEWEB)

    Palma, B. A.; Urba, A.; Leal, A.

    2011-07-01

    Techniques accelerated partial breast irradiation (APBI) is currently being investigated as an alternative to total breast irradiation (WBI). APBI technique involves irradiation of the tumor bed, in a short period of time, based on evidence of local recurrences occur near the primary tumor. The aim of this paper is to investigate the feasibility of APBI treatment plan using the techniques MERT or MERT+IMRT with a scheduler based on Monte Carlo methods (CARMEN).

  15. Highly accelerated cardiac cine parallel MRI using low-rank matrix completion and partial separability model

    Science.gov (United States)

    Lyu, Jingyuan; Nakarmi, Ukash; Zhang, Chaoyi; Ying, Leslie

    2016-05-01

    This paper presents a new approach to highly accelerated dynamic parallel MRI using low rank matrix completion, partial separability (PS) model. In data acquisition, k-space data is moderately randomly undersampled at the center kspace navigator locations, but highly undersampled at the outer k-space for each temporal frame. In reconstruction, the navigator data is reconstructed from undersampled data using structured low-rank matrix completion. After all the unacquired navigator data is estimated, the partial separable model is used to obtain partial k-t data. Then the parallel imaging method is used to acquire the entire dynamic image series from highly undersampled data. The proposed method has shown to achieve high quality reconstructions with reduction factors up to 31, and temporal resolution of 29ms, when the conventional PS method fails.

  16. Selective Human Estrogen Receptor Partial Agonists (ShERPAs) for Tamoxifen-Resistant Breast Cancer.

    Science.gov (United States)

    Xiong, Rui; Patel, Hitisha K; Gutgesell, Lauren M; Zhao, Jiong; Delgado-Rivera, Loruhama; Pham, Thao N D; Zhao, Huiping; Carlson, Kathryn; Martin, Teresa; Katzenellenbogen, John A; Moore, Terry W; Tonetti, Debra A; Thatcher, Gregory R J

    2016-01-14

    Almost 70% of breast cancers are estrogen receptor α (ERα) positive. Tamoxifen, a selective estrogen receptor modulator (SERM), represents the standard of care for many patients; however, 30-50% develop resistance, underlining the need for alternative therapeutics. Paradoxically, agonists at ERα such as estradiol (E2) have demonstrated clinical efficacy in patients with heavily treated breast cancer, although side effects in gynecological tissues are unacceptable. A drug that selectively mimics the actions of E2 in breast cancer therapy but minimizes estrogenic effects in other tissues is a novel, therapeutic alternative. We hypothesized that a selective human estrogen receptor partial agonist (ShERPA) at ERα would provide such an agent. Novel benzothiophene derivatives with nanomolar potency in breast cancer cell cultures were designed. Several showed partial agonist activity, with potency of 0.8-76 nM, mimicking E2 in inhibiting growth of tamoxifen-resistant breast cancer cell lines. Three ShERPAs were tested and validated in xenograft models of endocrine-independent and tamoxifen-resistant breast cancer, and in contrast to E2, ShERPAs did not cause significant uterine growth.

  17. The 10-Year Local Recurrence and Partial Breast Radiotherapy for Early Breast Cancer Treated by Conservative Surgery

    Institute of Scientific and Technical Information of China (English)

    Zhizhen Wang; Ruiying Li

    2006-01-01

    OBJECTIVE To study the local recurrence and the role of whole breast radiotherapy for early breast cancer treated by conservative surgery.METHODS From April 1990 to December 2000, 49 patients with early primary breast cancer were treated by conservative surgery in our hospital. The cases were comprised of Stage 0, 1; Stage Ⅰ, 31; and Stage Ⅱa,17. Forty cases underwent quadrantectomy plus axillary lymph node dissection, and the other 9 cases had lumpectomy alone. Irradiation, which was received by 39 patients, was administered by using low tangential half fields with 6 MV X-ray to decrease the pulmonary irradiative volume.The dose to the whole breast was 45 Gy/22~23f/4.5W, then a 15 Gy boost dose was delivered to the tumor bed by an electron beam. The other patients underwent an irradiated regional field according to postoperative pathology.RESULTS All patients were followed-up for 10 years or more. The 10year local recurrence rates, distant metastasis rates and survival rates were 6.1%, 4.1% and 98.0% respectively. All of the 3 patients who had a local recurrence had infiltrative carcinomas and negative lymph nodes.The 10-year local recurrence rate was higher (2.6% vs. 20.0%) with nonpostoperative whole breast radiotherapy, but the statistical difference was not marked because of the low number of cases. All of the recurrent lesions localized within 3 cm of the primary lesion.CONCLUSION Original recurrence of the tumor was the main type of local recurrence. Radiotherapy after conservative surgery is very essential.After conservative surgery it is feasible that irradiation can be delivered alone to the neighboring region of the tumor bed. Partial breast radiotherapy can substitute for whole breast radiotherapy.

  18. Current approaches to managing partial breast defects: the role of conservative breast surgery reconstruction.

    Science.gov (United States)

    Munhoz, Alexandre Mendonça; Montag, Eduardo; Filassi, José Roberto; Gemperli, Rolf

    2014-03-01

    Recently breast surgeons can offer patients a variety of treatment and reconstructive alternatives when early breast cancer is diagnosed. In fact, advances in reconstructive techniques have reduced surgical trauma and thus are capable of preserving the breast form as well as quality of life. Depending on a variety of different factors, including stage, tumor size, location, hystological type, but also breast volume, a reconstructive schedule is established. The main techniques are related to volume displacement or replacement procedures including local flaps, latissimus dorsi myocutaneous flap and reduction mammaplasty/ masthopexy. Regardless of the fact that there are is no consensus over the best approach, the criteria are determined by the surgeon's experience and the size of the defect in relation to the size of the remaining breast. Aim of every reconstructive procedure decision should be breast preservation and an adequate aesthetic outcome. Additionally, reconstruction permits wider excision of the tumor, with a superior mean volume of the specimen and potentially reducing the incidence of margin involvement. The objective of this review is to give an overview of reconstructive modalities for conservative breast surgery, based not only on traditional but also on the latest studies regarding the outcome of the main techniques employed. Surgical approaches, as well as conservative treatment options, such as lumpectomy and quadrantectomy, are further discussed. Surgical planning should include the patients' preferences, while chiefly addressing individual reconstructive requirements, and enabling each patient to receive an individual "custom-made" reconstruction.

  19. ACCELERATION OF POLARIZED PROTONS IN THE AGS WITH TWO HELICAL PARTIAL SNAKES.

    Energy Technology Data Exchange (ETDEWEB)

    HUANG,H.; AHRENS,L.; BAI,M.; ET AL.

    2005-05-16

    The RHIC spin program requires 2 x 10{sup 11} proton/bunch with 70% polarization. As the injector to RHIC, AGS is the bottleneck for preserving polarization: there is no space for a full snake to overcome numerous depolarizing resonances. An ac dipole and a partial snake have been used to preserve beam polarization in the past few years. Two helical snakes have been built and installed in the AGS. With careful setup of optics at injection and along the ramp, this combination can eliminate all depolarizing resonances encountered during acceleration. This paper presents the setup and preliminary results.

  20. Preoperative Single-Fraction Partial Breast Radiation Therapy: A Novel Phase 1, Dose-Escalation Protocol With Radiation Response Biomarkers

    Energy Technology Data Exchange (ETDEWEB)

    Horton, Janet K., E-mail: janet.horton@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Blitzblau, Rachel C.; Yoo, Sua [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Geradts, Joseph [Department of Pathology, Duke University Medical Center, Durham, North Carolina (United States); Chang, Zheng [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Baker, Jay A. [Department of Radiology, Duke University Medical Center, Durham, North Carolina (United States); Georgiade, Gregory S. [Department of Surgery, Duke University Medical Center, Durham, North Carolina (United States); Chen, Wei [Department of Bioinformatics: Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina (United States); Siamakpour-Reihani, Sharareh; Wang, Chunhao [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Broadwater, Gloria [Department of Biostatistics: Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina (United States); Groth, Jeff [Department of Pathology, Duke University Medical Center, Durham, North Carolina (United States); Palta, Manisha; Dewhirst, Mark [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Barry, William T. [Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina (United States); Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Duffy, Eileen A. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); and others

    2015-07-15

    Purpose: Women with biologically favorable early-stage breast cancer are increasingly treated with accelerated partial breast radiation (PBI). However, treatment-related morbidities have been linked to the large postoperative treatment volumes required for external beam PBI. Relative to external beam delivery, alternative PBI techniques require equipment that is not universally available. To address these issues, we designed a phase 1 trial utilizing widely available technology to 1) evaluate the safety of a single radiation treatment delivered preoperatively to the small-volume, intact breast tumor and 2) identify imaging and genomic markers of radiation response. Methods and Materials: Women aged ≥55 years with clinically node-negative, estrogen receptor–positive, and/or progesterone receptor–positive HER2−, T1 invasive carcinomas, or low- to intermediate-grade in situ disease ≤2 cm were enrolled (n=32). Intensity modulated radiation therapy was used to deliver 15 Gy (n=8), 18 Gy (n=8), or 21 Gy (n=16) to the tumor with a 1.5-cm margin. Lumpectomy was performed within 10 days. Paired pre- and postradiation magnetic resonance images and patient tumor samples were analyzed. Results: No dose-limiting toxicity was observed. At a median follow-up of 23 months, there have been no recurrences. Physician-rated cosmetic outcomes were good/excellent, and chronic toxicities were grade 1 to 2 (fibrosis, hyperpigmentation) in patients receiving preoperative radiation only. Evidence of dose-dependent changes in vascular permeability, cell density, and expression of genes regulating immunity and cell death were seen in response to radiation. Conclusions: Preoperative single-dose radiation therapy to intact breast tumors is well tolerated. Radiation response is marked by early indicators of cell death in this biologically favorable patient cohort. This study represents a first step toward a novel partial breast radiation approach. Preoperative radiation should

  1. Can We Predict Plan Quality for External Beam Partial Breast Irradiation: Results of a Multicenter Feasibility Study (Trans Tasman Radiation Oncology Group Study 06.02)

    Energy Technology Data Exchange (ETDEWEB)

    Kron, Tomas, E-mail: Tomas.Kron@petermac.org [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria (Australia); School of Science, Engineering and Technology, Royal Melbourne Institute of Technology University, Melbourne, Victoria (Australia); Willis, David; Link, Emma [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Lehman, Margot [Princess Alexandra Hospital, Department of Radiation Oncology, Brisbane, Queensland (Australia); Campbell, Gillian [Auckland City Hospital, Department of Radiation Oncology, Auckland (New Zealand); O' Brien, Peter [Newcastle Calvary Mater Hospital, Department of Radiation Oncology, Newcastle, NSW (Australia); Chua, Boon [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria (Australia)

    2013-11-15

    Purpose: Partial breast irradiation (PBI) after lumpectomy may be an option for selected patients with early breast cancer. A feasibility study of accelerated PBI delivered using external beam 3-dimensional conformal radiation therapy (RT) was undertaken at 8 Australasian centers. The present study evaluated the impact of patient, tumor, and RT technique-related factors on the quality of RT plans as determined by the dose–volume parameters of organs at risk. Methods and Materials: Forty-eight patients were enrolled in the study. All RT plans were centrally reviewed using predefined dosimetric criteria before commencement and after completion of protocol therapy. The RT plans of 47 patients met the dose–volume constraints, and all 47 patients received PBI to a prescribed dose of 38.5 Gy in 10 fractions. The RT plan quality was determined by volumes of the ipsilateral whole breast, lung, and heart that received 50% and 95%; 30%; and 5% of the prescribed dose, respectively. Patient, tumor, and RT technique-related factors were investigated for association with the parameters of RT plan quality. Results: The ratio of the planning target volume to the ipsilateral whole-breast volume was significantly associated with the ipsilateral breast doses on multiple variable analyses. The distance of the postlumpectomy surgical cavity from the heart and lung were predictive for heart and lung doses, respectively. A distance between surgical cavity and heart of >4 cm typically resulted in <1% of the heart volume receiving 5 Gy or less. It was more difficult to meet the heart dose constraint for left-sided and medially located tumors. Conclusions: Partial breast irradiation using 3-dimensional conformal RT was feasible within the study constraints. The ratio of planning target volume to ipsilateral whole-breast volume and the distance of surgical cavity from the heart were significant predictors of the quality of treatment plan for external beam PBI.

  2. Five-year results: the initial clinical trial of MammoSite balloon brachytherapy for partial breast irradiation in early-stage breast cancer.

    Science.gov (United States)

    Benitez, Pamela R; Keisch, Martin E; Vicini, Frank; Stolier, Alan; Scroggins, Troy; Walker, Alonzo; White, Julia; Hedberg, Peter; Hebert, Mary; Arthur, Doug; Zannis, Vic; Quiet, Coral; Streeter, Oscar; Silverstein, Mel

    2007-10-01

    Patients with early-stage invasive ductal breast cancer were prospectively evaluated using MammoSite RTS balloon brachytherapy (RTS Cytyc Corp, Marlborough, MA) as the sole modality for delivering accelerated partial breast irradiation to the lumpectomy bed with breast-conserving surgery. This report presents the 5-year results of the treated patients. From May 2000 to October 2001, 70 patients were enrolled in this prospective study. Forty-three patients completed accelerated partial breast irradiation with MammoSite brachytherapy following lumpectomy and axillary staging. Thirty-six patients have been followed for a median of 5.5 years (mean 65.2 months). Criteria for entry into the study were unifocal invasive ductal carcinoma, tumor size or = 45 years, absence of extensive intraductal component, cavity size > or = 3 cm in 1 dimension, node-negative, and final margins negative per National Surgical Adjuvant Breast and Bowel Project definition. A minimum balloon-to-skin surface distance of 5 mm was required. A dose of 34 Gy was delivered in 10 fractions over 5 days prescribed to 1 cm from the applicator surface using iridium-192 high-dose-rate brachytherapy. Data on infection, seromas, cosmetic outcome, and toxicities were collected at 3 and 6 months and at yearly intervals. Local recurrences, both true recurrences in the lumpectomy bed and failures outside the initially treated target volume (elsewhere failures), were recorded. Contralateral breast failure rates were noted. The catheter was not implanted in 16 of the 70 enrolled patients due to cavity size not amenable to balloon placement (n = 10), ineligible by criteria (n = 4), and skin spacing (n = 2). Fifty-four patients were implanted and 43 were successfully treated with MammoSite balloon brachytherapy. Reasons for catheter explantation in 11 patients were poor cavity conformance in 7, inadequate skin spacing in 2, positive node in 1 and age less than 45 years in 1. Of the 43 patients who completed

  3. ADAM12 produced by tumor cells rather than stromal cells accelerates breast tumor progression

    DEFF Research Database (Denmark)

    Frohlich, Camilla; Nehammer, Camilla; Albrechtsen, Reidar

    2011-01-01

    Expression of ADAM12 is low in most normal tissues, but is markedly increased in numerous human cancers, including breast carcinomas. We have previously shown that overexpression of ADAM12 accelerates tumor progression in a mouse model of breast cancer (PyMT). In the present study, we found...... that ADAM12 deficiency reduces breast tumor progression in the PyMT model. However, the catalytic activity of ADAM12 appears to be dispensable for its tumor-promoting effect. Interestingly, we demonstrate that ADAM12 endogenously expressed in tumor-associated stroma in the PyMT model does not influence...... tumor progression, but that ADAM12 expression by tumor cells is necessary for tumor progression in these mice. This finding is consistent with our observation that in human breast carcinoma ADAM12 is almost exclusively located in tumor cells and only rarely seen in the tumor-associated stroma. We...

  4. Dosimetric comparison of partial and whole breast external beam irradiation in the treatment of early stage breast cancer.

    Science.gov (United States)

    Kim, Yongbok; Parda, David S; Trombetta, Mark G; Colonias, Athanasios; Werts, E Day; Miller, Linda; Miften, Moyed

    2007-12-01

    A dosimetric comparison was performed on external-beam three-dimensional conformal partial breast irradiation (PBI) and whole breast irradiation (WBI) plans for patients enrolled in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39/Radiation Therapy Oncology Group (RTOG) 0413 protocol at our institution. Twenty-four consecutive patients were treated with either PBI (12 patients) or WBI (12 patients). In the PBI arm, the lumpectomy cavity was treated to a total dose of 38.5 Gy at 3.85 Gy per fraction twice daily using a four-field noncoplanar beam setup. A minimum 6 h interval was required between fractions. In the WBI arm, the whole breast including the entirety of the lumpectomy cavity was treated to a total dose of 50.4 Gy at 1.8 Gy per fraction daily using opposed tangential beams. The lumpectomy cavity volume, planning target volume for evaluation (PTV_EVAL), and critical structure volumes were contoured for both the PBI and WBI patients. Dosimetric parameters, dose volume histograms (DVHs), and generalized equivalent uniform dose (gEUD) for target and critical structures were compared. Dosimetric results show the PBI plans, compared to the WBI plans, have smaller hot spots in the PTV_EVAL (maximum dose: 104.2% versus 110.9%) and reduced dose to the ipsilateral breast (V50: 48.6% versus 92.1% and V100: 10.2% versus 50.5%), contralateral breast (V3: 0.16% versus 2.04%), ipsilateral lung (V30: 5.8% versus 12.7%), and thyroid (maximum dose: 0.5% versus 2.0%) with p values < or = 0.01. However, similar dose coverage of the PTV_EVAL (98% for PBI and 99% for WBI, on average) was observed and the dose difference for other critical structures was clinically insignificant in both arms. The gEUD data analysis showed the reduction of dose to the ipsilateral breast and lung, contralateral breast and thyroid. In addition, preliminary dermatologic adverse event assessment data suggested reduced skin toxicity for patients treated with the PBI technique.

  5. FAK deletion accelerates liver regeneration after two-thirds partial hepatectomy

    Science.gov (United States)

    Shang, Na; Arteaga, Maribel; Chitsike, Lennox; Wang, Fang; Viswakarma, Navin; Breslin, Peter; Qiu, Wei

    2016-01-01

    Understanding the molecular mechanisms of liver regeneration is essential to improve the survival rate of patients after surgical resection of large amounts of liver tissue. Focal adhesion kinase (FAK) regulates different cellular functions, including cell survival, proliferation and cell migration. The role of FAK in liver regeneration remains unknown. In this study, we found that Fak is activated and induced during liver regeneration after two-thirds partial hepatectomy (PHx). We used mice with liver-specific deletion of Fak and investigated the role of Fak in liver regeneration in 2/3 PHx model (removal of 2/3 of the liver). We found that specific deletion of Fak accelerates liver regeneration. Fak deletion enhances hepatocyte proliferation prior to day 3 post-PHx but attenuates hepatocyte proliferation 3 days after PHx. Moreover, we demonstrated that the deletion of Fak in liver transiently increases EGFR activation by regulating the TNFα/HB-EGF axis during liver regeneration. Furthermore, we found more apoptosis in Fak-deficient mouse livers compared to WT mouse livers after PHx. Conclusion: Our data suggest that Fak is involved in the process of liver regeneration, and inhibition of FAK may be a promising strategy to accelerate liver regeneration in recipients after liver transplantation. PMID:27677358

  6. Sequential changes of the breast after partial mastectomy with irradiation in breast cancer: mammographic and ultrasonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Pyeong Ho; Oh, Ki Keun; Yoon, Choon Sik; Suh, Chang Ok; Lee, Hy De; Chung, Woo Hee [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1994-02-15

    The purpose of the study is to determine the mammographic and ultrasonographic features of the breasts with partial mastectomy and irradiation. The authors reviewed the serial studies of 23 patients who had partial mastectomy and irradiation. Mammogram and ultrasonogram were performed every 6 months after surgery in all patients. Sixteen of 23 patients took mammogram and ultrasonogram 1 month after surgery additionally. We evaluated skin thickening, edema, new calcification, and postoperative scar. Skin thickening was observed in all patients at initial study after surgery and were most pronounced 6 months after surgery. In the most of patients, increased breast density suggesting edema was seen at the initial study after surgery. Skin thickening and edema were most pronounced 6 months who had retuned to normal state 18 months after surgery in 3 of 5 patients who had serial studies until 18 months after surgery. Scars were noted in 20 of 23 patients and 9 of 20 patients had scars 6 months after surgery. The postoperative changes including skin thickening, edema, and scar were most pronounced at 6 months after surgery and had retuned to normal at 18 months after surgery. We conclude that postoperative imaging should be obtained 6 months after surgery, followed be every 6 month intervals, which can be effective in differentiating postoperative scar from recurrent carcinoma and can avoid invasive studies.

  7. Constitutively activated PI3K accelerates tumor initiation and modifies histopathology of breast cancer.

    Science.gov (United States)

    Sheen, M R; Marotti, J D; Allegrezza, M J; Rutkowski, M; Conejo-Garcia, J R; Fiering, S

    2016-10-31

    The gene encoding phosphatidylinositol 3-kinase catalytic subunit α-isoform (PIK3CA, p110α) is frequently activated by mutation in human cancers. Based on detection in some breast cancer precursors, PIK3CA mutations have been proposed to have a role in tumor initiation. To investigate this hypothesis, we generated a novel mouse model with a Cre-recombinase regulated allele of p110α (myristoylated-p110α, myr-p110α) along with p53(fl/fl) deletion and Kras(G12D) also regulated by Cre-recombinase. After instillation of adenovirus-expressing Cre-recombinase into mammary ducts, we found that myr-p110α accelerated breast tumor initiation in a copy number-dependent manner. Breast tumors induced by p53(fl/fl);Kras(G12D) with no or one copy of myr-p110α had predominantly sarcomatoid features, whereas two copies of myr-p110α resulted in tumors with a carcinoma phenotype. This novel model provides experimental support for importance of active p110α in breast tumor initiation, and shows that the amount of PI3K activity can affect the rate of tumor initiation and modify the histological phenotype of breast cancer.

  8. Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Bush, David A., E-mail: dbush@llu.edu [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Do, Sharon [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Lum, Sharon; Garberoglio, Carlos [Department of Surgical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Mirshahidi, Hamid [Department of Medical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Patyal, Baldev; Grove, Roger; Slater, Jerry D. [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States)

    2014-11-01

    Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer. Methods and Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling. Subjects received postoperative proton beam radiation therapy to the surgical bed. The dose delivered was 40 Gy in 10 fractions, once daily over 2 weeks. Multiple fields were treated daily, and skin-sparing techniques were used. Following treatment, patients were evaluated with clinical assessments and annual mammograms to monitor toxicity, tumor recurrence, and cosmesis. Results: One hundred subjects were enrolled and treated. All patients completed the assigned treatment and were available for post-treatment analysis. The median follow-up was 60 months. Patients had a mean age of 63 years; 90% had ductal histology; the average tumor size was 1.3 cm. Actuarial data at 5 years included ipsilateral breast tumor recurrence-free survival of 97% (95% confidence interval: 100%-93%); disease-free survival of 94%; and overall survival of 95%. There were no cases of grade 3 or higher acute skin reactions, and late skin reactions included 7 cases of grade 1 telangiectasia. Patient- and physician-reported cosmesis was good to excellent in 90% of responses, was not changed from baseline measurements, and was well maintained throughout the entire 5-year follow-up period. Conclusions: Proton beam radiation therapy for PBI produced excellent ipsilateral breast recurrence-free survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and lumpectomy cavity configurations. Cosmetic results appear to be excellent and unchanged from baseline out to 5 years following treatment. Cosmetic results may be improved over those reported with photon

  9. YAP promotes breast cell proliferation and survival partially through stabilizing the KLF5 transcription factor.

    Science.gov (United States)

    Zhi, Xu; Zhao, Dong; Zhou, Zhongmei; Liu, Rong; Chen, Ceshi

    2012-06-01

    The Yes-associated protein (YAP), an oncoprotein in the Hippo tumor suppressor pathway, regulates tumorigenesis and has been found in a variety of tumors, including breast, ovarian, and hepatocellular cancers. Although YAP functions through its WW domains, the YAP WW domain-binding partners have not yet been completely determined. With this study, we demonstrate that YAP functions partially through its binding to KLF5, a transcription factor that promotes breast cell proliferation and survival. YAP interacted with the KLF5 PY motif through its WW domains, preventing the E3 ubiquitin ligase WWP1 from ubiquitinating KLF5. Overexpression of the wild-type YAP but not the WW domain-mutated YAP up-regulated KLF5 protein levels and mRNA expression levels of KLF5 downstream target genes, including FGFBP1 (alias FGF-BP) and ITGB2. In addition, knockdown of YAP decreased expression levels of KLF5, FGF-BP, and ITGB2. Depletion of either YAP or KLF5 decreased breast cell proliferation and survival in MCF10A and SW527 breast cell lines, and stable knockdown of either YAP or KLF5 suppressed SW527 xenograft growth in mice. The YAP upstream kinase LATS1 suppressed the KLF5-FGF-BP axis, as well as cell growth through YAP signaling. Both YAP and KLF5 are coexpressed in estrogen receptor ERα-negative breast cell lines. These findings suggest that KLF5 could be an important transcription factor partner for YAP and may contribute to the Hippo pathway. Copyright © 2012 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  10. Can we predict plan quality for external beam partial breast irradiation: results of a multicenter feasibility study (Trans Tasman Radiation Oncology Group Study 06.02).

    Science.gov (United States)

    Kron, Tomas; Willis, David; Link, Emma; Lehman, Margot; Campbell, Gillian; O'Brien, Peter; Chua, Boon

    2013-11-15

    Partial breast irradiation (PBI) after lumpectomy may be an option for selected patients with early breast cancer. A feasibility study of accelerated PBI delivered using external beam 3-dimensional conformal radiation therapy (RT) was undertaken at 8 Australasian centers. The present study evaluated the impact of patient, tumor, and RT technique-related factors on the quality of RT plans as determined by the dose-volume parameters of organs at risk. Forty-eight patients were enrolled in the study. All RT plans were centrally reviewed using predefined dosimetric criteria before commencement and after completion of protocol therapy. The RT plans of 47 patients met the dose-volume constraints, and all 47 patients received PBI to a prescribed dose of 38.5 Gy in 10 fractions. The RT plan quality was determined by volumes of the ipsilateral whole breast, lung, and heart that received 50% and 95%; 30%; and 5% of the prescribed dose, respectively. Patient, tumor, and RT technique-related factors were investigated for association with the parameters of RT plan quality. The ratio of the planning target volume to the ipsilateral whole-breast volume was significantly associated with the ipsilateral breast doses on multiple variable analyses. The distance of the postlumpectomy surgical cavity from the heart and lung were predictive for heart and lung doses, respectively. A distance between surgical cavity and heart of >4 cm typically resulted in planning target volume to ipsilateral whole-breast volume and the distance of surgical cavity from the heart were significant predictors of the quality of treatment plan for external beam PBI. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Selective Accelerated Proliferation of Malignant Breast Cancer Cells on Planar Graphene Oxide Films.

    Science.gov (United States)

    Kenry; Chaudhuri, Parthiv Kant; Loh, Kian Ping; Lim, Chwee Teck

    2016-03-22

    Graphene nanomaterials have been actively investigated for biomedical and biological applications, including that of cancer. Despite progress made, most of such studies are conducted on dispersed graphene nanosheets in solution. Consequently, the use of planar graphene films, especially in cancer research, has not been fully explored. Here, we investigate the cellular interactions between the graphene material films and breast cancer cell lines, specifically the effects these films have on cellular proliferation, spreading area, and cytotoxicity. We demonstrate that the graphene oxide (GO) film selectively accelerates the proliferation of both metastatic (MDA-MB-231) and nonmetastatic (MCF-7) breast cancer cells, but not that of noncancer breast epithelial cells (MCF-10A). Contrastingly, this accelerated proliferation is not observed with the use of graphene (G) film. Moreover, GO induces negligible cytotoxicity on these cells. We suggest that the observed phenomena originate from the synergistic effect resulted from the high loading capacity and conformational change of cellular attachment proteins on the GO film, and the high amount of oxygenated groups present in the material. We anticipate that our findings can further shed light on the graphene-cancer cellular interactions and provide better understanding for the future design and application of graphene-based nanomaterials in cancer research.

  12. Five Year Outcome of 145 Patients With Ductal Carcinoma In Situ (DCIS) After Accelerated Breast Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ciervide, Raquel [Department of Radiation Oncology, New York University School of Medicine, NYU Langone Medical Center, New York, New York (United States); Dhage, Shubhada; Guth, Amber; Shapiro, Richard L.; Axelrod, Deborah M.; Roses, Daniel F. [Department of Surgery, New York University School of Medicine, NYU Langone Medical Center, New York, New York (United States); Formenti, Silvia C., E-mail: silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine, NYU Langone Medical Center, New York, New York (United States)

    2012-06-01

    Background: Accelerated whole-breast radiotherapy (RT) with tumor bed boost in the treatment of early invasive breast cancer has demonstrated equivalent local control and cosmesis when compared with standard RT. Its efficacy in the treatment of ductal carcinoma in situ (DCIS) remains unknown. Methods and Materials: Patients treated for DCIS with lumpectomy and negative margins were eligible for 2 consecutive hypofractionated whole-breast RT clinical trials. The first trial (New York University [NYU] 01-51) prescribed to the whole breast 42 Gy (2.8 Gy in 15 fractions) and the second trial (NYU 05-181) 40.5 Gy (2.7 Gy in 15 fractions) with an additional daily boost of 0.5 Gy to the surgical cavity. Results: Between 2002 and 2009, 145 DCIS patients accrued, 59 to the first protocol and 86 to the second trial. Median age was 56 years and 65% were postmenopausal at the time of treatment. Based on optimal sparing of normal tissue, 79% of the patients were planned and treated prone and 21% supine. At 5 years' median follow-up (60 months; range 2.6-105.5 months), 6 patients (4.1%) experienced an ipsilateral breast recurrence in all cases of DCIS histology. In 3/6 patients, recurrence occurred at the original site of DCIS and in the remaining 3 cases outside the original tumor bed. New contralateral breast cancers arose in 3 cases (1 DCIS and 2 invasive carcinomas). Cosmetic self-assessment at least 2 years after treatment is available in 125 patients: 91% reported good-to-excellent and 9% reported fair-to-poor outcomes. Conclusions: With a median follow-up of 5 years, the ipsilateral local recurrence rate is 4.1%, comparable to that reported from the NSABP (National Surgical Adjuvant Breast and Bowel Project) trials that employed 50 Gy in 25 fractions of radiotherapy for DCIS. There were no invasive recurrences. These results provide preliminary evidence that accelerated hypofractionated external beam radiotherapy is a viable option for DCIS.

  13. Does accelerated hypofractionated adjuvant whole-breast radiotherapy increase mammographic density or change mammographic features?

    Science.gov (United States)

    Milanesio, Luisella; Brachet Cota, Piero B; Berrino, Carla; Cataldi, Aldo; Gatti, Giovanni; Mondini, Guido; Paino, Ovidio; Comello, Erika G; Orlassino, Renzo; Pasquino, Massimo; Cante, Domenico; La Porta, Maria R; Patania, Sebastiano; La Valle, Giovanni

    2015-01-01

    Objective: To compare mammographic features before and after accelerated hypofractionated adjuvant whole-breast radiotherapy (AWB-RT) and to evaluate possible appearance of modifications. Methods: A retrospective review of 177 females before and after an AWB-RT treatment (follow-up ranging from 5 to 9 years) was performed by four radiologists focused in breast imaging who independently evaluated diffuse mammographic density patterns and reported on possible onset of focal alterations; modifications in density and fibrosis with parenchymal distortion were deemed as indicators of AWB-RT treatment impact in breast imaging. Results: Prevalent mammographic density (D) patterns in the 177 females evaluated were according to the American College of Radiology–Breast Imaging Reporting and Data System (ACR-BIRADS): D1, fibroadipose density (score percentage from 55.9% to 43.5%); and D2, scattered fibroglandular density (from 42.9% to 32.7%). No change in diffuse mammographic density and no significant difference in mammographic breast parenchymal structure were observed. “No change” was reported with score percentage from 87% to 79.6%. Appearance of fibrosis with parenchymal distortion was reported by all radiologists in only two cases (1.1%, p = 0.3); dystrophic calcification was identified with percentage score from 2.2% to 3.3% (small type) and from 9.6% to 12.9% (coarse type). Conclusion: No statistically significant changes in follow-up mammographies 5–9 years after AWB-RT were detected, justifying large-scale selection of AWB-RT treatment with no risk of altering radiological breast parameters of common use in tumour recurrence detection. Advances in knowledge: The hypofractionated radiotherapy (AWB-RT treatment) is a new proven, safe and effective modality in post-operative patients with early breast cancer with excellent local control and survival. In our study, the absence of changes in mammographic density patterns and in breast imaging before and after

  14. Description and characterization of a novel method for partial volume simulation in software breast phantoms.

    Science.gov (United States)

    Chen, Feiyu; Bakic, Predrag R; Maidment, Andrew D A; Jensen, Shane T; Shi, Xiquan; Pokrajac, David D

    2015-10-01

    A modification to our previous simulation of breast anatomy is proposed to improve the quality of simulated x-ray projections images. The image quality is affected by the voxel size of the simulation. Large voxels can cause notable spatial quantization artifacts; small voxels extend the generation time and increase the memory requirements. An improvement in image quality is achievable without reducing voxel size by the simulation of partial volume averaging in which voxels containing more than one simulated tissue type are allowed. The linear x-ray attenuation coefficient of voxels is, thus, the sum of the linear attenuation coefficients weighted by the voxel subvolume occupied by each tissue type. A local planar approximation of the boundary surface is employed. In the two-material case, the partial volume in each voxel is computed by decomposition into up to four simple geometric shapes. In the three-material case, by application of the Gauss-Ostrogradsky theorem, the 3D partial volume problem is converted into one of a few simpler 2D surface area problems. We illustrate the benefits of the proposed methodology on simulated x-ray projections. An efficient encoding scheme is proposed for the type and proportion of simulated tissues in each voxel. Monte Carlo simulation was used to evaluate the quantitative error of our approximation algorithms.

  15. Partial tear of pectoralis major muscle masquerading as a breast mass in an 87-year-old woman. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Povoski, S.P. [Arthur G. James Cancer Hospital and Richard J. Solove Research Inst., The Ohio State Univ., Columbus, OH (United States). Dept. of Surgery; Spigos, D.G. [The Arthur G. James Cancer Hospital and Richard J. Solove Research Inst. of The Ohio State Univ., Columbus, OH (United States). Dept. of Radiology

    2002-11-01

    We report on a case of a partial tear of the pectoralis major muscle mimicking a breast mass in an elderly patient. Breast MR was useful in identifying the traumatic muscular injury and in demonstrating the lack of any intraparenchymal breast lesion.

  16. Partial mastectomy and m. latissimus dorsi reconstruction for radiation-induced fibrosis after breast-conserving cancer therapy

    NARCIS (Netherlands)

    A.N. van Geel (Albert); T. Lans (Titia); R. Haen (Roel); R.T.J. Wai (Rudi Tjong Joe); M. Menke-Pluijmers

    2011-01-01

    textabstractBackground: Patients with severe complaints of radiation-induced fibrosis after breast-conserving therapy and not responding to conservative therapy, were treated by partial mastectomy and m. latissimus dorsi reconstruction. Method: To determine the feasibility and outcome of this

  17. Does partial expander deflation exacerbate the adverse effects of radiotherapy in two-stage breast reconstruction?

    Directory of Open Access Journals (Sweden)

    Celet Ozden Burcu

    2012-02-01

    Full Text Available Abstract Background The optimum protocol for expander volume adjustment with respect to the timing and application of radiotherapy remains controversial. Methods Eighteen New Zealand rabbits were divided into three groups. Metallic port integrated anatomic breast expanders of 250 cc were implanted on the back of each animal and controlled expansion was performed. Group I underwent radiotherapy with full expanders while in Group II, expanders were partially deflated immediately prior to radiotherapy. Control group did not receive radiotherapy. The changes in blood flow at different volume adjustments were investigated in Group II by laser Doppler flowmetry. Variations in the histopathologic properties of the irradiated tissues including the skin, capsule and the pocket floor, were compared in the biopsy specimens taken from different locations in each group. Results A significant increase in skin blood flow was detected in Group II with partial expander deflation. Overall, histopathologic exam revealed aggravated findings of chronic radiodermatitis (epidermal atrophy, dermal inflammation and fibrosis, neovascularisation and vascular changes as well as increased capsule thickness especially around the lower expander pole, in Group II. Conclusions Expander deflation immediately prior to radiotherapy, may augment the adverse effects, especially in the lower expander pole, possibly via enhanced radiosensitization due to a relative increase in the blood flow and tissue oxygenation.

  18. SU-E-T-619: Comparison of CyberKnife Versus HDR (SAVI) for Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Mooij, R; Ding, X; Nagda, S [University of Pennsylvania, Philadelphia, PA (United States)

    2014-06-15

    Purpose: Compare SAVI plans and CyberKnife (CK) plans for the same accelerated course. Methods and Materials: Three SAVI patients were selected. Pre-SAVI CTs were used for CK planning. All prescriptions are 3400cGy in 10 fractions BID. Max dose to skin and chestwall is 425cGy. For SAVI, PTV is a 1cm expansion of the cavity minus the cavity. For CK, CTV is a 1cm expansion of the seroma, with 2mm margin. CK plans are normalized to SAVI, so that in both cases the 323cGy isodose line covers the same percentage of PTV. For CK Fiducial/Synchrony tracking is used. Results: In the following, all doses are per fraction and results are averaged. The PTVs for the CK plans are 2.4 times larger than the corresponding SAVI PTVs. Nonetheless the CK plans meet all constraints and are superior to SAVI plans in several respects. Max skin dose for SAVI vs CK is 332cGy vs 337cGy. Max dose to chestwall is 252cGy vs 286cGy. The volume of lung over 125cGy is 6.4cc for SAVI and 2.5cc for CK. Max heart dose is 60cGy for SAVI and 83cGy for CK. The volume of PTV receiving over 425cGy is 49cc for SAVI and 1.3cc for CK. Max dose to contra-lateral breast is 16cGy for SAVI and 4.5cGy for CK. Conclusion: CK PTVs are directly derived from the seroma. Corresponding SAVI PTVs tend to be much smaller. Dosimetrically, CK plans are equivalent or superior to SAVI plans despite the larger PTVs. Interestingly, the dose delivered to the lung is higher in SAVI vs CK. Fiducial/Synchrony tracking employed by CK might reduce errors in delivery compared to errors associated with shifts of the SAVI implant. In conclusion, when CK is an option for partial breast irradiation it may preferable to SAVI.

  19. Influence of Partial Solar Eclipse 2016 on the surface gravity acceleration using photogate sensor on Kater's reversible pendulum

    Science.gov (United States)

    Nugraha, M. G.; Saepuzaman, D.; Sholihat, F. N.; Ramayanti, S.; Setyadin, A. H.; Ferahenki, A. R.; Samsudin, A.; Utama, J. A.; Susanti, H.; Kirana, K. H.

    2016-11-01

    This study was conducted to determine the Earth's surface gravitational acceleration (g) prior to, during, and after a partial solar eclipse. Data was collected in Basic Physics Laboratory Universitas Pendidikan Indonesia, Bandung with coordinates S 6°51'48", E 107°35'40" for three days on March 8 - 10, 2016, in time interval measurement from 6 a.m. to 9 a.m. This research used a standard pendulum, Kater's reversible pendulum, which deviated less than 3° so that the motion can be regarded harmonics oscillation. The period of pendulum oscillation motion is measured by a light sensor (photogate sensor) with accuracy until 10-13 seconds. The data analysis shows that there is small difference value of gravity acceleration at the Earth's surface from three days of observation, i.e. in the order of 10-3 ms-2. It means, there is a changes in the Earth's surface gravitational acceleration (g) due to the partial solar eclipse but not significant.

  20. Collisionless shocks in a partially ionized medium: III. Efficient cosmic ray acceleration

    CERN Document Server

    Morlino, G; Bandiera, R; Amato, E; Caprioli, D

    2012-01-01

    In this paper we present the first formulation of the theory of non-linear particle acceleration in collisionless shocks in the presence of neutral hydrogen in the acceleration region. The dynamical reaction of the accelerated particles, the magnetic field amplification and the magnetic dynamical effects on the shock are also included. The main new aspect consists however in accounting for charge exchange and ionization of neutral hydrogen, which profoundly change the structure of the shock, as discussed in our previous work. This important dynamical effect of neutrals is mainly associated to the so-called neutral return flux, namely the return of hot neutrals from the downstream region to the upstream, where they deposit energy and momentum through charge exchange and ionization. We also present the self-consistent calculation of Balmer line emission from the shock region and discuss how to use measurements of the anomalous width of the different components of the Balmer line to infer the cosmic ray accelera...

  1. Graphic processing unit accelerated real-time partially coherent beam generator

    Science.gov (United States)

    Ni, Xiaolong; Liu, Zhi; Chen, Chunyi; Jiang, Huilin; Fang, Hanhan; Song, Lujun; Zhang, Su

    2016-07-01

    A method of using liquid-crystals (LCs) to generate a partially coherent beam in real-time is described. An expression for generating a partially coherent beam is given and calculated using a graphic processing unit (GPU), i.e., the GeForce GTX 680. A liquid-crystal on silicon (LCOS) with 256 × 256 pixels is used as the partially coherent beam generator (PCBG). An optimizing method with partition convolution is used to improve the generating speed of our LC PCBG. The total time needed to generate a random phase map with a coherence width range from 0.015 mm to 1.5 mm is less than 2.4 ms for calculation and readout with the GPU; adding the time needed for the CPU to read and send to LCOS with the response time of the LC PCBG, the real-time partially coherent beam (PCB) generation frequency of our LC PCBG is up to 312 Hz. To our knowledge, it is the first real-time partially coherent beam generator. A series of experiments based on double pinhole interference are performed. The result shows that to generate a laser beam with a coherence width of 0.9 mm and 1.5 mm, with a mean error of approximately 1%, the RMS values needed 0.021306 and 0.020883 and the PV values required 0.073576 and 0.072998, respectively.

  2. COLLISIONLESS SHOCKS IN A PARTIALLY IONIZED MEDIUM. III. EFFICIENT COSMIC RAY ACCELERATION

    Energy Technology Data Exchange (ETDEWEB)

    Morlino, G.; Blasi, P.; Bandiera, R.; Amato, E. [INAF-Osservatorio Astrofisico di Arcetri, Largo E. Fermi, 5, I-50125 Firenze (Italy); Caprioli, D. [Department of Astrophysical Sciences, Peyton Hall, Princeton University, Princeton, NJ 08544 (United States)

    2013-05-10

    In this paper, we present the first formulation of the theory of nonlinear particle acceleration in collisionless shocks in the presence of neutral hydrogen in the acceleration region. The dynamical reaction of the accelerated particles, the magnetic field amplification, and the magnetic dynamical effects on the shock are also included. The main new aspect of this study, however, consists of accounting for charge exchange and the ionization of a neutral hydrogen, which profoundly change the structure of the shock, as discussed in our previous work. This important dynamical effect of neutrals is mainly associated with the so-called neutral return flux, namely the return of hot neutrals from the downstream region to upstream, where they deposit energy and momentum through charge exchange and ionization. We also present the self-consistent calculation of Balmer line emission from the shock region and discuss how to use measurements of the anomalous width of the different components of the Balmer line to infer cosmic ray acceleration efficiency in supernova remnants showing Balmer emission: the broad Balmer line, which is due to charge exchange of hydrogen atoms with hot ions downstream of the shock, is shown to become narrower as a result of the energy drainage into cosmic rays, while the narrow Balmer line, due to charge exchange in the cosmic-ray-induced precursor, is shown to become broader. In addition to these two well-known components, the neutral return flux leads to the formation of a third component with an intermediate width: this too contains information on ongoing processes at the shock.

  3. Measurement of mean cardiac dose for various breast irradiation techniques and corresponding risk of major cardiovascular event

    NARCIS (Netherlands)

    T.R. Merino Lara (Tomas Rodrigo); E. Fleury (Emmanuelle); S. Mashouf (Shahram); J. Helou (Joelle); C. McCann (Claire); M. Ruschin (Mark); A. Kim (Anthony); N. Makhani (Nadiya); A. Ravi (Ananth); J.-P. Pignol (Jean-Philippe)

    2014-01-01

    textabstractAfter breast conserving surgery, early stage breast cancer patients are currently treated with a wide range of radiation techniques including whole breast irradiation (WBI), accelerated partial breast irradiation (APBI) using high-dose rate (HDR) brachytherapy, or 3D-conformal radiothera

  4. Accelerated hypofractionated adjuvant whole breast radiotherapy with concomitant photon boost after conserving surgery for early stage breast cancer: a prospective evaluation on 463 patients.

    Science.gov (United States)

    Cante, Domenico; Rosa La Porta, Maria; Casanova-Borca, Valeria; Sciacero, Piera; Girelli, Giuseppe; Pasquino, Massimo; Franco, Pierfrancesco; Ozzello, Franca

    2011-01-01

    The current standard therapeutic option for early stage breast cancer (EBC) employs a multimodality treatment approach including conservative surgery, radiotherapy, chemotherapy, and hormone therapy. The most common adjuvant radiotherapeutic strategy consists of external beam radiation therapy (EBRT) delivered to the whole breast using 1.8-2 Gy fractions given five times a week, up to a total dose of 45-50 Gy over a period of 5 weeks. In recent years, altered schedules employing larger dose per fraction delivered in fewer treatment sessions over a shorter overall treatment time began to be explored. We herein present clinical data on accelerated hypofractionated adjuvant whole-breast radiotherapy delivered on a daily basis for a total treatment time of 20 fractions. Between February 2005 and June 2009, a total of 463 patients underwent hypofractionated accelerated adjuvant radiation after conservative surgery for early breast cancer (pathological stage pTis, pT1 or pT2, pN0-N1). The basic course of radiotherapy consisted of 45 Gy, to the whole breast in 20 fractions with 2.25 Gy/fraction; an additional daily boost dose of 0.25 Gy was concomitantly delivered, to the lumpectomy cavity, for an additional total dose of 5 Gy. The cumulative nominal dose was 50 Gy. At follow-up, patients were examined at 3 and 6 months after the end of radiotherapy and twice a year afterward. Toxicity was scored according to the Common Terminology Criteria for Adverse Events, using the Radiation Therapy Oncology Group /European Organization for Research and Treatment of Cancer toxicity scale. Cosmetic results were assessed in agreement with the Harvard criteria. All the 463 patients treated with the accelerated hypofractionated adjuvant whole-breast radiotherapy schedule achieved at least 6 months' follow-up and subsequently were considered for the present analysis. With a median follow-up of 27 months, 5-year DFS is 93.1%. Only three patients experienced disease recurrence: two of them

  5. Acceleration of yoghurt fermentation time by yeast extract and partial characterisation of the active components.

    Science.gov (United States)

    Smith, Esti-Andrine; Myburgh, Jacobus; Osthoff, Gernot; de Wit, Maryna

    2014-11-01

    Water soluble autolysate of yeast, usually utilised for microbial growth support, was used as additive in yoghurt fermentation. The yeast extract (YE) resulted in a decrease of fermentation time by 21% to reach a pH of 4·6. However, the YE resulted in unacceptable flavour and taste. By size exclusion chromatography, a fraction of the YE was obtained that could account for the observed 21% decrease in fermentation time. The fraction contained molecules of low molecular weight, consisting of minerals, free amino acids and peptides. The acceleration of the yoghurt fermentation was ascribed to the short peptides in the fraction. It is proposed that the application of this extract in industrial yoghurt manufacture would result in savings for both the industry and the consumer.

  6. Mesenchymal stem cells develop tumor tropism but do not accelerate breast cancer tumorigenesis in a somatic mouse breast cancer model.

    Directory of Open Access Journals (Sweden)

    Lydia Usha

    Full Text Available The role of mesenchymal stem cells (MSCs on breast cancer progression, growth and tumorigenesis remains controversial or unknown. In the present study, we investigated the role of MSCs on breast tumor induction and growth in a clinically relevant somatic breast cancer model. We first conducted in vitro studies and found that conditioned media (CM of RCAS-Neu and RCAS-PyMT breast cancer cell lines and tumor cells themselves dramatically increased the proliferation and motility of MSCs and induced morphological changes of MSCs and differentiation into fibroblast-like cells. In contrast, the CM of MSCs inhibited the proliferation of two breast cancer cell lines by arresting the cell cycle at the G0/G1 phase. In vivo studies revealed that fluorescence dye-labeled MSCs migrated into tumor tissues. Unexpectedly, single or multiple intravenous injections of MSCs did not affect the latency of breast cancer in TVA- transgenic mice induced by intraductal injection of the RCAS vector encoding polyoma middle-T antigen (PyMT or Neu oncogenes. Moreover, MSCs had no effect on RCAS-Neu tumor growth in a syngeneic ectopic breast cancer model. While our studies consistently demonstrated the ability of breast cancer cells to profoundly induce MSCs migration, differentiation, and proliferation, the anti-proliferative effect of MSCs on breast tumor cells observed in vitro could not be translated into an antitumor activity in vivo, probably reflecting the antagonizing or complex effects of MSCs on tumor environment and tumor cells themselves.

  7. Dosimetric Evaluation of Three Partial Breast Irradiation Devices and the Dosimetric Effect of Tissue Thickness Surrounding a Multi-Lumen Partial Breast Applicator

    Science.gov (United States)

    Detwiler, Jordyn Ashle

    Many High Dose Rate treatment planning systems that are in use fail to correct for heterogeneities. If the treatment planning system does not correct for heterogeneities, it would assume that the patient is receiving full scatter when in reality, the patient will possibly be underdosed. A 1cm diameter planning target volume for a lumpectomy cavity could extend beyond the skin or chest wall for the patient and could be a great problem when it comes to treatment with the MammoSiteRTM single lumen breast applicator. A previous Monte Carlo study tested 3 MammoSiteRTM balloon sizes at various depths beyond the planning target volume to see how much tissue would be needed to achieve full scatter. The results showed that on average, if there was no tissue beyond the prescription line of 1cm there would be a 10% dose reduction for the breast -- skin interface. The purpose of this study is to use the Strut Adjusted Volume Implant (SAVI) multi-lumen breast applicator to re-create the measurements done with the MammoSiteRTM balloon and expand these measurements to include tissue thicknesses less than the PTV. Previous simulations with the MammoSiteRTM were done using Monte Carlo, with tissue thicknesses beyond the planning target volume of 0 -- 10cm. This study will re-create these measurements using Metal Oxide Semiconductor Field Effect Transistors (MOSFETs) and also take measurements below the prescription line of 1cm due to the ability of the SAVI applicator to adjust dose to the skin.

  8. Breast cancer radiotherapy: controversies and prospectives

    Institute of Scientific and Technical Information of China (English)

    YU Jin-ming; WANG Yong-sheng

    2008-01-01

    @@ Despite consensus on breast cancer radiotherapy, there are still some controversies over post-mastectomy radiotherapy (PMRT) in patients with 1-3 positive lymph nodes, accelerated partial breast irradiation (APBI), appropriate sequence of radiotherapy, chemotherapy and hormonal treatment, and radiotherapy after preoperative systemic therapy.

  9. Decorin accelerates the liver regeneration after partial hepatectomy in fibrotic mice

    Institute of Scientific and Technical Information of China (English)

    Ma Rui; Chen Jiang; Li Zheyong; Tang Jiacheng; Wang Yifan; Cai Xiujun

    2014-01-01

    Background Considering the existence of a large number of liver cell degeneration and necrosis in fibrotic liver,liver function was damaged severely and could not effectively regenerate after partial hepatectomy (PHx).The aim of this study was to investigate whether decorin (DCN) could promote the liver regeneration after PHx in fibrotic mice.Methods Forty mice (5-week-old,Balb/c) were injected with CCl4 intraperitoneally and liver fibrosis model was established after 5 weeks.The survival mice were randomly divided into two groups:control group and DCN group.Then,we performed 70% PHx on all these mice and injected DCN or phosphate-buffered saline plus normal saline (NS) to each group,respectively,after surgery.Liver body weight ratio (/BR),quantitative real-time polymerase chain reaction,and immunohistochemistry were used to analyze liver regeneration and fibrosis degree in both groups,and to find out whether exogenous protein DCN could promote the regeneration of fibrosis liver after PHx.Results Expressions of α-smooth muscle actin (SMA) mRNA and LBR had significant increases in the DCN group at postoperative Day 3 (POD 3,P<0.05).The protein expressions of CD31,α-SMA,and tumor necrosis factor (TNF)-α were higher in the DCN group than those in the control group by immunohistochemistry at POD 3 (P<0.05).Conclusion Exogenous protein DCN could promote liver regeneration after PHx in fibrotic mice.

  10. Accelerated hypofractionated adjuvant whole breast radiation with simultaneous integrated boost using volumetric modulated arc therapy for early breast cancer: A phase I/II dosimetric and clinical feasibility study from a tertiary cancer care centre of India

    Directory of Open Access Journals (Sweden)

    Dodul Mondal

    2017-03-01

    Mini abstract: Simultaneous integrated boost with accelerated hypofractionated whole breast radiotherapy using Volumetric Modulated Arc Therapy is a novel approach. Patient selection and technical considerations are of paramount importance. The present study describes successful implementation of this approach.

  11. Dixon imaging-based partial volume correction improves quantification of choline detected by breast 3D-MRSI

    Energy Technology Data Exchange (ETDEWEB)

    Minarikova, Lenka; Gruber, Stephan; Bogner, Wolfgang; Trattnig, Siegfried; Chmelik, Marek [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, MR Center of Excellence, Vienna (Austria); Pinker-Domenig, Katja; Baltzer, Pascal A.T.; Helbich, Thomas H. [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Vienna (Austria)

    2014-09-14

    Our aim was to develop a partial volume (PV) correction method of choline (Cho) signals detected by breast 3D-magnetic resonance spectroscopic imaging (3D-MRSI), using information from water/fat-Dixon MRI. Following institutional review board approval, five breast cancer patients were measured at 3 T. 3D-MRSI (1 cm{sup 3} resolution, duration ∝11 min) and Dixon MRI (1 mm{sup 3}, ∝2 min) were measured in vivo and in phantoms. Glandular/lesion tissue was segmented from water/fat-Dixon MRI and transformed to match the resolution of 3D-MRSI. The resulting PV values were used to correct Cho signals. Our method was validated on a two-compartment phantom (choline/water and oil). PV values were correlated with the spectroscopic water signal. Cho signal variability, caused by partial-water/fat content, was tested in 3D-MRSI voxels located in/near malignant lesions. Phantom measurements showed good correlation (r = 0.99) with quantified 3D-MRSI water signals, and better homogeneity after correction. The dependence of the quantified Cho signal on the water/fat voxel composition was significantly (p < 0.05) reduced using Dixon MRI-based PV correction, compared to the original uncorrected data (1.60-fold to 3.12-fold) in patients. The proposed method allows quantification of the Cho signal in glandular/lesion tissue independent of water/fat composition in breast 3D-MRSI. This can improve the reproducibility of breast 3D-MRSI, particularly important for therapy monitoring. (orig.)

  12. Ten-year results of accelerated hypofractionated adjuvant whole-breast radiation with concomitant boost to the lumpectomy cavity after conserving surgery for early breast cancer.

    Science.gov (United States)

    Cante, Domenico; Petrucci, Edoardo; Sciacero, Piera; Piva, Cristina; Ferrario, Silvia; Bagnera, Silvia; Patania, Sebastiano; Mondini, Guido; Pasquino, Massimo; Casanova Borca, Valeria; Vellani, Giorgio; La Porta, Maria Rosa; Franco, Pierfrancesco

    2017-09-01

    Accelerated hypofractionated whole-breast radiotherapy (WBRT) is considered a standard therapeutic option for early breast cancer (EBC) in the postoperative setting after breast conservation (BCS). A boost to the lumpectomy cavity may further increase local control. We herein report on the 10-year results of a series of EBC patients treated after BCS with hypofractionated WBRT with a concomitant photon boost to the surgical bed over 4 weeks. Between 2005 and 2007, 178 EBC patients were treated with a basic course of radiotherapy consisting of 45 Gy to the whole breast in 20 fractions (2.25 Gy daily) with an additional boost dose of 0.25 Gy delivered concomitantly to the lumpectomy cavity, for an additional dose of 5 Gy. Median follow-up period was 117 months. At 10-year, overall, cancer-specific, disease-free survival and local control were 92.2% (95% CI 88.7-93.4%), 99.2% (95% CI 96.7-99.7%), 95.5% (95% CI 91.2-97.2%) and 97.3% (95% CI 94.5-98.9%), respectively. Only eight patients recurred. Four in-breast recurrences, two axillary node relapses and two metastatic localizations were observed. Fourteen patients died during the observation period due to other causes while breast cancer-related deaths were eight. At last follow-up, ≥G2 fibrosis and telangiectasia were seen in 7% and 5% of patients. No major lung and heart toxicities were observed. Cosmetic results were excellent/good in 87.8% of patients and fair/poor in 12.2%. Hypofractionated WBRT with concomitant boost to the lumpectomy cavity after BCS in EBC led to consistent clinical results at 10 years. Hence, it can be considered a valid treatment option in this setting.

  13. Quantification of intra-fraction motion in breast radiotherapy using supine magnetic resonance imaging

    NARCIS (Netherlands)

    van Heijst, Tristan C F; Philippens, Mariëlle E P; Charaghvandi, Ramona K; den Hartogh, Mariska D; Lagendijk, JJW; van den Bongard, H J G Desirée; van Asselen, B

    2016-01-01

    In early-stage breast-cancer patients, accelerated partial-breast irradiation techniques (APBI) and hypofractionation are increasingly implemented after breast-conserving surgery (BCS). For a safe and effective radiation therapy (RT), the influence of intra-fraction motion during dose delivery becom

  14. Modified partially wide tangents technique in post-mastectomy radiotherapy for patients with left-sided breast cancer

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qian; CHEN Jia-yi; HU Wei-gang; GUO Xiao-mao

    2010-01-01

    Background The role of internal mammary nodes (IMN) irradiation for breast cancer patients after mastectomy remains controversial. This study aimed to compare different techniques for radiation of the chest wall (CW) and IMN post-mastectomy for left-breast cancer patients in terms of dose homogeneity within planning target volume (PTV) and dose to critical structures.Methods Thirty patients underwent CT simulation, while CW, IMN, left lung, heart and contralateral breast were contoured. Three three-dimensional conformal radiotherapy (3D-CRT) techniques, namely, standard tangents, partially wide tangents (PWT), and modified PWT techniques plus intensity modulated radiotherapy (IMRT) technique have been used to radiate CW and IMN. In addition to the target coverage and dose homogeneity, we also evaluated the dose to the critical structures including heart, left lung and contralateral breast.Results All three 3D-CRT techniques provided satisfactory coverage regarding total PTV. The PWT and the modified PWT gave better coverage of IMN PTV with V47.5 of (96.83±4.56)% and (95.19±3.90)% compared to standard tangents ((88.16±7.77)%), P <0.05. The standard tangents also contributed the biggest IMN VD105%, VD110%, VD115% and VD120%. The lowest mean dose of the heart was achieved by the modified PWT ((8.47±2.30) Gy), compared with PWT ((11.97±3.54)Gy) and standard tangents ((11.18±2.53) Gy). The mean dose of lung and contralateral breast with the modified PWT was significantly lower than those with PWT. Comparing IMRT with the modified PWT, both techniques provided satisfactory coverage. The conformity indexes (CI) with IMRT (CI1: 0.71±0.02; CI2: 0.64±0.02) were better than those with the modified PWT (CI1: 0.50±0.02; CI2: 0.45±0.02). The mean dose, V5, V10 and V5-10 of heart and left lung with the modified PWT were significantly lower than those with the IMRT. The mean dose and VD2% of contralateral breast with the modified PWT were not significantly different

  15. Multi-catheter interstitial brachytherapy for partial breast irradiation: an audit of implant quality based on dosimetric evaluation comparing intra-operative versus post-operative placement

    Science.gov (United States)

    Gurram, Lavanya; Joshi, Kishor; Phurailatpam, Reena; Paul, Siji; Sarin, Rajiv

    2016-01-01

    Purpose The use of multicatheter interstitial brachytherapy (MIB) for accelerated partial breast irradiation (APBI) in early breast cancer (EBC) patients outside the trial setting has increased. Hence, there is a need to critically evaluate implant quality. Moreover, there is a scarcity of reports using an open cavity technique. We report the dosimetric indices of open and closed cavity MIB techniques. Material and methods The dosimetric parameters of 60 EBC patients treated with MIB (open and closed cavity) who underwent three dimensional, computerized tomography (CT) based planning for APBI from November 2011 to July 2015 were evaluated. Coverage Index (CI), Dose Homogeneity Index (DHI), Conformity Index (COIN), Plan Quality Index (PQI), and Dose Non-uniformity Index (DNR) were assessed. Results Forty-one patients underwent open cavity and 19 patients underwent closed cavity placement of brachytherapy catheters. The median number of planes was 4 and median number of needles was 20. Median dose was 34 Gy with dose per fraction of 3.4 Gy, given twice a day, 6 hours apart. The D90 of the cavity and clinical target volume (CTV) were 105% and 89%, respectively. The median doses to the surgical clips were greater than 100%. The median CI of the cavity and CTV was 0.96 and 0.82, respectively. The DHI and COIN index of the CTV was 0.73 and 0.67. There were no significant differences in the dosimetric parameters based on whether the technique was done open or closed. Conclusions Critical evaluation of the dosimetric parameters of MIB-APBI is important for optimal results. While the open and closed techniques have similar dosimetry, our institutional preference is for an open technique which eases the procedure due to direct visualization of the tumor cavity. PMID:27257415

  16. Poster — Thur Eve — 10: Partial kV CBCT, complete kV CBCT and EPID in breast treatment: a dose comparison study for skin, breasts, heart and lungs

    Energy Technology Data Exchange (ETDEWEB)

    Roussin, E; Archambault, L K; Wierzbicki, W [Hopital Maisonneuve Rosemont, Montreal, Quebec (Canada)

    2014-08-15

    The advantages of kilovoltage cone beam CT (kV CBCT) imaging over electronic portal imaging device (EPID) such as accurate 3D anatomy, soft tissue visualization, fast rigid registration and enhanced precision on patient positioning has lead to its increasing use in clinics. The benefits of this imaging technique are at the cost of increasing the dose to healthy surrounding organs. Our center has moved toward the use of daily partial rotation kV CBCT to restrict the dose to healthy tissues. This study aims to better quantify radiation doses from different image-guidance techniques such as tangential EPID, complete and partial kV CBCT for breast treatments. Cross-calibrated ionization chambers and kV calibrated Gafchromic films were used to measure the dose to the heart, lungs, breasts and skin. It was found that performing partial kV CBCT decreases the heart dose by about 36%, the lungs dose by 31%, the contralateral breast dose by 41% and the ipsilateral breast dose by 43% when compared to a full rotation CBCT. The skin dose measured for a full rotation CBCT was about 0.8 cGy for the contralateral breast and about 0.3 cGy for the ipsilateral breast. The study is still ongoing and results on skin doses for partial rotation kV CBCT as well as for tangential EPID images are upcoming.

  17. A Prospective Pathologic Study to Define the Clinical Target Volume for Partial Breast Radiation Therapy in Women With Early Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Brandon T., E-mail: Brandon.Nguyen@act.gov.au [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Canberra Hospital, Radiation Oncology Department, Garran, ACT (Australia); Deb, Siddhartha [Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Victorian Cancer Biobank, Cancer Council of Victoria, Carlton, Victoria (Australia); Fox, Stephen [Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Hill, Prudence [Department of Anatomical Pathology, St. Vincent' s Hospital Melbourne, Fitzroy, Victoria (Australia); Collins, Marnie [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Chua, Boon H. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia)

    2012-12-01

    Purpose: To determine an appropriate clinical target volume for partial breast radiation therapy (PBRT) based on the spatial distribution of residual invasive and in situ carcinoma after wide local excision (WLE) for early breast cancer or ductal carcinoma in situ (DCIS). Methods and Materials: We performed a prospective pathologic study of women potentially eligible for PBRT who had re-excision and/or completion mastectomy after WLE for early breast cancer or DCIS. A pathologic assessment protocol was used to determine the maximum radial extension (MRE) of residual carcinoma from the margin of the initial surgical cavity. Women were stratified by the closest initial radial margin width: negative (>1 mm), close (>0 mm and {<=}1 mm), or involved. Results: The study population was composed of 133 women with a median age of 59 years (range, 27-82 years) and the following stage groups: 0 (13.5%), I (40.6%), II (38.3%), and III (7.5%). The histologic subtypes of the primary tumor were invasive ductal carcinoma (74.4%), invasive lobular carcinoma (12.0%), and DCIS alone (13.5%). Residual carcinoma was present in the re-excision and completion mastectomy specimens in 55.4%, 14.3%, and 7.2% of women with an involved, close, and negative margin, respectively. In the 77 women with a noninvolved radial margin, the MRE of residual disease, if present, was {<=}10 mm in 97.4% (95% confidence interval 91.6-99.5) of cases. Larger MRE measurements were significantly associated with an involved margin (P<.001), tumor size >30 mm (P=.03), premenopausal status (P=.03), and negative progesterone receptor status (P=.05). Conclusions: A clinical target volume margin of 10 mm would encompass microscopic residual disease in >90% of women potentially eligible for PBRT after WLE with noninvolved resection margins.

  18. Impact of partial versus whole breast radiation therapy on fatigue, perceived stress, quality of life and natural killer cell activity in women with breast cancer

    Directory of Open Access Journals (Sweden)

    Albuquerque Kevin

    2012-06-01

    Full Text Available Abstract Introduction This pilot study used a prospective longitudinal design to compare the effect of adjuvant whole breast radiation therapy (WBRT versus partial breast radiation therapy (PBRT on fatigue, perceived stress, quality of life and natural killer cell activity (NKCA in women receiving radiation after breast cancer surgery. Methods Women (N = 30 with early-stage breast cancer received either PBRT, Mammosite brachytherapy at dose of 34 Gy 10 fractions/5 days, (N = 15 or WBRT, 3-D conformal techniques at dose of 50 Gy +10 Gy Boost/30 fractions, (N = 15. Treatment was determined by the attending oncologist after discussion with the patient and the choice was based on tumor stage and clinical need. Women were assessed prior to initiation of radiation therapy and twice after completion of radiation therapy. At each assessment, blood was obtained for determination of NKCA and the following instruments were administered: Perceived Stress Scale (PSS, Functional Assessment of Cancer Therapy-Fatigue (FACT-F, and Functional Assessment of Cancer Therapy-General (FACT-G. Hierarchical linear modeling (HLM was used to evaluate group differences in initial outcomes and change in outcomes over time. Results Fatigue (FACT-F levels, which were similar prior to radiation therapy, demonstrated a significant difference in trajectory. Women who received PBRT reported progressively lower fatigue; conversely fatigue worsened over time for women who received WBRT. No difference in perceived stress was observed between women who received PBRT or WBRT. Both groups of women reported similar levels of quality of life (FACT-G prior to initiation of radiation therapy. However, HLM analysis revealed significant group differences in the trajectory of quality of life, such that women receiving PBRT exhibited a linear increase in quality of life over time after completion of radiation therapy; whereas women receiving WBRT showed a decreasing

  19. Dosimetric comparison of preoperative single-fraction partial breast radiotherapy techniques: 3D CRT, noncoplanar IMRT, coplanar IMRT, and VMAT.

    Science.gov (United States)

    Yoo, Sua; Blitzblau, Rachel; Yin, Fang-Fang; Horton, Janet K

    2015-01-08

    The purpose of this study was to compare dosimetric parameters of treatment plans among four techniques for preoperative single-fraction partial breast radiotherapy in order to select an optimal treatment technique. The techniques evaluated were noncoplanar 3D conformal radiation therapy (3D CRT), noncoplanar intensity-modulated radiation therapy (IMRTNC), coplanar IMRT (IMRTCO), and volumetric-modulated arc therapy (VMAT). The planning CT scans of 16 patients in the prone position were used in this study, with the single-fraction prescription doses of 15 Gy for the first eight patients and 18 Gy for the remaining eight patients. Six (6) MV photon beams were designed to avoid the heart and contralateral breast. Optimization for IMRT and VMAT was performed to reduce the dose to the skin and normal breast. All plans were normalized such that 100% of the prescribed dose covered greater than 95% of the clinical target volume (CTV) consisting of gross tumor volume (GTV) plus 1.5 cm margin. Mean homogeneity index (HI) was the lowest (1.05 ± 0.02) for 3D CRT and the highest (1.11 ± 0.04) for VMAT. Mean conformity index (CI) was the lowest (1.42 ± 0.32) for IMRTNC and the highest (1.60 ± 0.32) for VMAT. Mean of the maximum point dose to skin was the lowest (73.7 ± 11.5%) for IMRTNC and the highest (86.5 ± 6.68%) for 3D CRT. IMRTCO showed very similar HI, CI, and maximum skin dose to IMRTNC (differences radiotherapy, we can conclude that noncoplanar or coplanar IMRT were optimal in this study as IMRT plans provided homogeneous and conformal target coverage, skin sparing, and relatively short treatment delivery time.

  20. Multiclass prediction with partial least square regression for gene expression data: applications in breast cancer intrinsic taxonomy.

    Science.gov (United States)

    Huang, Chi-Cheng; Tu, Shih-Hsin; Huang, Ching-Shui; Lien, Heng-Hui; Lai, Liang-Chuan; Chuang, Eric Y

    2013-01-01

    Multiclass prediction remains an obstacle for high-throughput data analysis such as microarray gene expression profiles. Despite recent advancements in machine learning and bioinformatics, most classification tools were limited to the applications of binary responses. Our aim was to apply partial least square (PLS) regression for breast cancer intrinsic taxonomy, of which five distinct molecular subtypes were identified. The PAM50 signature genes were used as predictive variables in PLS analysis, and the latent gene component scores were used in binary logistic regression for each molecular subtype. The 139 prototypical arrays for PAM50 development were used as training dataset, and three independent microarray studies with Han Chinese origin were used for independent validation (n = 535). The agreement between PAM50 centroid-based single sample prediction (SSP) and PLS-regression was excellent (weighted Kappa: 0.988) within the training samples, but deteriorated substantially in independent samples, which could attribute to much more unclassified samples by PLS-regression. If these unclassified samples were removed, the agreement between PAM50 SSP and PLS-regression improved enormously (weighted Kappa: 0.829 as opposed to 0.541 when unclassified samples were analyzed). Our study ascertained the feasibility of PLS-regression in multi-class prediction, and distinct clinical presentations and prognostic discrepancies were observed across breast cancer molecular subtypes.

  1. A Prospective Study of the Utility of Magnetic Resonance Imaging in Determining Candidacy for Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Dorn, Paige L.; Al-Hallaq, Hania A.; Haq, Farah; Goldberg, Mira [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois (United States); Abe, Hiroyuki [Department of Radiology, University of Chicago Medical Center, Chicago, Illinois (United States); Hasan, Yasmin [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois (United States); Chmura, Steven J., E-mail: schmura@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois (United States)

    2013-03-01

    Purpose: Retrospective data have demonstrated that breast magnetic resonance imaging (MRI) may change a patient's eligibility for partial breast irradiation (PBI) by identifying multicentric, multifocal, or contralateral disease. The objective of the current study was to prospectively determine the frequency with which MRI identifies occult disease and to establish clinical factors associated with a higher likelihood of MRI prompting changes in PBI eligibility. Methods and Materials: At The University of Chicago, women with breast cancer uniformly undergo MRI in addition to mammography and ultrasonography. From June 2009 through May 2011, all patients were screened prospectively in a multidisciplinary conference for PBI eligibility based on standard imaging, and the impact of MRI on PBI eligibility according to National Surgical Adjuvant Breast and Bowel Project protocol B-39/Radiation Therapy Oncology Group protocol 0413 entry criteria was recorded. Univariable analysis was performed using clinical characteristics in both the prospective cohort and in a separate cohort of retrospectively identified patients. Pooled analysis was used to derive a scoring index predictive of the risk that MRI would identify additional disease. Results: A total of 521 patients were screened for PBI eligibility, and 124 (23.8%) patients were deemed eligible for PBI based on standard imaging. MRI findings changed PBI eligibility in 12.9% of patients. In the pooled univariable analysis, tumor size ≥2 cm on mammography or ultrasonography (P=.02), age <50 years (P=.01), invasive lobular histology (P=.01), and HER-2/neu amplification (P=.01) were associated with a higher likelihood of MRI changing PBI eligibility. A predictive score was generated by summing the number of significant risk factors. Patients with a score of 0, 1, 2, and 3 had changes to eligibility based on MRI findings in 2.8%, 13.2%, 38.1%, and 100%, respectively (P<.0001). Conclusions: MRI identified additional

  2. Neoadjuvant Trials in ER(+) Breast Cancer: A Tool for Acceleration of Drug Development and Discovery.

    Science.gov (United States)

    Guerrero-Zotano, Angel L; Arteaga, Carlos L

    2017-06-01

    Neoadjuvant therapy trials offer an excellent strategy for drug development and discovery in breast cancer, particularly in triple-negative and HER2-overexpressing subtypes, where pathologic complete response is a good surrogate of long-term patient benefit. For estrogen receptor-positive (ER(+)) breast cancers, however, use of this strategy has been challenging because of the lack of validated surrogates of long-term efficacy and the overall good prognosis of the majority of patients with this cancer subtype. We review below the clinical benefits of neoadjuvant endocrine therapy for ER(+)/HER2-negative breast cancer, its use and limitations for drug development, prioritization of adjuvant and metastatic trials, and biomarker discovery.Significance: Neoadjuvant endocrine therapy is an excellent platform for the development of investigational drugs, triaging of novel combinations, biomarker validation, and discovery of mechanisms of drug resistance. This review summarizes the clinical and investigational benefits of this approach, with a focus on how to best integrate predictive biomarkers into novel clinical trial designs. Cancer Discov; 7(6); 561-74. ©2017 AACR. ©2017 American Association for Cancer Research.

  3. Multi-probe-based resonance-frequency electrical impedance spectroscopy for detection of suspicious breast lesions: improving performance using partial ROC optimization

    Science.gov (United States)

    Lederman, Dror; Zheng, Bin; Wang, Xingwei; Wang, Xiao Hui; Gur, David

    2011-03-01

    We have developed a multi-probe resonance-frequency electrical impedance spectroscope (REIS) system to detect breast abnormalities. Based on assessing asymmetry in REIS signals acquired between left and right breasts, we developed several machine learning classifiers to classify younger women (i.e., under 50YO) into two groups of having high and low risk for developing breast cancer. In this study, we investigated a new method to optimize performance based on the area under a selected partial receiver operating characteristic (ROC) curve when optimizing an artificial neural network (ANN), and tested whether it could improve classification performance. From an ongoing prospective study, we selected a dataset of 174 cases for whom we have both REIS signals and diagnostic status verification. The dataset includes 66 "positive" cases recommended for biopsy due to detection of highly suspicious breast lesions and 108 "negative" cases determined by imaging based examinations. A set of REIS-based feature differences, extracted from the two breasts using a mirror-matched approach, was computed and constituted an initial feature pool. Using a leave-one-case-out cross-validation method, we applied a genetic algorithm (GA) to train the ANN with an optimal subset of features. Two optimization criteria were separately used in GA optimization, namely the area under the entire ROC curve (AUC) and the partial area under the ROC curve, up to a predetermined threshold (i.e., 90% specificity). The results showed that although the ANN optimized using the entire AUC yielded higher overall performance (AUC = 0.83 versus 0.76), the ANN optimized using the partial ROC area criterion achieved substantially higher operational performance (i.e., increasing sensitivity level from 28% to 48% at 95% specificity and/ or from 48% to 58% at 90% specificity).

  4. Molecular Cloning of Myostatin Partial cDNA of Beijing Duck and Its Expression in Breast Muscle

    Institute of Scientific and Technical Information of China (English)

    WANG Yong-sheng; HOU Shui-sheng; HUANG Wei; KANG Jun-mei

    2006-01-01

    In this experiment, 500 bp cDNA of myostatin gene was cloned from a Beijing duck's breast. The duck myostatin gene was found to have 98, 96, 95, 88, and 87% sequence similarity at the cDNA level with domestic goose, chicken, domestic pigeon, human, and pig, respectively. The predicted amino acid sequence has an overall similarity with a comparable region of turkey 99%, domestic goose 98%, and chicken 99%. Conserved domains of deduced amino acids showed that it belonged to the TGF-beta family. Myostatin expression in breast muscle was higher at 28, 35, and 42 days than at 7, 14, and 21 days. The pattern of myostatin expression was closely parallel to the trend of breast muscle growth, suggesting that myostatin might play an important role in breast muscle development. It was possible to postulate that myostatin may be a major determinant of muscle mass in breast muscle, as shown in other species.

  5. Development of a Dedicated Radiotherapy Unit with Real-Time Image Guidance and Motion Management for Accelerated Partial Breast Irradiation

    Science.gov (United States)

    2012-08-01

    Fudan Universtiy Cancer Hospital, Shanghai, Shanghai, CN, (2) UC San Francisco , San Francisco , CA Purpose: The accurate dose recalculation requires...amorphous silicon ( aSi ) flat panel detector (Varian Medical Systems) of an On-Board Imager (Varian Medical Systems) was modeled using BEAMnrc/EGSnrc

  6. COLLISIONLESS SHOCKS IN A PARTIALLY IONIZED MEDIUM. I. NEUTRAL RETURN FLUX AND ITS EFFECTS ON ACCELERATION OF TEST PARTICLES

    Energy Technology Data Exchange (ETDEWEB)

    Blasi, P.; Morlino, G.; Bandiera, R.; Amato, E. [INAF-Osservatorio Astrofisico di Arcetri, Largo E. Fermi, 5, I-50125 Firenze (Italy); Caprioli, D. [Department of Astrophysical Sciences, Peyton Hall, Princeton University, Princeton, NJ 08540 (United States)

    2012-08-20

    A collisionless shock may be strongly modified by the presence of neutral atoms through the processes of charge exchange between ions and neutrals and ionization of the latter. These two processes lead to exchange of energy and momentum between charged and neutral particles both upstream and downstream of the shock. In particular, neutrals that suffer a charge exchange downstream with shock-heated ions generate high-velocity neutrals that have a finite probability of returning upstream. These neutrals might then deposit heat in the upstream plasma through ionization and charge exchange, thereby reducing the fluid Mach number. A consequence of this phenomenon, which we refer to as the neutral return flux, is a reduction of the shock compression factor and the formation of a shock precursor upstream. The scale length of the precursor is determined by the ionization and charge-exchange interaction lengths of fast neutrals moving toward upstream infinity. In the case of a shock propagating in the interstellar medium, the effects of ion-neutral interactions are especially important for shock velocities <3000 km s{sup -1}. Such propagation velocities are common among shocks associated with supernova remnants, the primary candidate sources for the acceleration of Galactic cosmic rays. We then investigate the effects of the return flux of neutrals on the spectrum of test particles accelerated at the shock. We find that, for shocks slower than {approx}3000 km s{sup -1}, the particle energy spectrum steepens appreciably with respect to the naive expectation for a strong shock, namely, {proportional_to}E{sup -2}.

  7. Five-year results of a prospective case series of accelerated hypofractionated whole breast radiation with concomitant boost to the surgical bed after conserving surgery for early breast cancer.

    Science.gov (United States)

    Cante, Domenico; Franco, Pierfrancesco; Sciacero, Piera; Girelli, Giuseppe; Marra, Anna Maria; Pasquino, Massimo; Russo, Giuliana; Borca, Valeria Casanova; Mondini, Guido; Paino, Ovidio; Barmasse, Roberto; Tofani, Santi; Numico, Gianmauro; La Porta, Maria Rosa; Ricardi, Umberto

    2013-06-01

    Accelerated hypofractionation (HF) using larger dose per fraction, delivered in fewer fractions over a shorter overall treatment time, is presently a consistent possibility for adjuvant whole breast radiation (WBRT) after breast-conserving surgery for early breast cancer (EBC). Between 2005 and 2008, we submitted 375 consecutive patients to accelerated hypofractionated WBRT after breast-conserving surgery for EBC. The basic course of radiation consisted of 45 Gy in 20 fractions over 4 weeks to the whole breast (2.25 Gy daily) with an additional daily concomitant boost of 0.25 Gy up to 50 Gy to the surgical bed. Overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS) and local control (LC) were assessed. Late toxicity was scored according to the CTCAE v3.0; acute toxicity using the RTOG/EORTC toxicity scale. Cosmesis was assessed comparing treated and untreated breast. Quality of life (QoL) was determined using EORTC QLQ-C30/QLQ-BR23 questionnaires. With a median follow-up of 60 months (range 42-88), 5 years OS, CSS, DFS and LC were 97.6, 99.4, 96.6 and 100 %, respectively. Late skin and subcutaneous toxicity was generally mild, with few events > grade 2 observed. Cosmetic results were excellent in 75.7 % of patients, good in 20 % and fair in 4.3 %. QoL, assessed both through QLQ-C30/QLQ-BR23, was generally favorable, within the functioning and symptoms domains. Our study is another proof of principle that HF WBRT with a concurrent boost dose to the surgical cavity represents a safe and effective postoperative treatment modality with excellent local control and survival, consistent cosmetic results and mild toxicity.

  8. Predicting patient survival from microarray data by accelerated failure time modeling using partial least squares and LASSO.

    Science.gov (United States)

    Datta, Susmita; Le-Rademacher, Jennifer; Datta, Somnath

    2007-03-01

    We consider the problem of predicting survival times of cancer patients from the gene expression profiles of their tumor samples via linear regression modeling of log-transformed failure times. The partial least squares (PLS) and least absolute shrinkage and selection operator (LASSO) methodologies are used for this purpose where we first modify the data to account for censoring. Three approaches of handling right censored data-reweighting, mean imputation, and multiple imputation-are considered. Their performances are examined in a detailed simulation study and compared with that of full data PLS and LASSO had there been no censoring. A major objective of this article is to investigate the performances of PLS and LASSO in the context of microarray data where the number of covariates is very large and there are extremely few samples. We demonstrate that LASSO outperforms PLS in terms of prediction error when the list of covariates includes a moderate to large percentage of useless or noise variables; otherwise, PLS may outperform LASSO. For a moderate sample size (100 with 10,000 covariates), LASSO performed better than a no covariate model (or noise-based prediction). The mean imputation method appears to best track the performance of the full data PLS or LASSO. The mean imputation scheme is used on an existing data set on lung cancer. This reanalysis using the mean imputed PLS and LASSO identifies a number of genes that were known to be related to cancer or tumor activities from previous studies.

  9. SNPs in DNA repair or oxidative stress genes and late subcutaneous fibrosis in patients following single shot partial breast irradiation

    OpenAIRE

    2012-01-01

    Abstract Background The aim of this study was to evaluate the potential association between single nucleotide polymorphisms related response to radiotherapy injury, such as genes related to DNA repair or enzymes involved in anti-oxidative activities. The paper aims to identify marker genes able to predict an increased risk of late toxicity studying our group of patients who underwent a Single Shot 3D-CRT PBI (SSPBI) after BCS (breast conserving surgery). Methods A total of 57 breast cancer pa...

  10. Phase 2 Trial of Accelerated, Hypofractionated Whole-Breast Irradiation of 39 Gy in 13 Fractions Followed by a Tumor Bed Boost Sequentially Delivering 9 Gy in 3 Fractions in Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Jung, So-Youn; Lee, Seeyoun; Kang, Han-Sung; Lee, Eun Sook; Park, In Hae; Lee, Keun Seok; Ro, Jungsil [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Lee, Nam Kwon [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Department of Radiation Oncology, Korea University Medical Center, Collage of Medicine, Seoul (Korea, Republic of); Shin, Kyung Hwan, E-mail: radiat@ncc.re.kr [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Department of Radiation Oncology, Korea University Medical Center, Collage of Medicine, Seoul (Korea, Republic of)

    2013-12-01

    Purpose: To report a phase 2 trial of accelerated, hypofractionated whole-breast irradiation (AH-WBI) delivered as a daily dose of 3 Gy to the whole breast followed by a tumor bed boost. Methods and Materials: Two hundred seventy-six patients diagnosed with breast cancer (pT1-2 and pN0-1a) who had undergone breast-conserving surgery in which the operative margins were negative were treated with AH-WBI delivered as 39 Gy in 13 fractions of 3 Gy to the whole breast once daily over 5 consecutive working days, and 9 Gy in 3 sequential fractions of 3 Gy to a lumpectomy cavity, all within 3.2 weeks. Results: After a median follow-up period of 57 months (range: 27-75 months), the rate of 5-year locoregional recurrence was 1.4% (n=4), whereas that of disease-free survival was 97.4%. No grade 3 skin toxicity was reported during the follow-up period. Qualitative physician cosmetic assessments of good or excellent were noted in 82% of the patients at 2 months after the completion of AH-WBI. The global cosmetic outcome did not worsen over time, and a good or excellent cosmetic outcome was reported in 82% of the patients at 3 years. The mean pretreatment percentage breast retraction assessment was 12.00 (95% confidence interval [CI]: 11.14-12.86). The mean value of percentage breast retraction assessment increased to 13.99 (95% CI: 12.17-15.96) after 1 year and decreased to 13.54 (95% CI: 11.84-15.46) after 3 years but was not significant (P>.05). Conclusions: AH-WBI consisting of 39 Gy in 13 fractions followed by a tumor bed boost sequentially delivering 9 Gy in 3 fractions can be delivered with excellent disease control and tolerable skin toxicity in patients with early-stage breast cancer after breast-conserving surgery.

  11. Invasive ductal carcinomas of the breast showing partial reversed cell polarity are associated with lymphatic tumor spread and may represent part of a spectrum of invasive micropapillary carcinoma.

    Science.gov (United States)

    Acs, Geza; Esposito, Nicole N; Rakosy, Zsuzsa; Laronga, Christine; Zhang, Paul J

    2010-11-01

    Invasive micropapillary carcinomas (IMPC) of the breast are aggressive tumors frequently associated with lymphatic invasion and nodal metastasis even when micropapillary (MP) differentiation is very focal within the tumors. We have noticed that some breast carcinomas showing lymphatic spread but lacking histologic features of IMPC have occasional tumor cell clusters reminiscent of those of IMPC without the characteristic prominent retraction artifact. To study the clinicopathologic significance of such features, we prospectively selected 1323 invasive ductal carcinomas and determined the presence and extent of MP differentiation and retraction artifact in the tumors. One representative tumor block per case was used for immunostaining for epithelial membrane antigen (EMA). Partial reverse cell polarity (PRCP) was defined as prominent linear EMA reactivity on at least part of the periphery of tumor cell clusters usually associated with decreased cytoplasmic staining. The clinicopathologic features of carcinomas with PRCP were compared with IMPC and invasive ductal (no special type) carcinomas without this feature. Of the 1323 cases, 96 (7.3%) and 92 (7.0%) showed MP features and the presence of PRCP, respectively. We found that the presence of both PRCP and MP features were strongly associated with decreased cytoplasmic EMA immunoreactivity and the presence of lymphatic invasion and nodal metastasis, even if such features were present only very focally. Our results suggest that breast carcinomas with PRCP may have the same implication as MP differentiation and these tumors may represent part of a spectrum of IMPC. Complete or partial reversal of cell polarity may play a significant role in lymphatic tumor spread.

  12. Accelerated hypofractionated radiotherapy as adjuvant regimen after conserving surgery for early breast cancer: interim report of toxicity after a minimum follow up of 3 years

    Directory of Open Access Journals (Sweden)

    Marucci Laura

    2010-01-01

    Full Text Available Abstract Background Accelerated hypofractionation is an attractive approach for adjuvant whole breast radiotherapy. In this study we evaluated the adverse effects at least 3 years post an accelerated hypofractionated whole breast radiotherapy schedule. Methods From October 2004 to March 2006, 39 consecutive patients aged over 18 years with pTis, pT1-2, pN0-1 breast adenocarcinoma who underwent conservative surgery were treated with an adjuvant accelerated hypofractionated radiotherapy schedule consisting of 34 Gy in 10 daily fractions over 2 weeks to the whole breast, followed after 1 week by an electron boost dose of 8 Gy in a single fraction to the tumour bed. Skin and lung radiation toxicity was evaluated daily during therapy, once a week for one month after radiotherapy completion, every 3 months for the first year and from then on every six months. In particular lung toxicity was investigated in terms of CT density evaluation, pulmonary functional tests, and clinical and radiological scoring. Paired t-test, Chi-square test and non-parametric Wilcoxon test were performed. Results After a median follow-up of 43 months (range 36-52 months, all the patients are alive and disease-free. None of the patients showed any clinical signs of lung toxicity, no CT-lung toxicity was denoted by radiologist on CT lung images acquired about 1 year post-radiotherapy, no variation of pulmonary density evaluated in terms of normalised Hounsfield numbers was evident. Barely palpable increased density of the treated breast was noted in 9 out of 39 patients (in 2 patients this toxicity was limited to the boost area and teleangectasia (2 limited to the boost area was evident in 2 out of 39 patients. The compliance with the treatment was excellent (100%. Conclusion The radiotherapy schedule investigated in this study (i.e 34 Gy in 3.4 Gy/fr plus boost dose of 8 Gy in single fraction is a feasible and safe treatment and does not lead to adjunctive acute and late

  13. Dose and polymorphic genes xrcc1, xrcc3, gst play a role in the risk of articledeveloping erythema in breast cancer patients following single shot partial breast irradiation after conservative surgery

    Directory of Open Access Journals (Sweden)

    Muti Paola

    2011-07-01

    Full Text Available Abstract Background To evaluate the association between polymorphisms involved in DNA repair and oxidative stress genes and mean dose to whole breast on acute skin reactions (erythema in breast cancer (BC patients following single shot partial breast irradiation (SSPBI after breast conservative surgery. Materials and Methods Acute toxicity was assessed using vers.3 criteria. single nucleotides polymorphisms(SNPs in genes: XRCC1(Arg399Gln/Arg194Trp, XRCC3 (A4541G-5'UTR/Thr241Met, GSTP1(Ile105Val, GSTA1 and RAD51(untranslated region. SNPs were determined in 57 BC patients by the Pyrosequencing analysis. Univariate(ORs and 95% CI and logistic multivariate analyses (MVA were performed to correlate polymorphic genes with the risk of developing acute skin reactions to radiotherapy. Results After SSPBI on the tumour bed following conservative surgery, grade 1 or 2 acute erythema was observed in 19 pts(33%. Univariate analysis indicated a higher significant risk of developing erythema in patients with polymorphic variant wt XRCC1Arg194Trp, mut/het XRCC3Thr241Met, wt/het XRCC3A4541G-5'UTR. Similarly a higher erythema rate was also found in the presence of mut/het of XRCC1Arg194Trp or wt of GSTA1. Whereas, a lower erythema rate was observed in patients with mut/het of XRCC1Arg194Trp or wt of XRCC1Arg399Gln. The mean dose to whole breast(p = 0.002, the presence of either mut/het XRCC1Arg194Trp or wt XRCC3Thr241Met (p = 0.006 and the presence of either mut/het XRCC1Arg194Trp or wt GSTA1(p = 0.031 were confirmed as predictors of radiotherapy-induced erythema by MVA. Conclusions The Whole breast mean dose together with the presence of some polymorphic genes involved in DNA repair or oxidative stress could explain the erythema observed after SSPBI, but further studies are needed to confirm these results in a larger cohort. Trial Registration ClinicalTrials.gov Identifier: NCT01316328

  14. SU-E-J-37: Feasibility of Utilizing Carbon Fiducials to Increase Localization Accuracy of Lumpectomy Cavity for Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Y; Hieken, T; Mutter, R; Park, S; Yan, E; Brinkmann, D; Pafundi, D [Mayo Clinic, Rochester, MN (United States)

    2015-06-15

    Purpose To investigate the feasibility of utilizing carbon fiducials to increase localization accuracy of lumpectomy cavity for partial breast irradiation (PBI). Methods Carbon fiducials were placed intraoperatively in the lumpectomy cavity following resection of breast cancer in 11 patients. The patients were scheduled to receive whole breast irradiation (WBI) with a boost or 3D-conformal PBI. WBI patients were initially setup to skin tattoos using lasers, followed by orthogonal kV on-board-imaging (OBI) matching to bone per clinical practice. Cone beam CT (CBCT) was acquired weekly for offline review. For the boost component of WBI and PBI, patients were setup with lasers, followed by OBI matching to fiducials, with final alignment by CBCT matching to fiducials. Using carbon fiducials as a surrogate for the lumpectomy cavity and CBCT matching to fiducials as the gold standard, setup uncertainties to lasers, OBI bone, OBI fiducials, and CBCT breast were compared. Results Minimal imaging artifacts were introduced by fiducials on the planning CT and CBCT. The fiducials were sufficiently visible on OBI for online localization. The mean magnitude and standard deviation of setup errors were 8.4mm ± 5.3 mm (n=84), 7.3mm ± 3.7mm (n=87), 2.2mm ± 1.6mm (n=40) and 4.8mm ± 2.6mm (n=87), for lasers, OBI bone, OBI fiducials and CBCT breast tissue, respectively. Significant migration occurred in one of 39 implanted fiducials in a patient with a large postoperative seroma. Conclusion OBI carbon fiducial-based setup can improve localization accuracy with minimal imaging artifacts. With increased localization accuracy, setup uncertainties can be reduced from 8mm using OBI bone matching to 3mm using OBI fiducial matching for PBI treatment. This work demonstrates the feasibility of utilizing carbon fiducials to increase localization accuracy to the lumpectomy cavity for PBI. This may be particularly attractive for localization in the setting of proton therapy and other scenarios

  15. A high-fat, high-fructose diet accelerates nutrient absorption and impairs net hepatic glucose uptake in response to a mixed meal in partially pancreatectomized dogs.

    Science.gov (United States)

    Coate, Katie Colbert; Kraft, Guillaume; Lautz, Margaret; Smith, Marta; Neal, Doss W; Cherrington, Alan D

    2011-09-01

    The aim of this study was to elucidate the impact of a high-fat, high-fructose diet (HFFD; fat, 52%; fructose, 17%), in the presence of a partial (~65%) pancreatectomy (PPx), on the response of the liver and extrahepatic tissues to an orally administered, liquid mixed meal. Adult male dogs were fed either a nonpurified, canine control diet (CTR; fat, 26%; no fructose; n = 5) or a HFFD (n = 5) for 8 wk. Diets were provided in a quantity to maintain neutral or positive energy balance in CTR or HFFD, respectively. Dogs underwent a sham operation or PPx at wk 0, portal and hepatic vein catheterization at wk 6, and a mixed meal test at wk 8. Postprandial glucose concentrations were significantly greater in the HFFD group (14.5 ± 2.0 mmol/L) than in the CTR group (9.2 ± 0.5 mmol/L). Impaired glucose tolerance in HFFD was due in part to accelerated gastric emptying and glucose absorption, as indicated by a more rapid rise in arterial plasma acetaminophen and the rate of glucose output by the gut, respectively, in HFFD than in CTR. It was also attributable to lower net hepatic glucose uptake (NHGU) in the HFFD group (5.5 ± 3.9 μmol · kg(-1) · min(-1)) compared to the CTR group (26.6 ± 7.0 μmol · kg(-1) · min(-1)), resulting in lower hepatic glycogen synthesis (GSYN) in the HFFD group (10.8 ± 5.4 μmol · kg(-1) · min(-1)) than in the CTR group (30.4 ± 7.0 μmol · kg(-1) · min(-1)). HFFD also displayed aberrant suppression of lipolysis by insulin. In conclusion, HFFD feeding accelerates gastric emptying and diminishes NHGU and GSYN, thereby impairing glucose tolerance following a mixed meal challenge. These data reveal a constellation of deleterious metabolic consequences associated with consumption of a HFFD for 8 wk.

  16. A High-Fat, High-Fructose Diet Accelerates Nutrient Absorption and Impairs Net Hepatic Glucose Uptake in Response to a Mixed Meal in Partially Pancreatectomized Dogs12

    Science.gov (United States)

    Coate, Katie Colbert; Kraft, Guillaume; Lautz, Margaret; Smith, Marta; Neal, Doss W.; Cherrington, Alan D.

    2011-01-01

    The aim of this study was to elucidate the impact of a high-fat, high-fructose diet (HFFD; fat, 52%; fructose, 17%), in the presence of a partial (~65%) pancreatectomy (PPx), on the response of the liver and extrahepatic tissues to an orally administered, liquid mixed meal. Adult male dogs were fed either a nonpurified, canine control diet (CTR; fat, 26%; no fructose; n = 5) or a HFFD (n = 5) for 8 wk. Diets were provided in a quantity to maintain neutral or positive energy balance in CTR or HFFD, respectively. Dogs underwent a sham operation or PPx at wk 0, portal and hepatic vein catheterization at wk 6, and a mixed meal test at wk 8. Postprandial glucose concentrations were significantly greater in the HFFD group (14.5 ± 2.0 mmol/L) than in the CTR group (9.2 ± 0.5 mmol/L). Impaired glucose tolerance in HFFD was due in part to accelerated gastric emptying and glucose absorption, as indicated by a more rapid rise in arterial plasma acetaminophen and the rate of glucose output by the gut, respectively, in HFFD than in CTR. It was also attributable to lower net hepatic glucose uptake (NHGU) in the HFFD group (5.5 ± 3.9 μmol ⋅ kg−1 ⋅ min−1) compared to the CTR group (26.6 ± 7.0 μmol ⋅ kg−1 ⋅ min−1), resulting in lower hepatic glycogen synthesis (GSYN) in the HFFD group (10.8 ± 5.4 μmol ⋅ kg−1 ⋅ min−1) than in the CTR group (30.4 ± 7.0 μmol ⋅ kg−1 ⋅ min−1). HFFD also displayed aberrant suppression of lipolysis by insulin. In conclusion, HFFD feeding accelerates gastric emptying and diminishes NHGU and GSYN, thereby impairing glucose tolerance following a mixed meal challenge. These data reveal a constellation of deleterious metabolic consequences associated with consumption of a HFFD for 8 wk. PMID:21775526

  17. Brachytherapy in breast cancer: an effective alternative

    Directory of Open Access Journals (Sweden)

    Janusz Skowronek

    2014-03-01

    Full Text Available Breast conserving surgery (BCS with following external beam radiation therapy (EBRT of the conserved breast has become widely accepted in the last decades for the treatment of early invasive breast cancer. The standard technique of EBRT after BCS is to treat the whole breast up to a total dose of 42.5 to 50 Gy. An additional dose is given to treated volume as a boost to a portion of the breast. In the early stage of breast cancer, research has shown that the area requiring radiation treatment to prevent the cancer from local recurrence is the breast tissue that surrounds the area where the initial cancer was removed. Accelerated partial breast irradiation (APBI is an approach that treats only the lumpectomy bed plus a 1-2 cm margin rather than the whole breast and as a result allows accelerated delivery of the radiation dose in four to five days. There has been a growing interest for APBI and various approaches have been developed under phase I-III clinical studies; these include multicatheter interstitial brachytherapy, balloon catheter brachytherapy, conformal external beam radiation therapy (3D-EBRT and intra-operative radiation therapy (IORT. Balloon-based brachytherapy approaches include MammoSite, Axxent electronic brachytherapy, Contura, hybrid brachytherapy devices. Another indication for breast brachytherapy is reirradiation of local recurrence after mastectomy. Published results of brachytherapy are very promising. We discuss the current status, indications, and technical aspects of breast cancer brachytherapy.

  18. SNPs in DNA repair or oxidative stress genes and late subcutaneous fibrosis in patients following single shot partial breast irradiation

    Directory of Open Access Journals (Sweden)

    Falvo Elisabetta

    2012-01-01

    Full Text Available Abstract Background The aim of this study was to evaluate the potential association between single nucleotide polymorphisms related response to radiotherapy injury, such as genes related to DNA repair or enzymes involved in anti-oxidative activities. The paper aims to identify marker genes able to predict an increased risk of late toxicity studying our group of patients who underwent a Single Shot 3D-CRT PBI (SSPBI after BCS (breast conserving surgery. Methods A total of 57 breast cancer patients who underwent SSPBI were genotyped for SNPs (single nucleotide polymorphisms in XRCC1, XRCC3, GST and RAD51 by Pyrosequencing technology. Univariate analysis (ORs and 95% CI was performed to correlate SNPs with the risk of developing ≥ G2 fibrosis or fat necrosis. Results A higher significant risk of developing ≥ G2 fibrosis or fat necrosis in patients with: polymorphic variant GSTP1 (Ile105Val (OR = 2.9; 95%CI, 0.88-10.14, p = 0.047. Conclusions The presence of some SNPs involved in DNA repair or response to oxidative stress seem to be able to predict late toxicity. Trial Registration ClinicalTrials.gov: NCT01316328

  19. SU-E-J-76: Incorporation of Ultrasound Elastography in Target Volume Delineation for Partial Breast Radiotherapy Planning: A Comparative Study

    Energy Technology Data Exchange (ETDEWEB)

    Juneja, P; Harris, E; Bamber, J [The Institute of Cancer Research, London (United Kingdom); Royal Marsden NHS Foundation Trust, London (United Kingdom)

    2014-06-01

    Purpose: There is substantial observer variability in the delineation of target volumes for post-surgical partial breast radiotherapy because the tumour bed has poor x-ray contrast. This variability may result in substantial variations in planned dose distribution. Ultrasound elastography (USE) has an ability to detect mechanical discontinuities and therefore, the potential to image the scar and distortion in breast tissue architecture. The goal of this study was to compare USE techniques: strain elastography (SE), shear wave elastography (SWE) and acoustic radiation force impulse (ARFI) imaging using phantoms that simulate features of the tumour bed, for the purpose of incorporating USE in breast radiotherapy planning. Methods: Three gelatine-based phantoms (10% w/v) containing: a stiff inclusion (gelatine 16% w/v) with adhered boundaries, a stiff inclusion (gelatine 16% w/v) with mobile boundaries and fluid cavity inclusion (to mimic seroma), were constructed and used to investigate the USE techniques. The accuracy of the elastography techniques was quantified by comparing the imaged inclusion with the modelled ground-truth using the Dice similarity coefficient (DSC). For two regions of interest (ROI), the DSC measures their spatial overlap. Ground-truth ROIs were modelled using geometrical measurements from B-mode images. Results: The phantoms simulating stiff scar tissue with adhered and mobile boundaries and seroma were successfully developed and imaged using SE and SWE. The edges of the stiff inclusions were more clearly visible in SE than in SWE. Subsequently, for all these phantoms the measured DSCs were found to be higher for SE (DSCs: 0.91–0.97) than SWE (DSCs: 0.68–0.79) with an average relative difference of 23%. In the case of seroma phantom, DSC values for SE and SWE were similar. Conclusion: This study presents a first attempt to identify the most suitable elastography technique for use in breast radiotherapy planning. Further analysis will

  20. Combined deletion of Pten and p53 in mammary epithelium accelerates triple-negative breast cancer with dependency on eEF2K.

    Science.gov (United States)

    Liu, Jeff C; Voisin, Veronique; Wang, Sharon; Wang, Dong-Yu; Jones, Robert A; Datti, Alessandro; Uehling, David; Al-awar, Rima; Egan, Sean E; Bader, Gary D; Tsao, Ming; Mak, Tak W; Zacksenhaus, Eldad

    2014-12-01

    The tumor suppressors Pten and p53 are frequently lost in breast cancer, yet the consequences of their combined inactivation are poorly understood. Here, we show that mammary-specific deletion of Pten via WAP-Cre, which targets alveolar progenitors, induced tumors with shortened latency compared to those induced by MMTV-Cre, which targets basal/luminal progenitors. Combined Pten-p53 mutations accelerated formation of claudin-low, triple-negative-like breast cancer (TNBC) that exhibited hyper-activated AKT signaling and more mesenchymal features relative to Pten or p53 single-mutant tumors. Twenty-four genes that were significantly and differentially expressed between WAP-Cre:Pten/p53 and MMTV-Cre:Pten/p53 tumors predicted poor survival for claudin-low patients. Kinome screens identified eukaryotic elongation factor-2 kinase (eEF2K) inhibitors as more potent than PI3K/AKT/mTOR inhibitors on both mouse and human Pten/p53-deficient TNBC cells. Sensitivity to eEF2K inhibition correlated with AKT pathway activity. eEF2K monotherapy suppressed growth of Pten/p53-deficient TNBC xenografts in vivo and cooperated with doxorubicin to efficiently kill tumor cells in vitro. Our results identify a prognostic signature for claudin-low patients and provide a rationale for using eEF2K inhibitors for treatment of TNBC with elevated AKT signaling.

  1. Dosimetric validation of planning system Eclipse 10 in partial breast irradiation treatments with IMRT; Validacion dosimetrica del sistema de planeacion Eclipse 10 en tratamientos de irradiacion parcial de mama con IMRT

    Energy Technology Data Exchange (ETDEWEB)

    Velazquez T, J. J.; Gutierrez M, J. G.; Ortiz A, C. S.; Chagoya G, A.; Gutierrez C, J. G., E-mail: jvelaesfm@gmail.com [Centro Medico Nacional Siglo XXI, Hospital de Oncologia, Departamentos de Fisica Medica y Radioterapia, Av. Cuauhtemoc 330, 03020 Mexico D. F. (Mexico)

    2015-10-15

    Partial breast irradiation is a new type of external radiation therapy to treat breast cancer in early clinical stages. Consist of administering to the channel surgical high doses of radiation in few treatment sessions. In this paper the dose calculations of the planning system Eclipse version 10 for a treatment of partial breast irradiation with X-rays beams (6 MV) intensity modulated were compared against the measurements made with OSL dosimeters and radio-chromic dye film. An anthropomorphic mannequin was used in which OSL dosimeters were collocated near the surface, an inside the radio-chromic dye film one plate; with this latest one dimensional dose distribution was measured. Previously dosimeters were calibrated irradiating them with a beam of X-rays 6 MV under the conditions specified in the IAEA-398 protocol. The OSL dosimeters were read in the Micro star Landauer equipment, the radio-chromic dye films were read with a scanner Epson 10000-Xl and analyzed with FilmCal and PTW Verisoft programs. The differences between measured and calculated dose were as follows: 3.6±1% for the OSL dosimeter and 96.3±1% of the analyzed points approved the gamma index criterion (3%, 3m m) when comparing the matrices of calculated dose and measured with the radio-chromic dye film. These results confirm the good dosimetric performance of planning system used under specific conditions used in the partial breast irradiation technique. (Author)

  2. Intraoperative Radiation Therapy in Early Breast Cancer Using a Linear Accelerator Outside of the Operative Suite: An “Image-Guided” Approach

    Energy Technology Data Exchange (ETDEWEB)

    Hanna, Samir Abdallah, E-mail: samir.hanna@hsl.org.br [Department of Radiation Oncology, Hospital Sirio-Libanes, Sao Paulo (Brazil); Simões Dornellas de Barros, Alfredo Carlos; Martins de Andrade, Felipe Eduardo; Barbosa Bevilacqua, Jose Luiz [Department of Mastology, Hospital Sirio-Libanes, Sao Paulo (Brazil); Morales Piato, José Roberto [Department of Mastology, Hospital Sirio-Libanes, Sao Paulo (Brazil); Department of Gynecology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo (Brazil); Lopes Pelosi, Edilson [Department of Radiation Oncology, Hospital Sirio-Libanes, Sao Paulo (Brazil); Martella, Eduardo [Department of Radiation Oncology, Hospital Perola Byington, Sao Paulo (Brazil); Fernandes da Silva, João Luis [Department of Radiation Oncology, Hospital Sirio-Libanes, Sao Paulo (Brazil); Andrade Carvalho, Heloisa de [Department of Radiation Oncology, Hospital Sirio-Libanes, Sao Paulo (Brazil); Department of Radiology and Oncology, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo (Brazil)

    2014-08-01

    Purpose: To present local control, complications, and cosmetic outcomes of intraoperative radiation therapy (IORT) for early breast cancer, as well as technical aspects related to the use of a nondedicated linear accelerator. Methods and Materials: This prospective trial began in May of 2004. Eligibility criteria were biopsy-proven breast-infiltrating ductal carcinoma, age >40 years, tumor <3 cm, and cN0. Exclusion criteria were in situ or lobular types, multicentricity, skin invasion, any contraindication for surgery and/or radiation therapy, sentinel lymph node involvement, metastasis, or another malignancy. Patients underwent classic quadrantectomy with intraoperative sentinel lymph node and margins evaluation. If both free, the patient was transferred from operative suite to linear accelerator room, and IORT was delivered (21 Gy). Primary endpoint: local recurrence (LR); secondary endpoints: toxicities and aesthetics. Quality assurance involved using a customized shield for chest wall protection, applying procedures to minimize infection caused by patient transportation, and using portal films to check collimator-shield alignment. Results: A total of 152 patients were included, with at least 1 year follow-up. Median age (range) was 58.3 (40-85.4) years, and median follow-up time was 50.7 (12-110.5) months. The likelihood of 5-year local recurrence was 3.7%. There were 3 deaths, 2 of which were cancer related. The Kaplan-Meier 5-year actuarial estimates of overall, disease-free, and local recurrence-free survivals were 97.8%, 92.5%, and 96.3%, respectively. The overall incidences of acute and late toxicities were 12.5% and 29.6%, respectively. Excellent, good, fair, and bad cosmetic results were observed in 76.9%, 15.8%, 4.3%, and 2.8% of patients, respectively. Most treatments were performed with a 5-cm collimator, and in 39.8% of the patients the electron-beam energy used was ≥12 MeV. All patients underwent portal film evaluation, and the shielding was

  3. EGFR antisense RNA blocks expression of the epidermal growth factor receptor and partially reverse the malignant phenotype of human breast cancer MDA—MB—231 cells

    Institute of Scientific and Technical Information of China (English)

    FANWENHONG; YINGLINLU; 等

    1998-01-01

    The effects of human EGFR to the malignant phenotype of human breast cancer cell line MDA-MB-231 were investigated experimentally.A retroviral vector containing a 5'1350bp fragment of the human EGFR cDNA in the antisense orientation was transfected into targeted cells by lipofectamine.The effects on cell proliferation,cell cycle and adherent ability to extracellular matrix(ECM) components were studied after the expression of antisense transcripts to EGFR5'1350bp fragment in target cells,In vitro studies showed that the growth ability of the transfected cells was partialy inhibited in comparison to parental cells and to cells transfected with the plasmid containing the neomycin resistance gene only.It was found that EGF(10ng/ml) had an augmenation effect on the growth of transfected MDA-AS10 cells but not MDA-MB-231 cells.Flow cytometric analysis showed that the cell cycle of the transfected cells was abnormal with a decrease of cells in G2/M and S phases and an increase of cells in G1 phase,indicating a blockage in phase G1.Immunofluorescence of EGFR expression in transfectants stained with an antiEGFR antibody was decreased and their growth in soft agarose was also severely imparired.The transfected cells showed less adherence to laminin(LN) and fibronectin (FN).In short,EGFR antisense RNA decreases the expression of EGFR on MDA-MB-231 cells and partially reverses their malignant phenotype as well.

  4. The interplay between TEAD4 and KLF5 promotes breast cancer partially through inhibiting the transcription of p27 Kip1

    OpenAIRE

    Wang, Chunyan; Nie, Zhi; Zhou, Zhongmei; Zhang, Hailin; Liu, Rong; Wu, Jing; Qin, Junying; Ma, Yun; Chen, Liang; Li, Shumo; Chen, Wenlin; Li, Fubing; Shi, Peiguo; Wu, Yingying; Shen, Jian

    2015-01-01

    Growing evidence suggests that YAP/TAZ are mediators of the Hippo pathway and promote breast cancer. However, the roles of YAP/TAZ transcription factor partners TEADs in breast cancer remain unclear. Here we found that TEAD4 was expressed in breast cancer cell lines, especially in triple negative breast cancers (TNBC) cell lines. TEAD4 binds to KLF5. Knockdown of either TEAD4 or KLF5 in HCC1937 and HCC1806 cells induced the expression of CDK inhibitor p27. Depletion of either TEAD4 or KLF5 ac...

  5. Pushing the limits of hypofractionation for adjuvant whole breast radiotherapy.

    Science.gov (United States)

    Yarnold, John; Haviland, Joanne

    2010-06-01

    Randomised trials report no disadvantages for hypofractionation based on 2.67 Gy fractions of adjuvant whole breast radiotherapy in terms of local tumour control and late adverse effects. Current 15- or 16-fraction schedules may not represent the limits of this approach, and limited data suggest that fewer larger fractions can be delivered safely provided appropriate downward adjustments are made to the total dose. Therapeutic gain will be undermined if breast cancer proves to be, on average, significantly less sensitive to fraction size than the dose-limiting late reacting normal tissues. If so, shortening overall treatment time might wholly or partially offset these limitations, and these uncertainties are addressed in ongoing or planned trials. Meanwhile, the experience of accelerated partial breast irradiation suggests a strong volume effect for late normal tissue damage. Schedules that may be safe when delivered to small partial volumes cannot be assumed to be safe if delivered to larger partial volumes or to the whole breast. Based on current evidence, testing the effectiveness of a 5-fraction schedule of hypofractionated whole breast radiotherapy appears to be a realisable research objective.

  6. Power plant units load economic dispatch based on partial derivative acceleration fruit fly optimization algorithm%偏导加速果蝇优化算法的电厂机组负荷分配

    Institute of Scientific and Technical Information of China (English)

    荣淼; 王庆; 陈杨; 夏长红; 张勇

    2015-01-01

    As for defects in accuracy and convergence rate of the fruit fly optimization algorithm in power plant units load economic dispatch,a partial derivative acceleration fruit fly optimization algorithm was proposed,with the fruit fly optimization algorithm as first optimization algorithm and partial derivative descent algorithm as second optimization algorithm.The case analysis of power plant units load economic dispatch shows that partial derivative acceleration fruit fly optimization algorithm,maintaining the simplicity in principle and calculation,has great advantage of accuracy,convergence property and robustness compared with fruit fly optimization algorithm,PSO algorithm,GA algorithm.%针对果蝇优化算法等进化算法在电厂机组负荷分配问题中准确性和收敛速度的缺陷,将果蝇优化算法作为一次优化算法,所得结果作为偏导下降算法的输入,即偏导下降算法作为二次优化算法,提出一种偏导加速果蝇优化算法。电厂机组负荷分配实例分析表明:偏导加速果蝇优化算法保持了果蝇优化算法原理简明、计算简洁的特点,且在求解准确性、收敛快速性、稳定性上均优于果蝇优化算法、PSO 算法和 GA 算法。

  7. TU-F-CAMPUS-T-01: Potential of Using Cerium Oxide Nanoparticles (CONP) for Protecting Healthy Tissue During Accelerated Partial Breast Irradiation (APBI)

    Energy Technology Data Exchange (ETDEWEB)

    Mainali, M [University of Massachusetts Boston/Dana Farber cancer institute, Boston, MA (United States); Ngwa, W [Harvard Medical School, Boston, MA (United States); Cifter, G [University of Massachusetts Lowell/ Dana Farber cancer institute, Boston, MA (United States); Celli, J [University of Massachusetts Boston, Boston, MA (United States)

    2015-06-15

    Purpose: The purpose of this research is to investigate the feasibility of using targeted cerium oxide nanoparticles (CONP) during APBI to protect healthy cells. Methods: In one approach, CONP are assumed to be incorporated in a micrometer-thick polymer film on the surface of routinely used mammosite balloon applicators for sustained in-situ release of the CONP. In case two, CONPs are administered directly into the lumpectomy cavity. The concentration of H{sub 2}O{sub 2} produced by ionizing radiation was estimated from previously published work using short range linear extrapolation. The assessment of CONPs concentration required to absorb corresponding H{sub 2}O{sub 2} to protect healthy tissue was calculated. Fick’s Second law of diffusion was employed to determine the initial concentration of CONP needed to achieve the minimum concentration for radioprotection at distance 1 cm and 2 cm from the lumpectomy cavity during APBI. The study was carried out for different nanoparticle sizes. Results: The initial concentration of CONPs required to get desired radioprotection concentration at 1 cm and 2 cm after 7 days was found to be 0.4089 mg per Kg and 59.7605 g per Kg respectively for 2 nm size nanoparticles. Using concentrations of 5 mg per kg of CONP that have been shown to be used to confer radioprotection (for about 7.97 Gy) in experiments it was observed that 4.5631, 8.5286, 10.9247, 22.0408, 43.6796 and 65.5618 number of days are required to achieve radioprotection at 1 cm for CONP of sizes 2 nm, 3.8 nm, 5 nm, 10 nm, 20 nm, 30 nm, respectively. Conclusion: Our preliminary results show that smaller size (2 nm and 3.8 nm) CONP would be suitable as radio protectant during APBI because they took a reasonable number of days, i.e. less than 10 days to reach tissues of 1 cm or 2 cm thickness.

  8. Intraoperative Radiotherapy for Breast Cancer: The Lasting Effects of a Fleeting Treatment

    Directory of Open Access Journals (Sweden)

    Harriet B. Eldredge-Hindy

    2014-01-01

    Full Text Available In well-selected patients who choose to pursue breast conservation therapy (BCT for early-stage breast cancer, partial breast irradiation (PBI delivered externally or intraoperatively, may be a viable alternative to conventional whole breast irradiation. Two large, contemporary randomized trials have demonstrated breast intraoperative radiotherapy (IORT to be noninferior to whole breast external beam radiotherapy (EBRT when assessing for ipsilateral breast tumor recurrence in select patients. Additionally, IORT and other PBI techniques are likely to be more widely adopted in the future because they improve patient convenience by offering an accelerated course of treatment. Coupled with these novel techniques for breast radiotherapy (RT are distinct toxicity profiles and unique cosmetic alterations that differ from conventional breast EBRT and have the potential to impact disease surveillance and patient satisfaction. This paper will review the level-one evidence for treatment efficacy as well as important secondary endpoints like RT toxicity, breast cosmesis, quality of life, patient satisfaction, and surveillance mammography following BCT with IORT.

  9. MO-E-BRD-03: Intra-Operative Breast Brachytherapy: Is One Stop Shopping Best? [Non-invasive Image-Guided Breast Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Libby, B. [University of Virginia (United States)

    2015-06-15

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  10. 乳腺癌常规钼靶摄影与局部加压放大摄影65例对照分析%Comparative analysis between breast conventional mammography and amplificatory mammography with partial compression in 65 cases of breast cancer

    Institute of Scientific and Technical Information of China (English)

    段华秀; 赵春林; 鲍翔; 石群

    2014-01-01

    Objective To discuss the correlationship between the diagnosis of surgical pathology and the signs of malignancy which is both displayed by breast conventional mammography and amplificatory mammography with partial compression.Methods 65 cases with breast cancer were examined by both breast conventional mammography and amplificatory mammography with partial compression.The results of the two methods were analyzed.Results In all 65 cases of breast cancer,the comparison between breast conventional mammography and amplificatory mammography with partial compression could provide 16/60 cases in the X-ray signs of malignancy,which were in accordance with pathological examination results,19/41cases in the occurrence of calcification,13/37 cases in ductal calcification,0/4 cases in mixed type calcification,18/46 and 14/59 cases in the occurrence of lobulation and spicule signs.Conclusion Amplificatory mammography with partial compression can provide better insight in breast cancer than conventional mammography,especially in the region of dense shadow,small calcification and dense breast lesions,amplificatory mammography with partial compression can provide higher accuracy in diagnosis,especially for early breast cancer.%目的 探讨乳腺常规钼靶摄影与局部加压放大钼靶摄影显示乳腺肿块的恶性征象与手术病理定性诊断的正确率.方法 对65例乳腺癌患者进行常规钼靶摄影及局部加压放大钼靶摄影检查,并将X线征象进行对照性分析.结果 65例乳腺癌病例中,普通常规钼靶摄影与局部加压放大钼靶摄影检查结果在恶性符合病理检查例数分别为16例、60例,钙化灶显示例数分别为19例、41例,导管型钙化显示例数分别为13例、37例,混合型钙化显示例数分别为0例、4例,分叶征及毛刺征的显示例数分别为18例、46例、14例、59例.结论 局部放大摄影对乳腺肿块的诊断明显优于常规乳腺钼靶,对团状致密影、细小钙化、

  11. MO-E-BRD-00: Breast Brachytherapy: The Phoenix of Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  12. MO-E-BRD-01: Is Non-Invasive Image-Guided Breast Brachytherapy Good?

    Energy Technology Data Exchange (ETDEWEB)

    Hiatt, J. [Rhode Island Hospital (United States)

    2015-06-15

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  13. Partial priapism

    DEFF Research Database (Denmark)

    Høyerup, Peter; Dahl, Claus; Azawi, Nessn Htum

    2014-01-01

    Partial priapism, also called partial segmental thrombosis of the corpus cavernosum, is a rare urological condition. Factors such as bicycle riding, drug usage, penile trauma and haematological diseases have been associated with the condition. Medical treatment with low molecular weight heparin (...... (LMWH) or acetylsalicylic acid is first choice treatment, and surgery is preserved for patients unresponsive to analgesics. In this report we describe the case of a 70-year-old man with partial priapism after blood transfusions treated successfully with LMWH....

  14. A Core MYC Gene Expression Signature Is Prominent in Basal-Like Breast Cancer but Only Partially Overlaps the Core Serum Response

    Science.gov (United States)

    Chandriani, Sanjay; Frengen, Eirik; Cowling, Victoria H.; Pendergrass, Sarah A.; Perou, Charles M.; Whitfield, Michael L.; Cole, Michael D.

    2009-01-01

    Background The MYC oncogene contributes to induction and growth of many cancers but the full spectrum of the MYC transcriptional response remains unclear. Methodology/Principal Findings Using microarrays, we conducted a detailed kinetic study of genes that respond to MYCN or MYCNΔMBII induction in primary human fibroblasts. In parallel, we determined the response to steady state overexpression of MYCN and MYCNΔMBII in the same cell type. An overlapping set of 398 genes from the two protocols was designated a ‘Core MYC Signature’ and used for further analysis. Comparison of the Core MYC Signature to a published study of the genes induced by serum stimulation revealed that only 7.4% of the Core MYC Signature genes are in the Core Serum Response and display similar expression changes to both MYC and serum. Furthermore, more than 50% of the Core MYC Signature genes were not influenced by serum stimulation. In contrast, comparison to a panel of breast cancers revealed a strong concordance in gene expression between the Core MYC Signature and the basal-like breast tumor subtype, which is a subtype with poor prognosis. This concordance was supported by the higher average level of MYC expression in the same tumor samples. Conclusions/Significance The Core MYC Signature has clinical relevance as this profile can be used to deduce an underlying genetic program that is likely to contribute to a clinical phenotype. Therefore, the presence of the Core MYC Signature may predict clinical responsiveness to therapeutics that are designed to disrupt MYC-mediated phenotypes. PMID:19690609

  15. A core MYC gene expression signature is prominent in basal-like breast cancer but only partially overlaps the core serum response.

    Directory of Open Access Journals (Sweden)

    Sanjay Chandriani

    Full Text Available BACKGROUND: The MYC oncogene contributes to induction and growth of many cancers but the full spectrum of the MYC transcriptional response remains unclear. METHODOLOGY/PRINCIPAL FINDINGS: Using microarrays, we conducted a detailed kinetic study of genes that respond to MYCN or MYCNDeltaMBII induction in primary human fibroblasts. In parallel, we determined the response to steady state overexpression of MYCN and MYCNDeltaMBII in the same cell type. An overlapping set of 398 genes from the two protocols was designated a 'Core MYC Signature' and used for further analysis. Comparison of the Core MYC Signature to a published study of the genes induced by serum stimulation revealed that only 7.4% of the Core MYC Signature genes are in the Core Serum Response and display similar expression changes to both MYC and serum. Furthermore, more than 50% of the Core MYC Signature genes were not influenced by serum stimulation. In contrast, comparison to a panel of breast cancers revealed a strong concordance in gene expression between the Core MYC Signature and the basal-like breast tumor subtype, which is a subtype with poor prognosis. This concordance was supported by the higher average level of MYC expression in the same tumor samples. CONCLUSIONS/SIGNIFICANCE: The Core MYC Signature has clinical relevance as this profile can be used to deduce an underlying genetic program that is likely to contribute to a clinical phenotype. Therefore, the presence of the Core MYC Signature may predict clinical responsiveness to therapeutics that are designed to disrupt MYC-mediated phenotypes.

  16. Acceleration of pro-caspase-3 maturation and cell migration inhibition in human breast cancer cells by phytoconstituents of Rheum emodi rhizome extracts

    OpenAIRE

    Naveen Kumar, D. R.; V. Cijo George; Suresh, P K; Kumar, R. Ashok

    2013-01-01

    The aggressive nature of estrogen receptor (ER)-negative breast cancer subtype obligates for innovative targeted therapies. The present study aimed to investigate the phytoconstituents and specific anticancer activities of Rheum emodi rhizome, a known food source used locally to treat various ailments. Petroleum ether extracts (hot [PHR] and cold [PCR]) of R. emodi, exhibited significant free radical scavenging potentials through DPPH and reducing power assays, rendering them as good sources ...

  17. Breast lift

    Science.gov (United States)

    Mastopexy; Breast lift with reduction; Breast lift with augmentation ... enlargement with implants) when they have a breast lift. ... it for medical reasons. Women usually have breast lifts to lift sagging, loose breasts. Pregnancy, breastfeeding, and ...

  18. Propofol induces proliferation partially via downregulation of p53 protein and promotes migration via activation of the Nrf2 pathway in human breast cancer cell line MDA-MB-231.

    Science.gov (United States)

    Meng, Chao; Song, Linlin; Wang, Juan; Li, Di; Liu, Yanhong; Cui, Xiaoguang

    2017-02-01

    Antioxidants induce the proliferation of cancers by decreasing the expression of p53. Propofol, one of the most extensively used intravenous anesthetics, provides its antioxidative activity via activation of the nuclear factor E2-related factor-2 (Nrf2) pathway, but the mechanisms involved in the effects remain unknown. Thus, we aimed to investigate the function of p53 and Nrf2 in the human breast cancer cell line MDA-MB-231 following treatment with propofol. The cells were treated with propofol (2, 5 and 10 µg/ml) for 1, 4 and 12 h, and MTT assay was used to evaluate cell proliferation, and a wound healing assay was used to evaluate cell migration. Cell apoptosis, caspase-3 activity, and western blot analysis for p53 and Nrf2 protein were also assessed. Finally, PIK-75, a potent Nrf2 inhibitor, was used to confirm the effects of Nrf2 after treatment with propofol. Treatment of MDA-MB‑231 cells with propofol resulted in increased proliferation and migration in a dose- and time-dependent manner. After treatment with propofol for 12 h, the Nrf2 protein expression was increased, while the percentage of apoptotic cells, caspase-3 activity, and expression of p53 were significantly decreased. Additionally, treatment with the Nrf2 inhibitor increased the percentage of apoptotic cells, inhibited the migration almost completely, and decreased the degree of proliferation, while the expression of p53 was not affected. In conclusion, propofol increased the proliferation of human breast cancer MDA-MB‑231 cells, which was at least partially associated with the inhibition of the expression of p53, and induced cell migration, which was involved in the activation of the Nrf2 pathway.

  19. Future accelerators (?)

    Energy Technology Data Exchange (ETDEWEB)

    John Womersley

    2003-08-21

    I describe the future accelerator facilities that are currently foreseen for electroweak scale physics, neutrino physics, and nuclear structure. I will explore the physics justification for these machines, and suggest how the case for future accelerators can be made.

  20. 妊娠对TA2小鼠乳腺癌生长影响的初步研究%Acceleration of Breast Cancer Growth during Pregnancy in Tientsin Albino 2 Mice

    Institute of Scientific and Technical Information of China (English)

    张丹芳; 孙保存; 赵秀兰; 崔艳芬; 徐少艳; 董学易; 车娜

    2011-01-01

    0.001, respectively ).The results of immunohistochemical staining indicated PCNA expression in the tumors of the pregnant group compared with the control group.This implies that the tumors in the pregnant TA2 mice have higher proliferation activity.Moreover, more tumor vessels were observed in the pregnant group than in the virgin group.Conclusion: The spontaneous breast cancer of TA2 mice is similar to the human pregnancy-associated breast cancer.Pregnancy can accelerate the breast cancer growth in the mice; however, the promoting effect of estradiol and progestin on cell proliferation of the TA2 breast cancer might be indirect.%目的:通过检测妊娠环境对TA2小鼠乳腺癌生长的影响,初步探讨人妊娠相关乳腺癌发生发展的机制.方法:收集TA2自发乳腺癌小鼠84只,观察其生物学行为、形态及免疫表型特征;建立妊娠TA2小鼠乳腺癌移植瘤模型(n=20),检测妊娠环境下肿瘤生长;电化学法检测小鼠血清雌二醇与孕酮浓度,Real-time PCR检测妊娠组肿瘤和乳腺组织ERα和PR mRNA相对表达,免疫组织化学染色检测ERα、PR、p53、PCNA和CD31在各组瘤组织内的表达.结果:TA2自发乳腺癌均发生于妊娠期或哺乳期,易内脏转移,乳腺癌分化程度低,不表达ER和PR,表达p53.妊娠组肿瘤生长速度显著加快,肿瘤体积和重量均大于对照组(t=4.142,P<0.001),且癌组织PCNA表达水平增高.TA2孕鼠体内血清雌二醇和孕酮水平显著增高(t=-1.568,-8.927,P=0.168,0.001),而ERα和PR mRNA相对表达相对很低(t=12.245,10.933,P<0.001,0.001),肿瘤血管数量增多.结论:TA2自发乳腺癌与人妊娠相关乳腺癌相似,妊娠促进TA2乳腺癌生长,但雌二醇与孕酮对乳腺癌增殖的促进作用可能是间接实现的.

  1. Accelerating Value Creation with Accelerators

    DEFF Research Database (Denmark)

    Jonsson, Eythor Ivar

    2015-01-01

    accelerator programs. Microsoft runs accelerators in seven different countries. Accelerators have grown out of the infancy stage and are now an accepted approach to develop new ventures based on cutting-edge technology like the internet of things, mobile technology, big data and virtual reality. It is also...... with the traditional audit and legal universes and industries are examples of emerging potentials both from a research and business point of view to exploit and explore further. The accelerator approach may therefore be an Idea Watch to consider, no matter which industry you are in, because in essence accelerators...

  2. Accelerating Value Creation with Accelerators

    DEFF Research Database (Denmark)

    Jonsson, Eythor Ivar

    2015-01-01

    Accelerators can help to accelerate value creation. Accelerators are short-term programs that have the objective of creating innovative and fast growing ventures. They have gained attraction as larger corporations like Microsoft, Barclays bank and Nordea bank have initiated and sponsored accelera......Accelerators can help to accelerate value creation. Accelerators are short-term programs that have the objective of creating innovative and fast growing ventures. They have gained attraction as larger corporations like Microsoft, Barclays bank and Nordea bank have initiated and sponsored...... an approach to facilitate implementation and realization of business ideas and is a lucrative approach to transform research into ventures and to revitalize regions and industries in transition. Investors have noticed that the accelerator approach is a way to increase the possibility of success by funnelling...

  3. Radiation-induced lung damage promotes breast cancer lung-metastasis through CXCR4 signaling

    Science.gov (United States)

    Feys, Lynn; Descamps, Benedicte; Vanhove, Christian; Vral, Anne; Veldeman, Liv; Vermeulen, Stefan; De Wagter, Carlos; Bracke, Marc; De Wever, Olivier

    2015-01-01

    Radiotherapy is a mainstay in the postoperative treatment of breast cancer as it reduces the risks of local recurrence and mortality after both conservative surgery and mastectomy. Despite recent efforts to decrease irradiation volumes through accelerated partial irradiation techniques, late cardiac and pulmonary toxicity still occurs after breast irradiation. The importance of this pulmonary injury towards lung metastasis is unclear. Preirradiation of lung epithelial cells induces DNA damage, p53 activation and a secretome enriched in the chemokines SDF-1/CXCL12 and MIF. Irradiated lung epithelial cells stimulate adhesion, spreading, growth, and (transendothelial) migration of human MDA-MB-231 and murine 4T1 breast cancer cells. These metastasis-associated cellular activities were largely mimicked by recombinant CXCL12 and MIF. Moreover, an allosteric inhibitor of the CXCR4 receptor prevented the metastasis-associated cellular activities stimulated by the secretome of irradiated lung epithelial cells. Furthermore, partial (10%) irradiation of the right lung significantly stimulated breast cancer lung-specific metastasis in the syngeneic, orthotopic 4T1 breast cancer model. Our results warrant further investigation of the potential pro-metastatic effects of radiation and indicate the need to develop efficient drugs that will be successful in combination with radiotherapy to prevent therapy-induced spread of cancer cells. PMID:26396176

  4. Ultrasound - Breast

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Ultrasound - Breast Ultrasound imaging of the breast uses sound waves ... the Breast? What is Ultrasound Imaging of the Breast? Ultrasound is safe and painless, and produces pictures ...

  5. Breast pain

    Science.gov (United States)

    Pain - breast; Mastalgia; Mastodynia; Breast tenderness ... There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some swelling and tenderness just before your period ...

  6. Breast Reconstruction

    Science.gov (United States)

    ... rebuild the shape of the breast. Instead of breast reconstruction, you could choose to wear a breast form ... one woman may not be right for another. Breast reconstruction may be done at the same time as ...

  7. Tissue modeling schemes in low energy breast brachytherapy.

    Science.gov (United States)

    Afsharpour, Hossein; Landry, Guillaume; Reniers, Brigitte; Pignol, Jean-Philippe; Beaulieu, Luc; Verhaegen, Frank

    2011-11-21

    Breast tissue is heterogeneous and is mainly composed of glandular (G) and adipose (A) tissues. The proportion of G versus A varies considerably among the population. The absorbed dose distributions in accelerated partial breast irradiation therapy with low energy photon brachytherapy sources are very sensitive to tissue heterogeneities. Current clinical algorithms use the recommendations of the AAPM TG43 report which approximates the human tissues by unit density water. The aim of this study is to investigate various breast tissue modeling schemes for low energy brachytherapy. A special case of breast permanent seed implant is considered here. Six modeling schemes are considered. Uniform and non-uniform water breast (UWB and NUWB) consider the density but neglect the effect of the composition of tissues. The uniform and the non-uniform G/A breast (UGAB and NUGAB) as well the age-dependent breast (ADB) models consider the effect of the composition. The segmented breast tissue (SBT) method uses a density threshold to distinguish between G and A tissues. The PTV D(90) metric is used for the analysis and is based on the dose to water (D(90(w,m))). D(90(m,m)) is also reported for comparison to D(90(w,m)). The two-month post-implant D(90(w,m)) averaged over 38 patients is smaller in NUWB than in UWB by about 4.6% on average (ranging from 5% to 13%). Large average differences of G/A breast models with TG43 (17% and 26% in UGAB and NUGAB, respectively) show that the effect of the chemical composition dominates the effect of the density on dose distributions. D(90(w,m)) is 12% larger in SBT than in TG43 when averaged. These differences can be as low as 4% or as high as 20% when the individual patients are considered. The high sensitivity of dosimetry on the modeling scheme argues in favor of an agreement on a standard tissue modeling approach to be used in low energy breast brachytherapy. SBT appears to generate the most geometrically reliable breast tissue models in this

  8. Are the American Society for Radiation Oncology Guidelines Accurate Predictors of Recurrence in Early Stage Breast Cancer Patients Treated with Balloon-Based Brachytherapy?

    Directory of Open Access Journals (Sweden)

    Moira K. Christoudias

    2013-01-01

    Full Text Available The American Society for Radiation Oncology (ASTRO consensus statement (CS provides guidelines for patient selection for accelerated partial breast irradiation (APBI following breast conserving surgery. The purpose of this study was to evaluate recurrence rates based on ASTRO CS groupings. A single institution review of 238 early stage breast cancer patients treated with balloon-based APBI via balloon based brachytherapy demonstrated a 4-year actuarial ipsilateral breast tumor recurrence (IBTR rate of 5.1%. There were no significant differences in the 4-year actuarial IBTR rates between the “suitable,” “cautionary,” and “unsuitable” ASTRO categories (0%, 7.2%, and 4.3%, resp., P=0.28. ER negative tumors had higher rates of IBTR than ER positive tumors. The ASTRO groupings are poor predictors of patient outcomes. Further studies evaluating individual clinicopathologic features are needed to determine the safety of APBI in higher risk patients.

  9. RECIRCULATING ACCELERATION

    Energy Technology Data Exchange (ETDEWEB)

    BERG,J.S.; GARREN,A.A.; JOHNSTONE,C.

    2000-04-07

    This paper compares various types of recirculating accelerators, outlining the advantages and disadvantages of various approaches. The accelerators are characterized according to the types of arcs they use: whether there is a single arc for the entire recirculator or there are multiple arcs, and whether the arc(s) are isochronous or non-isochronous.

  10. LIBO accelerates

    CERN Multimedia

    2002-01-01

    The prototype module of LIBO, a linear accelerator project designed for cancer therapy, has passed its first proton-beam acceleration test. In parallel a new version - LIBO-30 - is being developed, which promises to open up even more interesting avenues.

  11. Accelerating Inspire

    CERN Document Server

    AUTHOR|(CDS)2266999

    2017-01-01

    CERN has been involved in the dissemination of scientific results since its early days and has continuously updated the distribution channels. Currently, Inspire hosts catalogues of articles, authors, institutions, conferences, jobs, experiments, journals and more. Successful orientation among this amount of data requires comprehensive linking between the content. Inspire has lacked a system for linking experiments and articles together based on which accelerator they were conducted at. The purpose of this project has been to create such a system. Records for 156 accelerators were created and all 2913 experiments on Inspire were given corresponding MARC tags. Records of 18404 accelerator physics related bibliographic entries were also tagged with corresponding accelerator tags. Finally, as a part of the endeavour to broaden CERN's presence on Wikipedia, existing Wikipedia articles of accelerators were updated with short descriptions and links to Inspire. In total, 86 Wikipedia articles were updated. This repo...

  12. Partial axillary dissection in early breast cancer

    African Journals Online (AJOL)

    Tarek Abdel Halim El-Fayoumi

    2013-03-07

    Mar 7, 2013 ... cellulites and repeated infection of the upper arm.7,8 Dull ach- ing pain and ... The sensitivity of intra-operative pathological examination of level I axillary lymph ..... Kissin MW, Thompson EM, Price AB, et al. The inadequacy of.

  13. Normal breast physiology: the reasons hormonal contraceptives and induced abortion increase breast-cancer risk.

    Science.gov (United States)

    Lanfranchi, Angela

    2014-01-01

    A woman gains protection from breast cancer by completing a full-term pregnancy. In utero, her offspring produce hormones that mature 85 percent of the mother's breast tissue into cancer-resistant breast tissue. If the pregnancy ends through an induced abortion or a premature birth before thirty-two weeks, the mother's breasts will have only partially matured, retaining even more cancer-susceptible breast tissue than when the pregnancy began. This increased amount of immature breast tissue will leave the mother with more sites for cancer initiation, thereby increasing her risk of breast cancer. Hormonal contraceptives increase breast-cancer risk by their proliferative effect on breast tissue and their direct carcinogenic effects on DNA. Hormonal contraceptives include estrogen-progestin combination drugs prescribed in any manner of delivery: orally, transdermally, vaginally, or intrauterine. This article provides the detailed physiology and data that elucidate the mechanisms through which induced abortion and hormonal contraceptives increase breast-cancer risk.

  14. Horizontal Accelerator

    Data.gov (United States)

    Federal Laboratory Consortium — The Horizontal Accelerator (HA) Facility is a versatile research tool available for use on projects requiring simulation of the crash environment. The HA Facility is...

  15. Future accelerators

    CERN Document Server

    Hübner, K

    1999-01-01

    An overview of the various schemes for electron-positron linear colliders is given and the status of the development of key components and the various test facilities is given. The present studies of muon-muon colliders and very large hadron colliders are summarized including the plans for component development and tests. Accelerator research and development to achieve highest gradients in linear accelerators is outlined. (44 refs).

  16. Research Progress on the Serratus Anterior Muscle Flap in the Reconstruction of Partial Breast Defects after Breast Conserving Surgery for Patients with Breast Cancer%前锯肌肌瓣修补保乳手术后乳房局部缺损的应用

    Institute of Scientific and Technical Information of China (English)

    陈朝华(综述); 韦兴中(审校)

    2014-01-01

    Traditional operation treatment for patients with breast cancer will destroy the graceful female sexuality and the figure,which causes great psychological trauma to the patients,and severely impacts on the postoperative quality of life.The treatment for early breast cancer has been developed from the traditional rad-ical surgery to the breast-conserving surgery,application of serratus anterior muscle flap in repairing breast defects is not only safe, but also have satisfactory aesthetic outcomes.Moreover,it can not only alleviate the mental stress and mood disorders of the patients due to the loss of breast ,but also recover the patients confi-dence and social participation awareness,and greatly improve the postoperative quality of life of the patients.%传统的乳腺癌手术在治疗的同时破坏了女性优美的性征和曲线,给患者造成极大的心理创伤,严重影响患者术后生存质量。早期乳腺癌治疗手段已经由传统的根治手术发展到现在的保乳术,应用前锯肌肌瓣修复保乳术后局部的缺损,可明显改善美容效果。其不仅可以缓解患者因失去乳房而导致的心理压力和情绪障碍,恢复患者的自信与社会参与意识,而且可以极大地提高乳腺癌患者术后的生活质量。

  17. Paget Disease of the Breast

    Science.gov (United States)

    ... Breast Cancer Breast Cancer Patient Breast Cancer Treatment Male Breast Cancer Treatment Breast Cancer Treatment & Pregnancy Breast Cancer Prevention Breast Cancer Screening Health Professional Breast Cancer Treatment Male ... Treatment Breast Cancer Treatment & Pregnancy Breast Cancer Prevention ...

  18. Comparison of recurrence and survival rates after breast-conserving therapy and mastectomy in young women with breast cancer

    OpenAIRE

    Cao, J Q; Olson, R. A.; Tyldesley, S.K.

    2013-01-01

    Multiple randomized trials have demonstrated that breast-conserving therapy with partial mastectomy and radiotherapy provides survival equivalent to that seen with mastectomy for patients with early-stage breast cancer. Breast-conserving therapy has been associated with better quality of life relative to mastectomy and has become the standard of care for patients with early-stage breast cancer. Young age has been identified as a risk factor for recurrence and death from breast cancer. Some st...

  19. Breast Implants

    Science.gov (United States)

    ... Medical Procedures Implants and Prosthetics Breast Implants Breast Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Breast implants are medical devices that are implanted under the ...

  20. Fibroadenoma - breast

    Science.gov (United States)

    Breast lump - fibroadenoma; Breast lump - noncancerous; Breast lump - benign ... The cause of fibroadenomas is not known. There may be a connection to a problem with genes. Fibroadenoma is the most common benign ...

  1. What Is Breast Cancer?

    Science.gov (United States)

    ... Research? Breast Cancer About Breast Cancer What Is Breast Cancer? Breast cancer starts when cells in the breast ... spread, see our section on Cancer Basics . Where breast cancer starts Breast cancers can start from different parts ...

  2. Accelerated Unification

    OpenAIRE

    Arkani-Hamed, Nima; Cohen, Andrew; Georgi, Howard

    2001-01-01

    We construct four dimensional gauge theories in which the successful supersymmetric unification of gauge couplings is preserved but accelerated by N-fold replication of the MSSM gauge and Higgs structure. This results in a low unification scale of $10^{13/N}$ TeV.

  3. Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study

    Energy Technology Data Exchange (ETDEWEB)

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Margenthaler, Julie A. [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Aft, Rebecca [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri (United States); Gillanders, William E.; Eberlein, Timothy [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Matesa, Melissa A. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-03-15

    Purpose: To prospectively evaluate cosmetic outcomes in women treated with accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy for early-stage breast cancer. Methods and Materials: Between 2004 and 2008, 151 patients with early-stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients had stage Tis-T2 tumors of ≤3 cm that were excised with negative margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. Both the patients and the treating radiation oncologist qualitatively rated cosmesis as excellent, good, fair, or poor over time and ascribed a cause for changes in cosmesis. Cosmetic outcome was evaluated quantitatively by percentage of breast retraction assessment (pBRA). Patients also reported their satisfaction with treatment over time. Results: Median follow-up was 55 months. The rates of excellent-to-good cosmesis reported by patients and the treating radiation oncologist were 92% and 97% pretreatment, 91% and 97% at 3 to 4 months' follow-up, 87% and 94% at 2 years, and 92% and 94% at 3 years, respectively. Breast infection and adjuvant chemotherapy were independent predictors of a fair-to-poor cosmetic outcome at 3 years. Compared to pretreatment pBRA (7.35), there was no significant change in pBRA over time. The volume receiving more than 150 Gy (V150) was the only significant predictor of pBRA. The majority of patients (86.6%) were completely satisfied with their treatment. Conclusions: Patients and the treating physician reported a high rate of excellent-to-good cosmetic outcomes at all follow-up time points. Acute breast infection and chemotherapy were associated with worse cosmetic outcomes. Multicatheter interstitial brachytherapy does not significantly change breast size as measured by pBRA.

  4. Whole breast irradiation vs. APBI using multicatheter brachytherapy in early breast cancer – simulation of treatment costs based on phase 3 trial data

    Science.gov (United States)

    Harat, Maciej; Makarewicz, Roman

    2016-01-01

    Purpose A recent large phase 3 trial demonstrated that the efficacy of accelerated partial-breast irradiation (APBI) in the treatment of early breast cancer is non-inferior to that of whole breast irradiation (WBI) commonly used in this indication. The aim of this study was to compare the costs of treatment with APBI and WBI in a population of patients after conserving surgery for early breast cancer, and to verify if the use of APBI can result in direct savings of a public payer. Material and methods The hereby presented cost analysis was based on the results of GEC-ESTRO trial. Expenditures for identified cost centers were estimated on the basis of reimbursement data for the public payer. After determining the average cost of early breast cancer treatment with APBI and WBI over a 5-year period, the variance in this parameter resulting from fluctuations in the price per single procedure was examined on univariate sensitivity analysis. Then, incremental cost-effectiveness ratio (ICER) was calculated to verify the cost against clinical outcome. Finally, a simulation of public payer’s expenditures for the treatment of early breast cancer with APBI and WBI in 2013 and 2025 has been conducted. Results The average cost of treatment with APBI is lower than for WBI, even assuming a potential increase in the unit price of the former procedure. There was no additional health benefit of WBI and the calculation of cost-effectiveness was based on the absolute difference in overall local control rate. However, this difference (0.92% vs. 1.44%) was fairly minimal and was not identified as statistically significant during 5 years. Conclusions The use of APBI as an alternative to WBI in the treatment of early breast cancer would substantially reduce healthcare expenditures in both 2013 and 2025, even assuming an increase in the price per single APBI procedure.

  5. Genomic profiling of breast cancer.

    Science.gov (United States)

    Pandey, Anjita; Singh, Alok Kumar; Maurya, Sanjeev Kumar; Rai, Rajani; Tewari, Mallika; Kumar, Mohan; Shukla, Hari S

    2009-05-01

    Genome study provides significant changes in the advancement of molecular diagnosis and treatment in Breast cancer. Several recent critical advances and high-throughput techniques identified the genomic trouble and dramatically accelerated the pace of research in preventing and curing this malignancy. Tumor-suppressor genes, proto-oncogenes, DNA-repair genes, carcinogen-metabolism genes are critically involved in progression of breast cancer. We reviewed imperative finding in breast genetics, ongoing work to segregate further susceptible genes, and preliminary studies on molecular profiling.

  6. Accelerated rehabilitation nursing of perioperative surgical treatment of breast cancer%加速康复外科治疗乳腺癌围术期护理配合

    Institute of Scientific and Technical Information of China (English)

    姜金娟

    2014-01-01

    Objective To observe the effect of accelerated rehabilitation surgery idea in the nursing effect of breastcancer during operation period. Methods In our hospital in 91 cases of breast cancer patients with operation in 2012February~2014 year in July admitted to the nursing as the object of study, and randomly divided into experimentalgroup 46 cases and control group 45 cases of patients in the experimental group, using the concept of fast track surgery nursing, the control group of patients with routine nursing, observation and nursing satisfaction and two groups of patients with the occurrence of complications. Results The total satisfaction of patients in the experimental group care rate was 93.4%, control total satisfaction rate of 82.2%groups of patient care, nursing satisfaction of the experimental group were higher than the patients in the control group (P<0.05), and complications from view, the emergence of the patients in the experimental group was less than that in control group of patients with complications.Conclusion The application of fast track surgery concept has a very good application effect in nursing care of patients with breast cancer, nursing satisfaction is high, the emergence of less complications, and can be popularized andapplied in nursing.%目的:观察加速康复外科观念在乳腺癌围手术期的护理效果。方法选取我院在2012年2月~2014年7月收治的乳腺癌手术患者91例作为本次研究的护理对象,并且随意分为实验组46例和对照组患者45例,对实验组采用加速康复外科理念进行护理,对照组患者采用常规护理,观察两组患者的护理满意度和并发症情况。结果实验组患者护理的总满意率为93.4%,对照组患者护理的总满意率为82.2%,实验组患者的护理满意度高于对照组患者(P<0.05),并且从并发症上看,实验组患者出现的并发症也少于对照组患者。结论采用加速康复外科观念应用在乳

  7. Breast Diseases

    Science.gov (United States)

    ... bumps, and discharges (fluids that are not breast milk). If you have a breast lump, pain, discharge or skin irritation, see your health care provider. Minor and serious breast problems have similar symptoms. Although many women fear cancer, most breast problems are not cancer. Some common ...

  8. Particle Accelerators in China

    Science.gov (United States)

    Zhang, Chuang; Fang, Shouxian

    As the special machines that can accelerate charged particle beams to high energy by using electromagnetic fields, particle accelerators have been widely applied in scientific research and various areas of society. The development of particle accelerators in China started in the early 1950s. After a brief review of the history of accelerators, this article describes in the following sections: particle colliders, heavy-ion accelerators, high-intensity proton accelerators, accelerator-based light sources, pulsed power accelerators, small scale accelerators, accelerators for applications, accelerator technology development and advanced accelerator concepts. The prospects of particle accelerators in China are also presented.

  9. MUON ACCELERATION

    Energy Technology Data Exchange (ETDEWEB)

    BERG,S.J.

    2003-11-18

    One of the major motivations driving recent interest in FFAGs is their use for the cost-effective acceleration of muons. This paper summarizes the progress in this area that was achieved leading up to and at the FFAG workshop at KEK from July 7-12, 2003. Much of the relevant background and references are also given here, to give a context to the progress we have made.

  10. Gamma-ray detector guidance of breast cancer therapy

    Science.gov (United States)

    Ravi, Ananth

    2009-12-01

    Breast cancer is the most common form of cancer in women. Over 75% of breast cancer patients are eligible for breast conserving therapy. Breast conserving therapy involves a lumpectomy to excise the gross tumour, followed by adjuvant radiation therapy to eradicate residual microscopic disease. Recent advances in the understanding of breast cancer biology and recurrence have presented the opportunity to improve breast conserving therapy techniques. This thesis has explored the potential of gamma-ray detecting technology to improve guidance of both surgical and adjuvant radiation therapy aspects of breast conserving therapy. The task of accurately excising the gross tumour during breast conserving surgery (BCS) is challenging, due to the limited guidance currently available to surgeons. Radioimmuno guided surgery (RIGS) has been investigated to determine its potential to delineate the gross tumour intraoperatively. The effects of varying a set of user controllable parameters on the ability of RIGS to detect and delineate model breast tumours was determined. The parameters studied were: Radioisotope, blood activity concentration, collimator height and energy threshold. The most sensitive combination of parameters was determined to be an 111Indium labelled radiopharmaceutical with a gamma-ray detecting probe collimated to a height of 5 mm and an energy threshold at the Compton backscatter peak. Using these parameters it was found that, for the breast tumour model used, the minimum tumour-to-background ratio required to delineate the tumour edge accurately was 5.2+/-0.4 at a blood activity concentration of 5 kBq/ml. Permanent breast seed implantation (PBSI) is a form of accelerated partial breast irradiation that dramatically reduces the treatment burden of adjuvant radiation therapy on patients. Unfortunately, it is currently difficult to localize the implanted brachytherapy seeds, making it difficult to perform a correction in the event that seeds have been misplaced

  11. Laser acceleration

    Science.gov (United States)

    Tajima, T.; Nakajima, K.; Mourou, G.

    2017-02-01

    The fundamental idea of Laser Wakefield Acceleration (LWFA) is reviewed. An ultrafast intense laser pulse drives coherent wakefield with a relativistic amplitude robustly supported by the plasma. While the large amplitude of wakefields involves collective resonant oscillations of the eigenmode of the entire plasma electrons, the wake phase velocity ˜ c and ultrafastness of the laser pulse introduce the wake stability and rigidity. A large number of worldwide experiments show a rapid progress of this concept realization toward both the high-energy accelerator prospect and broad applications. The strong interest in this has been spurring and stimulating novel laser technologies, including the Chirped Pulse Amplification, the Thin Film Compression, the Coherent Amplification Network, and the Relativistic Mirror Compression. These in turn have created a conglomerate of novel science and technology with LWFA to form a new genre of high field science with many parameters of merit in this field increasing exponentially lately. This science has triggered a number of worldwide research centers and initiatives. Associated physics of ion acceleration, X-ray generation, and astrophysical processes of ultrahigh energy cosmic rays are reviewed. Applications such as X-ray free electron laser, cancer therapy, and radioisotope production etc. are considered. A new avenue of LWFA using nanomaterials is also emerging.

  12. Antiestrogens: structure-activity relationships and use in breast cancer treatment

    Science.gov (United States)

    Traboulsi, T; El Ezzy, M; Gleason, J L

    2016-01-01

    About 70% of breast tumors express estrogen receptor alpha (ERα), which mediates the proliferative effects of estrogens on breast epithelial cells, and are candidates for treatment with antiestrogens, steroidal or non-steroidal molecules designed to compete with estrogens and antagonize ERs. The variable patterns of activity of antiestrogens (AEs) in estrogen target tissues and the lack of systematic cross-resistance between different types of molecules have provided evidence for different mechanisms of action. AEs are typically classified as selective estrogen receptor modulators (SERMs), which display tissue-specific partial agonist activity (e.g. tamoxifen and raloxifene), or as pure AEs (e.g. fulvestrant), which enhance ERα post-translational modification by ubiquitin-like molecules and accelerate its proteasomal degradation. Characterization of second- and third-generation AEs, however, suggests the induction of diverse ERα structural conformations, resulting in variable degrees of receptor downregulation and different patterns of systemic properties in animal models and in the clinic. PMID:27729460

  13. Debate: Pro intraoperative radiation therapy in breast cancer; Debat: pour la radiotherapie peroperatoire dans le cancer du sein

    Energy Technology Data Exchange (ETDEWEB)

    Dubois, J.B.; Lemanski, C.; Azria, D. [Departement de radiotherapie, CRLC Val-d' Aurelle-Paul-Lamarque, 208, rue des Apothicaires, 34298 Montpellier cedex 5 (France); Gutowski, M.; Rouanet, P.; Saint-Aubert, B. [Departement de chirurgie, CRLC Val-d' Aurelle-Paul-Lamarque, 208, rue des Apothicaires, 34298 Montpellier cedex 5 (France)

    2011-10-15

    The use of intraoperative radiation therapy in breast cancer patients started about 20 years ago. Several retrospective and prospective studies have been published. Intraoperative radiation therapy was initially given as a boost to the tumour bed, followed by whole-breast irradiation. These studies have demonstrated the feasibility of the technique, with local control rates and cosmetic results similar to those obtained with standard treatments. Accelerated partial breast irradiation yields local recurrence rates as low as those observed after whole-breast irradiation. Intraoperative radiation therapy as a single irradiation modality with a unique dose has been investigated in recent prospective studies showing satisfactory local results. Intraoperative radiation therapy can be proposed either as a boost or as a unique treatment in selected cases (tumour size, nodal and hormonal status, patient's age). Intraoperative radiation therapy can be delivered by orthovoltage (50 kV) X-rays from mobile generators, or by electrons from linear accelerators, mobile or fixed, dedicated or not to intraoperative radiation therapy. (authors)

  14. Accelerators and the Accelerator Community

    Energy Technology Data Exchange (ETDEWEB)

    Malamud, Ernest; Sessler, Andrew

    2008-06-01

    In this paper, standing back--looking from afar--and adopting a historical perspective, the field of accelerator science is examined. How it grew, what are the forces that made it what it is, where it is now, and what it is likely to be in the future are the subjects explored. Clearly, a great deal of personal opinion is invoked in this process.

  15. accelerating cavity

    CERN Multimedia

    On the inside of the cavity there is a layer of niobium. Operating at 4.2 degrees above absolute zero, the niobium is superconducting and carries an accelerating field of 6 million volts per metre with negligible losses. Each cavity has a surface of 6 m2. The niobium layer is only 1.2 microns thick, ten times thinner than a hair. Such a large area had never been coated to such a high accuracy. A speck of dust could ruin the performance of the whole cavity so the work had to be done in an extremely clean environment.

  16. Impact accelerations

    Science.gov (United States)

    Vongierke, H. E.; Brinkley, J. W.

    1975-01-01

    The degree to which impact acceleration is an important factor in space flight environments depends primarily upon the technology of capsule landing deceleration and the weight permissible for the associated hardware: parachutes or deceleration rockets, inflatable air bags, or other impact attenuation systems. The problem most specific to space medicine is the potential change of impact tolerance due to reduced bone mass and muscle strength caused by prolonged weightlessness and physical inactivity. Impact hazards, tolerance limits, and human impact tolerance related to space missions are described.

  17. Diazepam use and progression of breast cancer.

    Science.gov (United States)

    Kleinerman, R A; Brinton, L A; Hoover, R; Fraumeni, J F

    1984-03-01

    The relationship between diazepam and breast cancer was evaluated using data from a case-control study of breast cancer, in which 1075 cases and 1146 controls who were participants in a breast cancer screening program were interviewed. Diazepam use was negatively associated with extent of disease and lymph node involvement, and this effect seemed greatest for long-term users of diazepam. It is not certain to what extent these data reflect an ascertainment bias, an association with the reasons for which the drug was prescribed, or chance. Whatever the explanation, the findings do not support a previous contention that diazepam promotes or accelerates breast cancer growth.

  18. Breast Gangrene

    Directory of Open Access Journals (Sweden)

    Husasin Irfan

    2011-08-01

    Full Text Available Abstract Background Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene. Methods A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed Results All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area. Conclusion Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.

  19. Who Should Bear the Cost of Convenience? A Cost-effectiveness Analysis Comparing External Beam and Brachytherapy Radiotherapy Techniques for Early Stage Breast Cancer.

    Science.gov (United States)

    McGuffin, M; Merino, T; Keller, B; Pignol, J-P

    2017-03-01

    Standard treatment for early breast cancer includes whole breast irradiation (WBI) after breast-conserving surgery. Recently, accelerated partial breast irradiation (APBI) has been proposed for well-selected patients. A cost and cost-effectiveness analysis was carried out comparing WBI with two APBI techniques. An activity-based costing method was used to determine the treatment cost from a societal perspective of WBI, high dose rate brachytherapy (HDR) and permanent breast seed implants (PBSI). A Markov model comparing the three techniques was developed with downstream costs, utilities and probabilities adapted from the literature. Sensitivity analyses were carried out for a wide range of variables, including treatment costs, patient costs, utilities and probability of developing recurrences. Overall, HDR was the most expensive ($14 400), followed by PBSI ($8700), with WBI proving the least expensive ($6200). The least costly method to the health care system was WBI, whereas PBSI and HDR were less costly for the patient. Under cost-effectiveness analyses, downstream costs added about $10 000 to the total societal cost of the treatment. As the outcomes are very similar between techniques, WBI dominated under cost-effectiveness analyses. WBI was found to be the most cost-effective radiotherapy technique for early breast cancer. However, both APBI techniques were less costly to the patient. Although innovation may increase costs for the health care system it can provide cost savings for the patient in addition to convenience. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  20. A Prospective Longitudinal Clinical Trial Evaluating Quality of Life After Breast-Conserving Surgery and High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd A. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Deshields, Teresa L. [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Margenthaler, Julie A.; Cyr, Amy E. [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Aft, Rebecca [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri (United States); Gillanders, William E.; Eberlein, Timothy [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Matesa, Melissa A.; Ochoa, Laura L. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-12-01

    Purpose: To prospectively examine quality of life (QOL) of patients with early stage breast cancer treated with accelerated partial breast irradiation (APBI) using high-dose-rate (HDR) interstitial brachytherapy. Methods and Materials: Between March 2004 and December 2008, 151 patients with early stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients included those with Tis-T2 tumors measuring ≤3 cm excised with negative surgical margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. QOL was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, version 3.0, and QLQ-BR23 questionnaires. The QLQ-C30 and QLQ-BR23 questionnaires were evaluated during pretreatment and then at 6 to 8 weeks, 3 to 4 months, 6 to 8 months, and 1 and 2 years after treatment. Results: The median follow-up was 55 months. Breast symptom scores remained stable in the months after treatment, and they significantly improved 6 to 8 months after treatment. Scores for emotional functioning, social functioning, and future perspective showed significant improvement 2 years after treatment. Symptomatic fat necrosis was associated with several changes in QOL, including increased pain, breast symptoms, systemic treatment side effects, dyspnea, and fatigue, as well as decreased role functioning, emotional functioning, and social functioning. Conclusions: HDR multicatheter interstitial brachytherapy was well tolerated, with no significant detrimental effect on measured QOL scales/items through 2 years of follow-up. Compared to pretreatment scores, there was improvement in breast symptoms, emotional functioning, social functioning, and future perspective 2 years after treatment.

  1. Radiotherapy in the management of early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Wei [Westmead Breast Cancer Institute, Westmead Hospital, Westmead, New South Wales (Australia); Department of Radiation Oncology, Westmead Hospital, New South Wales (Australia)

    2013-03-15

    Radiotherapy is an indispensible part of the management of all stages of breast cancer. In this article, the common indications for radiotherapy in the management of early breast cancer (stages 0, I, and II) are reviewed, including whole-breast radiotherapy as part of breast-conserving treatment for early invasive breast cancer and pre-invasive disease of ductal carcinoma in situ, post-mastectomy radiotherapy, locoregional radiotherapy, and partial breast irradiation. Key clinical studies that underpin our current practice are discussed briefly.

  2. Measurement of mean cardiac dose for various breast irradiation techniques and corresponding risk of major cardiovascular event.

    Directory of Open Access Journals (Sweden)

    Tomas Rodrigo Merino Lara

    2014-10-01

    Full Text Available After breast conserving surgery, early stage breast cancer patients are currently treated with a wide range of radiation techniques including whole breast irradiation (WBI, accelerated partial breast irradiation (APBI using high dose rate (HDR brachytherapy, or 3D conformal radiotherapy (3D-CRT. This study compares the mean heart’s doses for a left breast irradiated with different breast techniques.An anthropomorphic Rando phantom was modified with gelatin-based breast of different sizes and tumors located medially or laterally. The breasts were treated with WBI, 3D-CRT or HDR APBI. The heart’s mean doses were measured with Gafchromic films and controlled with optically stimulated luminescent dosimeters (OSLDs. Following the model reported by Darby (16, major cardiac were estimated assuming a linear risk increase with the mean dose to the heart of 7.4% per gray.Whole breast irradiation lead to the highest mean heart dose (2.99 Gy compared to 3D-CRT APBI, (0.51 Gy, multicatheter (1.58 Gy and balloon HDR (2.17 Gy for a medially located tumor. This translated into long-term coronary event increases of 22%, 3.8%, 11.7%, and 16% respectively. The sensitivity analysis showed that the tumor location had almost no effect on the mean heart dose for 3D-CRT APBI and a minimal impact for HDR APBI. For WBI large breast size and set-up errors lead to sharp increases of the mean heart dose. Its value reached 10.79 Gy for women with large breast and a set-up error of 1.5 cm. Such a high value could increase the risk of having long-term coronary events by 80%.Comparison among different irradiation techniques demonstrates that 3D-CRT APBI appears the safest one with less probability of having cardiovascular events in the future. A sensitivity analysis showed that WBI is the most challenging technique for patients with large breasts or when significant set-up errors are anticipated. In those cases additional heart shielding techniques are required.

  3. Breast Cancer

    Science.gov (United States)

    Breast cancer affects one in eight women during their lives. No one knows why some women get breast cancer, but there are many risk factors. Risks that ... who have family members with breast or ovarian cancer may wish to be tested for the genes. ...

  4. The future of breast cancer radiotherapy: From one size fits all to taylor-made treatment; L'avenir de la radiotherapie du cancer du sein: de la taille unique au sur-mesure

    Energy Technology Data Exchange (ETDEWEB)

    Hennequin, C. [Service de cancerologie-radiotherapie, hopital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris (France); Azria, D. [Departement de cancerologie radiotherapie, CRLC Val-d' Aurelle-Paul-Lamarque, rue Croix-Verte, 34298 Montpellier cedex 5 (France); Universite de Montpellier I, 5, boulevard Henri-IV, CS 19044, 34967 Montpellier cedex 2 (France); Inserm U896, institut de recherche en cancerologie de Montpellier, CRLC Val-d' Aurelle-Paul-Lamarque, rue Croix-Verte, 34298 Montpellier cedex 5 (France)

    2011-10-15

    Various subgroups of breast tumours have been identified during the last 10 years according to the risk of local relapse. Prognostic factors for local relapse are age, surgical margins, tumour size, Her2 expression and hormonal receptors status. For tumours with a high risk of local relapse, an increased in boost dose or the addition of new drugs (trastuzumab, anti-angiogenics, PARP inhibitors) could be considered. For low risk tumours, hypo-fractionated, accelerated partial breast and intraoperative radiotherapy are being evaluated. The classical schedule (45-50 Gy to the whole gland followed by a boost dose of 16 Gy) is no longer the universal rule. Treatment individualization, according to clinical and biological characteristics of the tumour and - possibly - to the radiobiological profile of the patient, is likely to be the future of breast cancer radiotherapy. (authors)

  5. REMOTE OPERATIONS IN A GLOBAL ACCELERATOR NETWORK

    Energy Technology Data Exchange (ETDEWEB)

    PEGGS,S.SATOGATA,TAGARWAL,DRICE,D

    2003-05-12

    The INTRODUCTION to this paper summarizes the history of the Global Accelerator Network (GAN) concept and the recent workshops that discussed the relationship between GAN and Remote Operations. The REMOTE OPERATIONS SCENARIOS section brings out the organizational philosophy embodied in GAN-like and to non-GAN-like scenarios. The set of major TOPICS RAISED AT THE WORKSHOPS are only partially resolved. COLLABORATION TOOLS are described and discussed, followed by examples of REMOTE ACCELERATOR CONTROL PROJECTS around the world.

  6. Breast augmentation surgery

    Science.gov (United States)

    ... on the underside of your breast, in the natural skin fold. The surgeon places the implant through this ... lift Breast pain Breast reconstruction - implants Breast reconstruction - natural tissue Breast ... wound care - open Review Date 2/10/2015 Updated by: ...

  7. Breast cancer screening

    Science.gov (United States)

    Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening ... performed to screen women to detect early breast cancer when it is more likely to be cured. ...

  8. Breast Reconstruction Alternatives

    Science.gov (United States)

    ... Breast Reconstruction Surgery Breast Cancer Breast Reconstruction Surgery Breast Reconstruction Alternatives Some women who have had a ... chest. What if I choose not to get breast reconstruction? Some women decide not to have any ...

  9. Surgery for Breast Cancer

    Science.gov (United States)

    ... Pregnancy Breast Cancer Breast Cancer Treatment Surgery for Breast Cancer Surgery is a common treatment for breast cancer, ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  10. Breast Reconstruction with Implants

    Science.gov (United States)

    Breast reconstruction with implants Overview By Mayo Clinic Staff Breast reconstruction is a surgical procedure that restores shape to ... treat or prevent breast cancer. One type of breast reconstruction uses breast implants — silicone devices filled with silicone ...

  11. Breast Cancer Overview

    Science.gov (United States)

    ... Cancer > Breast Cancer > Breast Cancer: Overview Request Permissions Breast Cancer: Overview Approved by the Cancer.Net Editorial Board , ... bean-shaped organs that help fight infection. About breast cancer Cancer begins when healthy cells in the breast ...

  12. Partial tooth gear bearings

    Science.gov (United States)

    Vranish, John M. (Inventor)

    2010-01-01

    A partial gear bearing including an upper half, comprising peak partial teeth, and a lower, or bottom, half, comprising valley partial teeth. The upper half also has an integrated roller section between each of the peak partial teeth with a radius equal to the gear pitch radius of the radially outwardly extending peak partial teeth. Conversely, the lower half has an integrated roller section between each of the valley half teeth with a radius also equal to the gear pitch radius of the peak partial teeth. The valley partial teeth extend radially inwardly from its roller section. The peak and valley partial teeth are exactly out of phase with each other, as are the roller sections of the upper and lower halves. Essentially, the end roller bearing of the typical gear bearing has been integrated into the normal gear tooth pattern.

  13. Breast cancer management: Past, present and evolving

    Directory of Open Access Journals (Sweden)

    M Akram

    2012-01-01

    Full Text Available Breast cancer is known from ancient time,and the treatment strategy evolved as our understanding of the disease changed with time. In 460 BC Hippocrates described breast cancer as a humoral disease and presently after a lot of studies breast cancer is considered as a local disease with systemic roots. For most of the twentieth century Halsted radical mastectomy was the "established and standardized operation for cancer of the breast in all stages, early or late". New information about tumor biology and its behavior suggested that less radical surgery might be just as effective as the more extensive one. Eventually, with the use of adjuvant therapy likeradiation and systemic therapy, the extent of surgical resection in the breast and axilla got reduced further and led to an era of breast conservation. The radiation treatment of breast cancer has evolved from 2D to 3D Conformal and to accelarated partial breast irradiation, aiming to reduce normal tissue toxicity and overall treatment time. Systemic therapy in the form of hormone therapy, chemotherapy and biological agents is now a well-established modality in treatment of breast cancer. The current perspective of breast cancer management is based on the rapidly evolving and increasingly integrated study on the genetic, molecular , biochemical and cellular basis of disease. The challenge for the future is to take advantage of this knowledge for the prediction of therapeutic outcome and develop therapies and rapidly apply more novel biologic therapeutics.

  14. Multiple Partial Siberian Snakes in the AGS

    Science.gov (United States)

    Takano, J.; Ahrens, L. A.; Bai, M.; Brown, K.; Courant, E. D.; Gardner, C. J.; Glenn, J. W.; Hattori, T.; Huang, H.; Lin, F.; Luccio, A. U.; MacKay, W. W.; Okamura, M.; Roser, T.; Tepikian, S.; Tsoupas, N.; Yip, K.; Zelenski, A.; Zeno, K.

    2007-06-01

    Polarized protons are accelerated up to 24.3 GeV in the Alternating Gradient Synchrotron (AGS) at Brookhaven National Laboratory (BNL). To accelerate the beam with preserving the polarization, two different types of helical dipole partial Siberian snake have been installed to the AGS. One is a superconducting magnet (Cold Snake, CSNK), and the other is a normal conducting one (Warm Snake, WSNK). With these snake magnets, the polarization at the AGS extraction achieved 65%. However, the AGS has spin mismatches at the injection and extraction. This description shows calculated results to have better spin matching with using two or three snakes.

  15. Laparoscopic Partial Nephrectomy

    Directory of Open Access Journals (Sweden)

    Ender Özden

    2015-03-01

    Full Text Available Patients with renal tumors <7 cm and those at risk for a significant loss of renal function should be managed with a partial nephrectomy if it is technically feasible. Partial nephrectomy (PN results in similar oncologic outcomes with radical nephrectomy. With advent of the technology and increase utilization of laparoscopic surgery, laparoscopic approach is considered as one of the option for partial nephrectomy. However laparoscopic partial nephrectomy is technically very difficult procedure and should be performed only by physicians with extensive experience using this approach. In this section, we aimed to present the technical steps of laparoscopic partial nephrectomy

  16. Comparison of Patient-reported Outcomes after Implant Versus Autologous Tissue Breast Reconstruction Using the BREAST-Q

    OpenAIRE

    Pirro, Ortensia; Mestak, Ondrej; Vindigni, Vincenzo; Sukop, Andrej; Hromadkova, Veronika; Nguyenova, Alena; Vitova, Lenka; Bassetto, Franco

    2017-01-01

    Background: The demand for reconstructive breast procedures of various types has accelerated in recent years. Coupled with increased patient expectations, it has fostered the development of oncoplastic and reconstructive techniques in breast surgery. In the setting of postmastectomy reconstruction, patient satisfaction and quality of life are the most significant outcome variables when evaluating surgical success. The aim of this study was to evaluate the quality of life after implant breast ...

  17. Intensity modulated radiation therapy for breast cancer: current perspectives

    Science.gov (United States)

    Buwenge, Milly; Cammelli, Silvia; Ammendolia, Ilario; Tolento, Giorgio; Zamagni, Alice; Arcelli, Alessandra; Macchia, Gabriella; Deodato, Francesco; Cilla, Savino; Morganti, Alessio G

    2017-01-01

    Background Owing to highly conformed dose distribution, intensity modulated radiation therapy (IMRT) has the potential to improve treatment results of radiotherapy (RT). Postoperative RT is a standard adjuvant treatment in conservative treatment of breast cancer (BC). The aim of this review is to analyze available evidence from randomized controlled trials (RCTs) on IMRT in BC, particularly in terms of reduction of side effects. Methods A literature search of the bibliographic database PubMed, from January 1990 through November 2016, was performed. Only RCTs published in English were included. Results Ten articles reporting data from 5 RCTs fulfilled the selection criteria and were included in our review. Three out of 5 studies enrolled only selected patients in terms of increased risk of toxicity. Three studies compared IMRT with standard tangential RT. One study compared the results of IMRT in the supine versus the prone position, and one study compared standard treatment with accelerated partial breast IMRT. Three studies reported reduced acute and/or late toxicity using IMRT compared with standard RT. No study reported improved quality of life. Conclusion IMRT seems able to reduce toxicity in selected patients treated with postoperative RT for BC. Further analyses are needed to better define patients who are candidates for this treatment modality. PMID:28293119

  18. Neoadjuvant breast cancer therapy and drug development.

    Science.gov (United States)

    Cortazar, Patricia; Kluetz, Paul G

    2015-11-01

    Neoadjuvant treatment of breast cancer initially was limited to patients with locally advanced breast cancer in which downstaging was necessary. Now, neoadjuvant trials have become an increasingly common way to facilitate the rapid assessment of new cancer therapies. The appeal of neoadjuvant trials is that they provide the opportunity to study translational science, tumor biomarkers, and intermediate endpoints in response to systemic therapy within a shortened period. This review summarizes the data that contribute to our understanding of the association between pathological complete response and long-term outcomes, describes the implications of drug development and accelerated approval in neoadjuvant treatment of breast cancer, and provides a perspective on future neoadjuvant drug development.

  19. Breast Cysts

    Science.gov (United States)

    ... cells may be collected to check for cancer (fine-needle aspiration biopsy). No treatment is necessary for simple breast cysts — those that are fluid-filled and don't cause any symptoms — that are confirmed on breast ultrasound or after a fine-needle aspiration. If the lump persists or feels ...

  20. Piezoelectric particle accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Kemp, Mark A.; Jongewaard, Erik N.; Haase, Andrew A.; Franzi, Matthew

    2017-08-29

    A particle accelerator is provided that includes a piezoelectric accelerator element, where the piezoelectric accelerator element includes a hollow cylindrical shape, and an input transducer, where the input transducer is disposed to provide an input signal to the piezoelectric accelerator element, where the input signal induces a mechanical excitation of the piezoelectric accelerator element, where the mechanical excitation is capable of generating a piezoelectric electric field proximal to an axis of the cylindrical shape, where the piezoelectric accelerator is configured to accelerate a charged particle longitudinally along the axis of the cylindrical shape according to the piezoelectric electric field.

  1. Acceleration without Horizons

    CERN Document Server

    Doria, Alaric

    2015-01-01

    We derive the metric of an accelerating observer moving with non-constant proper acceleration in flat spacetime. With the exception of a limiting case representing a Rindler observer, there are no horizons. In our solution, observers can accelerate to any desired terminal speed $v_{\\infty} < c$. The motion of the accelerating observer is completely determined by the distance of closest approach and terminal velocity or, equivalently, by an acceleration parameter and terminal velocity.

  2. Other Considerations for Pregnancy and Breast Cancer

    Science.gov (United States)

    ... Cancer Patient Breast Cancer Patient Breast Cancer Treatment Male Breast Cancer Treatment Breast Cancer Treatment & Pregnancy Breast Cancer Prevention Breast Cancer Screening Health Professional Breast Cancer Treatment Male ... Treatment Breast Cancer Treatment & Pregnancy Breast Cancer Prevention ...

  3. Accelerating flight: Edge with arbitrary acceleration

    CSIR Research Space (South Africa)

    Gledhill, Irvy MA

    2011-11-01

    Full Text Available ? temporal scales ? Euler ? convection ? Reynolds ? translational viscous ? Ekman ? rotational viscous ? Translational acceleration ? related to g ? Rotational accleration ? Rossby ? Coriolis ? Centrifugal ? Gravitational ? CSIR 2009...

  4. Breast cancer in Singapore: some perspectives.

    Science.gov (United States)

    Jara-Lazaro, Ana Richelia; Thilagaratnam, Shyamala; Tan, Puay Hoon

    2010-01-01

    Breast cancer is the commonest malignancy among Singapore women, accounting for 29.7% of all female cancers, with an age-standardized rate of 54.9 per 100,000 per year. It has been the most frequent cancer in Singapore women for the last 30 years, with the highest rates previously reported in those aged between 45 and 49 years, but with a more recent observation of a change in peak age group to women in their late 50s. About 1,100 new cases are diagnosed annually and approximately 270 women die in Singapore each year from breast cancer. In the multiethnic population of Singapore, it has been noted that rising breast cancer incidence is consistent across all three ethnic groups (Chinese, Malays, and Indians). Singapore has among the highest breast cancer incidence in Asia. Possible explanations include rapid urbanization, improvement in socio-economic status, and adoption of a western lifestyle. Our experience with the Singapore breast screening pilot project (1994-1997) and the national breast-screening program (BreastScreen Singapore) has led to increased understanding of this disease in the country. Data from the pilot project showed that breast screening is just as effective in a predominantly Asian population as in the west. Early breast cancer accounted for most breast cancers detected, with pre-invasive ductal carcinoma in situ (DCIS) comprising 26% of all screen-detected cancers in the pilot study. In the currently on-going BreastScreen Singapore, DCIS forms >30% of all breast cancers among pre-menopausal women, a relatively high proportion probably accounted for partially by the greater participation of women aged between 40 and 49 years. Despite the ready availability of subsidized mammographic screening, there are still women in Singapore who present with locally advanced breast cancer. Clinical management of an increasing number of women with breast cancer embraces a multidisciplinary team-based approach, with regular discussions of therapeutic

  5. Acellular dermis-assisted breast reconstruction.

    Science.gov (United States)

    Spear, S L; Parikh, P M; Reisin, E; Menon, N G

    2008-05-01

    In 2004, the authors reported their findings with placement of tissue expanders for breast reconstruction in the partial submuscular position, the equivalent of the "dual-plane" technique for breast augmentation. Limitations with subpectoral expander placement include difficulty controlling the lower pole of the pocket during expansion, unprotected device coverage by a thin inferior mastectomy flap, possible effacement of the inframammary fold, and limited control over the superior migration of the pectoralis major muscle. This study aimed to examine the safety and efficacy of an acellular dermal sling in providing inferolateral support to the device during immediate breast reconstruction and expansion. This study prospectively investigated 58 breasts of 43 consecutive women who underwent immediate breast reconstruction with tissue expanders and acellular dermis. After completion of adjuvant therapy and expansion, the devices were exchanged for implants. The patients were tracked through January, 2007. The study parameters included demographic information, oncologic data, complications, and aesthetic outcomes. The mean time required to complete reconstruction was 8.6 months. The overall complication rate after expander/acellular dermis placement was 12%, whereas the complication rate after exchange to implants was 2.2%. The aesthetic outcome for reconstructed breasts did not differ significantly from that for the control subjects who had no surgery. Acellular dermis appears to be a useful adjunct in immediate prosthetic breast reconstruction. Acellular dermis-assisted breast reconstruction has a low complication rate, helps to reconstruct an aesthetically pleasing breast, and facilitates expeditious completion of the reconstruction.

  6. On the polarized beam acceleration in medium energy synchrotrons

    Energy Technology Data Exchange (ETDEWEB)

    Lee, S.Y.

    1992-12-31

    This lecture note reviews physics of spin motion in a synchrotron, spin depolarization mechanisms of spin resonances, and methods of overcoming the spin resonances during acceleration. Techniques used in accelerating polarized ions in the low/medium energy synchrotrons, such as the ZGS, the AGS, SATURNE, and the KEK PS and PS Booster are discussed. Problems related to polarized proton acceleration with snakes or partial snake are also examined.

  7. Breast MRI scan

    Science.gov (United States)

    MRI - breast; Magnetic resonance imaging - breast; Breast cancer - MRI; Breast cancer screening - MRI ... radiologist) see some areas more clearly. During the MRI, the person who operates the machine will watch ...

  8. Types of Breast Pumps

    Science.gov (United States)

    ... Devices Consumer Products Breast Pumps Types of Breast Pumps Share Tweet Linkedin Pin it More sharing options ... used for feeding a baby. Types of Breast Pumps There are three basic types of breast pumps: ...

  9. Breast enlargement in males

    Science.gov (United States)

    ... substances can cause breast enlargement: Alcohol Amphetamines Heroin Marijuana Methadone Men who have enlarged breasts may have an increased risk for breast cancer . Breast cancer in men is rare. Signs that ...

  10. Breast Cancer Treatment

    Science.gov (United States)

    ... Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer ... clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have ...

  11. Breast Cancer Research Update

    Science.gov (United States)

    ... JavaScript on. Feature: Breast Cancer Breast Cancer Research Update Winter 2017 Table of Contents National Cancer Institute ... Addressing Breast Cancer's Unequal Burden / Breast Cancer Research Update Winter 2017 Issue: Volume 11 Number 4 Page ...

  12. 2014 CERN Accelerator Schools: Plasma Wake Acceleration

    CERN Multimedia

    2014-01-01

    A specialised school on Plasma Wake Acceleration will be held at CERN, Switzerland from 23-29 November, 2014.   This course will be of interest to staff and students in accelerator laboratories, university departments and companies working in or having an interest in the field of new acceleration techniques. Following introductory lectures on plasma and laser physics, the course will cover the different components of a plasma wake accelerator and plasma beam systems. An overview of the experimental studies, diagnostic tools and state of the art wake acceleration facilities, both present and planned, will complement the theoretical part. Topical seminars and a visit of CERN will complete the programme. Further information can be found at: http://cas.web.cern.ch/cas/PlasmaWake2014/CERN-advert.html http://indico.cern.ch/event/285444/

  13. Understanding a Breast Cancer Diagnosis

    Science.gov (United States)

    ... Cancer A-Z Breast Cancer Understanding a Breast Cancer Diagnosis If you’ve been diagnosed with breast cancer, ... Prevention Early Detection and Diagnosis Understanding a Breast Cancer Diagnosis Treatment Breast Reconstruction Surgery Living as a Breast ...

  14. Breast Reconstruction with Flap Surgery

    Science.gov (United States)

    Breast reconstruction with flap surgery Overview By Mayo Clinic Staff Breast reconstruction is a surgical procedure that restores shape to ... breast tissue to treat or prevent breast cancer. Breast reconstruction with flap surgery is a type of breast ...

  15. Mammographic density estimation with automated volumetric breast density measurement.

    Science.gov (United States)

    Ko, Su Yeon; Kim, Eun-Kyung; Kim, Min Jung; Moon, Hee Jung

    2014-01-01

    To compare automated volumetric breast density measurement (VBDM) with radiologists' evaluations based on the Breast Imaging Reporting and Data System (BI-RADS), and to identify the factors associated with technical failure of VBDM. In this study, 1129 women aged 19-82 years who underwent mammography from December 2011 to January 2012 were included. Breast density evaluations by radiologists based on BI-RADS and by VBDM (Volpara Version 1.5.1) were compared. The agreement in interpreting breast density between radiologists and VBDM was determined based on four density grades (D1, D2, D3, and D4) and a binary classification of fatty (D1-2) vs. dense (D3-4) breast using kappa statistics. The association between technical failure of VBDM and patient age, total breast volume, fibroglandular tissue volume, history of partial mastectomy, the frequency of mass > 3 cm, and breast density was analyzed. The agreement between breast density evaluations by radiologists and VBDM was fair (k value = 0.26) when the four density grades (D1/D2/D3/D4) were used and moderate (k value = 0.47) for the binary classification (D1-2/D3-4). Twenty-seven women (2.4%) showed failure of VBDM. Small total breast volume, history of partial mastectomy, and high breast density were significantly associated with technical failure of VBDM (p = 0.001 to 0.015). There is fair or moderate agreement in breast density evaluation between radiologists and VBDM. Technical failure of VBDM may be related to small total breast volume, a history of partial mastectomy, and high breast density.

  16. Mammography density estimation with automated volumetic breast density measurement

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Su Yeon; Kim, Eun Kyung; Kim, Min Jung; Moon, Hee Jung [Dept. of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-06-15

    To compare automated volumetric breast density measurement (VBDM) with radiologists' evaluations based on the Breast Imaging Reporting and Data System (BI-RADS), and to identify the factors associated with technical failure of VBDM. In this study, 1129 women aged 19-82 years who underwent mammography from December 2011 to January 2012 were included. Breast density evaluations by radiologists based on BI-RADS and by VBDM (Volpara Version 1.5.1) were compared. The agreement in interpreting breast density between radiologists and VBDM was determined based on four density grades (D1, D2, D3, and D4) and a binary classification of fatty (D1-2) vs. dense (D3-4) breast using kappa statistics. The association between technical failure of VBDM and patient age, total breast volume, fibroglandular tissue volume, history of partial mastectomy, the frequency of mass > 3 cm, and breast density was analyzed. The agreement between breast density evaluations by radiologists and VBDM was fair (k value = 0.26) when the four density grades (D1/D2/D3/D4) were used and moderate (k value = 0.47) for the binary classification (D1-2/D3-4). Twenty-seven women (2.4%) showed failure of VBDM. Small total breast volume, history of partial mastectomy, and high breast density were significantly associated with technical failure of VBDM (p 0.001 to 0.015). There is fair or moderate agreement in breast density evaluation between radiologists and VBDM. Technical failure of VBDM may be related to small total breast volume, a history of partial mastectomy, and high breast density.

  17. The Partial Fuzzy Set

    OpenAIRE

    Dr.Pranita Goswami

    2011-01-01

    The Partial Fuzzy Set is a portion of the Fuzzy Set which is again a Fuzzy Set. In the Partial Fuzzy Set the baseline is shifted from 0 to 1 to any of its α cuts . In this paper we have fuzzified a portion of the Fuzzy Set by transformation

  18. Breast lump

    Science.gov (United States)

    ... a woman are often caused by fibrocystic changes, fibroadenomas, and cysts. Fibrocystic changes are painful, lumpy breasts. ... period, and then improve after your period starts. Fibroadenomas are noncancerous lumps that feel rubbery. They move ...

  19. Breast Reconstruction

    Science.gov (United States)

    ... senos Preguntas Para el Médico Datos Para la Vida Komen El cuidado de sus senos:Consejos útiles ... can help . Cost Federal law requires most insurance plans cover the cost of breast reconstruction. Learn more ...

  20. Breast Augmentation

    Science.gov (United States)

    ... surgery might even improve your body image and self-esteem. If you're looking for perfection, however, you ... www.mayoclinic.org/tests-procedures/breast-augmentation/basics/definition/prc-20021493 . Mayo Clinic Footer Legal Conditions and ...

  1. Breast Lumps

    Science.gov (United States)

    ... You might notice: A distinct lump with definite borders A firm, hard area within your breast A ... MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo ...

  2. Dense Breasts

    Science.gov (United States)

    ... also appear white on mammography, they can be hidden by or within dense breast tissue. Other imaging ... understanding of the possible charges you will incur. Web page review process: This Web page is reviewed ...

  3. Breast Rash

    Science.gov (United States)

    ... rashes/rash-in-adults. Accessed Dec. 29, 2016. Papadakis MA, et al., eds. Breast disorders. In: Current ... http://www.accessmedicine.com. Accessed Dec. 28, 2016. Papadakis MA, et al., eds. Dermatologic disorders. In: Current ...

  4. Two Cases of Post-Radiation Sarcoma after Breast Cancer Treatment

    OpenAIRE

    Noh, Jae Myoung; Huh, Seung Jae; Choi, Doo Ho; Park, Won; Nam, Seok Jin

    2012-01-01

    We describe two cases of post-radiation sarcoma after breast cancer treatment. The first patient was a 61-year-old woman who underwent partial mastectomy of the right breast and adjuvant whole breast irradiation 7 years previously. Subsequently, a rapidly growing mass from the anterior arc of the right fifth rib was incidentally detected on an abdomino-pelvic computed tomography scan. The second patient was a 70-year-old woman who received neoadjuvant chemotherapy and a partial mastectomy of ...

  5. High Energy Particle Accelerators

    CERN Multimedia

    Audio Productions, Inc, New York

    1960-01-01

    Film about the different particle accelerators in the US. Nuclear research in the US has developed into a broad and well-balanced program.Tour of accelerator installations, accelerator development work now in progress and a number of typical experiments with high energy particles. Brookhaven, Cosmotron. Univ. Calif. Berkeley, Bevatron. Anti-proton experiment. Negative k meson experiment. Bubble chambers. A section on an electron accelerator. Projection of new accelerators. Princeton/Penn. build proton synchrotron. Argonne National Lab. Brookhaven, PS construction. Cambridge Electron Accelerator; Harvard/MIT. SLAC studying a linear accelerator. Other research at Madison, Wisconsin, Fixed Field Alternate Gradient Focusing. (FFAG) Oakridge, Tenn., cyclotron. Two-beam machine. Comments : Interesting overview of high energy particle accelerators installations in the US in these early years. .

  6. Improved plasma accelerator

    Science.gov (United States)

    Cheng, D. Y.

    1971-01-01

    Converging, coaxial accelerator electrode configuration operates in vacuum as plasma gun. Plasma forms by periodic injections of high pressure gas that is ionized by electrical discharges. Deflagration mode of discharge provides acceleration, and converging contours of plasma gun provide focusing.

  7. Accelerator Technology Division

    Science.gov (United States)

    1992-04-01

    In fiscal year (FY) 1991, the Accelerator Technology (AT) division continued fulfilling its mission to pursue accelerator science and technology and to develop new accelerator concepts for application to research, defense, energy, industry, and other areas of national interest. This report discusses the following programs: The Ground Test Accelerator Program; APLE Free-Electron Laser Program; Accelerator Transmutation of Waste; JAERI, OMEGA Project, and Intense Neutron Source for Materials Testing; Advanced Free-Electron Laser Initiative; Superconducting Super Collider; The High-Power Microwave Program; (Phi) Factory Collaboration; Neutral Particle Beam Power System Highlights; Accelerator Physics and Special Projects; Magnetic Optics and Beam Diagnostics; Accelerator Design and Engineering; Radio-Frequency Technology; Free-Electron Laser Technology; Accelerator Controls and Automation; Very High-Power Microwave Sources and Effects; and GTA Installation, Commissioning, and Operations.

  8. Breast fibromatosis associated with breast implants.

    Science.gov (United States)

    Seo, Yoon Nae; Park, Young Mi; Yoon, Hye Kyoung; Lee, Sun Joo; Choo, Hye Jung; Ryu, Ji Hwa

    2015-09-01

    Fibromatosis refers to an extra-abdominal desmoid tumor or aggressive fibromatosis. Breast fibromatosis can develop in association with the capsule around a breast implant, although reports of cases of fibromatosis associated with breast implants are rare. As the demand for breast augmentation has increased, it is important to understand the diseases associated with breast implants. In the present report, we describe a case of breast fibromatosis that developed adjacent to a breast implant and demonstrated a relatively well-defined border even though it invaded the surrounding structures. We also explore the specific imaging features for diagnosing breast fibromatosis in association with implants by reviewing previous literature.

  9. Accelerators, Colliders, and Snakes

    Science.gov (United States)

    Courant, Ernest D.

    2003-12-01

    The author traces his involvement in the evolution of particle accelerators over the past 50 years. He participated in building the first billion-volt accelerator, the Brookhaven Cosmotron, which led to the introduction of the "strong-focusing" method that has in turn led to the very large accelerators and colliders of the present day. The problems of acceleration of spin-polarized protons are also addressed, with discussions of depolarizing resonances and "Siberian snakes" as a technique for mitigating these resonances.

  10. The CERN Accelerator School

    CERN Multimedia

    2016-01-01

    Introduction to accelerator physics The CERN Accelerator School: Introduction to Accelerator Physics, which should have taken place in Istanbul, Turkey, later this year has now been relocated to Budapest, Hungary.  Further details regarding the new hotel and dates will be made available as soon as possible on a new Indico site at the end of May.

  11. Accelerators and Dinosaurs

    CERN Multimedia

    Turner, Michael Stanley

    2003-01-01

    Using naturally occuring particles on which to research might have made accelerators become extinct. But in fact, results from astrophysics have made accelerator physics even more important. Not only are accelerators used in hospitals but they are also being used to understand nature's inner workings by searching for Higgs bosons, CP violation, neutrino mass and dark matter (2 pages)

  12. Far field acceleration

    Energy Technology Data Exchange (ETDEWEB)

    Fernow, R.C.

    1995-07-01

    Far fields are propagating electromagnetic waves far from their source, boundary surfaces, and free charges. The general principles governing the acceleration of charged particles by far fields are reviewed. A survey of proposed field configurations is given. The two most important schemes, Inverse Cerenkov acceleration and Inverse free electron laser acceleration, are discussed in detail.

  13. Acceleration: It's Elementary

    Science.gov (United States)

    Willis, Mariam

    2012-01-01

    Acceleration is one tool for providing high-ability students the opportunity to learn something new every day. Some people talk about acceleration as taking a student out of step. In actuality, what one is doing is putting a student in step with the right curriculum. Whole-grade acceleration, also called grade-skipping, usually happens between…

  14. Mammographic density and breast cancer risk: a mediation analysis.

    Science.gov (United States)

    Rice, Megan S; Bertrand, Kimberly A; VanderWeele, Tyler J; Rosner, Bernard A; Liao, Xiaomei; Adami, Hans-Olov; Tamimi, Rulla M

    2016-09-21

    High mammographic density (MD) is a strong risk factor for breast cancer. However, it is unclear whether high MD is an intermediate phenotype or whether breast cancer risk factors influence breast cancer risk and MD independently. Our study population included 1290 invasive breast cancer cases and 3422 controls from the Nurses' Health Studies. We estimated the percent of the total association between the risk factor and breast cancer that was mediated by MD. In both pre- and postmenopausal women, the association between history of biopsy-confirmed benign breast disease and risk was partially mediated by percent MD (percent mediated (PM) = 17 %, p breast cancer risk were substantially mediated by percent MD (PM = 73 %, p = 0.05 and PM = 82 %, p = 0.04, respectively). In postmenopausal women, the proportion of the associations of childhood somatotype and adolescent somatotype that were mediated by percent MD were lower (PM = 26 %, p = 0.01 for both measures). Hormone therapy use at mammogram was significantly mediated by percent MD in postmenopausal women (PM = 22 %, p breast cancer, were not mediated by percent MD. Percent MD partially mediated some of the associations between risk factors and breast cancer, though the magnitude varied by risk factor and menopausal status. These findings suggest that high MD may be an intermediate in some biological pathways for breast cancer development.

  15. Beginning partial differential equations

    CERN Document Server

    O'Neil, Peter V

    2011-01-01

    A rigorous, yet accessible, introduction to partial differential equations-updated in a valuable new edition Beginning Partial Differential Equations, Second Edition provides a comprehensive introduction to partial differential equations (PDEs) with a special focus on the significance of characteristics, solutions by Fourier series, integrals and transforms, properties and physical interpretations of solutions, and a transition to the modern function space approach to PDEs. With its breadth of coverage, this new edition continues to present a broad introduction to the field, while also addres

  16. Hyperbolic partial differential equations

    CERN Document Server

    Witten, Matthew

    1986-01-01

    Hyperbolic Partial Differential Equations III is a refereed journal issue that explores the applications, theory, and/or applied methods related to hyperbolic partial differential equations, or problems arising out of hyperbolic partial differential equations, in any area of research. This journal issue is interested in all types of articles in terms of review, mini-monograph, standard study, or short communication. Some studies presented in this journal include discretization of ideal fluid dynamics in the Eulerian representation; a Riemann problem in gas dynamics with bifurcation; periodic M

  17. Circumscribed breast carcinoma: Mammographic and sonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Soo Young; Lee, Yul; Park, Ki Soon; Lee, Ke Sook [College of Medicine, Hallym University, Seoul (Korea, Republic of)

    1992-03-15

    Circumscribe breast cancer is a well demarcated mass with or without a lobulated border simulating a benign tumor like fibroadenoma on mammography or breast US and is reported as approximate 10% of the incidence among primary breast carcinoma(1.2). Pathologically medullary, colloid, papillary, intraductal and rarely invasive ductal carcinomas are included in this group which show the less intense desmoplastic reaction than the scirrhous type cancer, resulting in the most favorable prognosis of all carcinoma of the breast. Among 214 primary breast carcinoma during the past 8 years, we experienced 6 case of pathologically proven circumscribed breast cancer(2 cases of medullary carcinoma, 1 of colloid carcinoma, 1 of intracystic papillary carcinoma, 2 of comedo type intraductal carcinoma). Clinically 2 cases showed bloody nipple discharge from one hole of a unilateral nipple orifice. Mammography showed a well circumscribed nodule with or without partial lobular contour and no pathologic calcification. Breast sonographic findings were a well defined heterogeneous hypoechoic nodule with weak posterior acoustic enhancement. Characteristically a thin dilated lactiferous duct between the mass and the nipple on US could be detected in 2 cases which clinically was accompanied by bloody nipple discharge. Although the mammographic criteria is promising as benign tumor, the possibility of circumscribed as benign tumor, the possibility of circumscribed breast carcinoma must be considered in heterogeneous hypoechoic nodule with weak posterior acoustic enhancement in US, especially in the presence of a dilated lactiferous duct between the mass and the nipple with bloody nipple discharge.

  18. The Accelerator Reliability Forum

    CERN Document Server

    Lüdeke, Andreas; Giachino, R

    2014-01-01

    A high reliability is a very important goal for most particle accelerators. The biennial Accelerator Reliability Workshop covers topics related to the design and operation of particle accelerators with a high reliability. In order to optimize the over-all reliability of an accelerator one needs to gather information on the reliability of many different subsystems. While a biennial workshop can serve as a platform for the exchange of such information, the authors aimed to provide a further channel to allow for a more timely communication: the Particle Accelerator Reliability Forum [1]. This contribution will describe the forum and advertise it’s usage in the community.

  19. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  20. Reducing the overheads of hardware acceleration through datapath integration

    Science.gov (United States)

    Jääskeläinen, Pekka; Kultala, Heikki; Pitkänen, Teemu; Takala, Jarmo

    2008-02-01

    Hardware accelerators are used to speed up execution of specific tasks such as video coding. Often the purpose of hardware acceleration is to be able to use a cheaper or, for example, more energy economical processor for executing the majority of the application in software. However, when using hardware acceleration, new overheads are produced mainly due to the need to transfer data to and from the accelerator and signaling the readiness of the accelerator computation to the processor. We find the traditional mechanisms suboptimal for fine-grain hardware acceleration, especially when energy efficiency is important. This paper explores a technique unique to Transport Triggered Architectures to interface with hardware accelerators. The proposed technique places hardware accelerators to the processor data path, making them visible as regular function units to the programmer. This way communication costs are reduced as data can be transferred directly to the accelerator from other processor data path components and synchronization can be done by polling a simple ready flag in the accelerator function unit. Additionally, this setup enables the instruction scheduler of the compiler to schedule the hardware accelerator like any other operation, thus partially hide its latency with other program operations. The paper presents a case study with an audio decoder application in which fine-grain and coarse-grain hardware accelerators are integrated to the processor data path as function units. The case is used to study several different synchronization, communication, and latency-hiding techniques enabled by this kind of setup.

  1. Industrial Application of Accelerators

    CERN Document Server

    CERN. Geneva

    2017-01-01

    At CERN, we are very familiar with large, high energy particle accelerators. However, in the world outside CERN, there are more than 35000 accelerators which are used for applications ranging from treating cancer, through making better electronics to removing harmful micro-organisms from food and water. These are responsible for around $0.5T of commerce each year. Almost all are less than 20 MeV and most use accelerator types that are somewhat different from what is at CERN. These lectures will describe some of the most common applications, some of the newer applications in development and the accelerator technology used for them. It will also show examples of where technology developed for particle physics is now being studied for these applications. Rob Edgecock is a Professor of Accelerator Science, with a particular interest in the medical applications of accelerators. He works jointly for the STFC Rutherford Appleton Laboratory and the International Institute for Accelerator Applications at the Univer...

  2. Industrial Application of Accelerators

    CERN Document Server

    CERN. Geneva

    2017-01-01

    At CERN, we are very familiar with large, high energy particle accelerators. However, in the world outside CERN, there are more than 35000 accelerators which are used for applications ranging from treating cancer, through making better electronics to removing harmful micro-organisms from food and water. These are responsible for around $0.5T of commerce each year. Almost all are less than 20 MeV and most use accelerator types that are somewhat different from what is at CERN. These lectures will describe some of the most common applications, some of the newer applications in development and the accelerator technology used for them. It will also show examples of where technology developed for particle physics is now being studied for these applications. Rob Edgecock is a Professor of Accelerator Science, with a particular interest in the medical applications of accelerators. He works jointly for the STFC Rutherford Appleton Laboratory and the International Institute for Accelerator Applications at the Uni...

  3. Beginning partial differential equations

    CERN Document Server

    O'Neil, Peter V

    2014-01-01

    A broad introduction to PDEs with an emphasis on specialized topics and applications occurring in a variety of fields Featuring a thoroughly revised presentation of topics, Beginning Partial Differential Equations, Third Edition provides a challenging, yet accessible,combination of techniques, applications, and introductory theory on the subjectof partial differential equations. The new edition offers nonstandard coverageon material including Burger's equation, the telegraph equation, damped wavemotion, and the use of characteristics to solve nonhomogeneous problems. The Third Edition is or

  4. Generalized Partial Volume

    DEFF Research Database (Denmark)

    Darkner, Sune; Sporring, Jon

    2011-01-01

    Mutual Information (MI) and normalized mutual information (NMI) are popular choices as similarity measure for multimodal image registration. Presently, one of two approaches is often used for estimating these measures: The Parzen Window (PW) and the Generalized Partial Volume (GPV). Their theoret......Mutual Information (MI) and normalized mutual information (NMI) are popular choices as similarity measure for multimodal image registration. Presently, one of two approaches is often used for estimating these measures: The Parzen Window (PW) and the Generalized Partial Volume (GPV...

  5. Developmental Partial Differential Equations

    OpenAIRE

    Duteil, Nastassia Pouradier; Rossi, Francesco; Boscain, Ugo; Piccoli, Benedetto

    2015-01-01

    In this paper, we introduce the concept of Developmental Partial Differential Equation (DPDE), which consists of a Partial Differential Equation (PDE) on a time-varying manifold with complete coupling between the PDE and the manifold's evolution. In other words, the manifold's evolution depends on the solution to the PDE, and vice versa the differential operator of the PDE depends on the manifold's geometry. DPDE is used to study a diffusion equation with source on a growing surface whose gro...

  6. Breast-Volume Displacement Using an Extended Glandular Flap for Small Dense Breasts

    Directory of Open Access Journals (Sweden)

    Tomoko Ogawa

    2011-01-01

    Full Text Available We defined the glandular flap including fat in the subclavicular area as an extended glandular flap, which has been used for breast-conserving reconstruction in the upper portion of the breast. Indication. The excision volume was 20% to 40% of the breast volume, and the breast density was dense. Surgical Technique. The upper edge of the breast at the subclavicular area was drawn in the standing position before surgery. After partial mastectomy, an extended glandular flap was made by freeing the breast from both the skin and the pectoralis fascia up to the preoperative marking in the subclavicular area. It is important to keep the perforators of the internal mammary artery and/or the branches of the lateral thoracic artery intact while making the flap. Results. Seventeen patients underwent remodeling using an extended glandular flap. The cosmetic results at 1 year after the operation: excellent in 11, good in 1, fair in 3, and poor in 2. All cases of unacceptable outcome except one were cases with complications, and more than 30% resection of moderate or large size breasts did not obtain an excellent result for long-term followup. Conclusion. This technique is useful for performing the breast-conserving reconstruction of small dense breasts.

  7. Glutaminolysis and glycolysis regulation by troglitazone in breast cancer cells: Relationship to mitochondrial membrane potential.

    Science.gov (United States)

    Friday, Ellen; Oliver, Robert; Welbourne, Tomas; Turturro, Francesco

    2011-02-01

    We studied the roles of glycolysis and glutaminolysis following an acute reduction in mitochondrial membrane potential (Ψ(m)) induced by the thiazolidinedione troglitazone (TRO) and compared the responses with CCCP-induced depolarization in breast cancer derived MCF-7 and MDA-MB-231 cells as well as in the MCF-10A normal breast cell line. TRO and CCCP both acutely reduced Ψ(m) but after 24 h TRO-treated cells had restored Ψ(m) associated with both increased glycolysis and glutaminolysis. In contrast, CCCP-treated cells exhibited only a partial restoration of Ψ(m) associated with increased glycolysis but decreased glutaminolysis. TRO-induced glutaminolysis was coupled to increased ammonium (GDH flux) and decreased alanine production (ALT flux) in all three cell lines. Both cancer cell lines exhibited a higher spontaneous GDH/ALT flux than the normal breast cell line associated with a reduced keto-acid pool. TRO's effect on GDH/ALT fluxes and mitochondrial keto-acid pool homeostasis was additive with glucose withdrawal suggesting limited intramitochondrial pyruvate availability. The TRO-induced acceleration in GDH flux supplies substrate for Complex I contributing to the restoration of Ψ(m) as well as Krebs cycle intermediates for biosynthesis. Inhibiting mitochondrial proton ATPase with oligomycin or nullifying the proton gradient with CCCP prevented both the TRO-induced recovery of Ψ(m) and accelerated GDH flux but restored ALT flux consonant with important roles for proton pumping in regulating GDH flux and Ψ(m) recovery. Blocking enhanced GDH flux reduced DNA synthesis consistent with glutaminolysis via GDH playing an important biosynthetic role in tumorigenesis. © 2010 Wiley-Liss, Inc.

  8. Acceleration in astrophysics

    Energy Technology Data Exchange (ETDEWEB)

    Colgate, S.A.

    1993-12-31

    The origin of cosmic rays and applicable laboratory experiments are discussed. Some of the problems of shock acceleration for the production of cosmic rays are discussed in the context of astrophysical conditions. These are: The presumed unique explanation of the power law spectrum is shown instead to be a universal property of all lossy accelerators; the extraordinary isotropy of cosmic rays and the limited diffusion distances implied by supernova induced shock acceleration requires a more frequent and space-filling source than supernovae; the near perfect adiabaticity of strong hydromagnetic turbulence necessary for reflecting the accelerated particles each doubling in energy roughly 10{sup 5} to {sup 6} scatterings with negligible energy loss seems most unlikely; the evidence for acceleration due to quasi-parallel heliosphere shocks is weak. There is small evidence for the expected strong hydromagnetic turbulence, and instead, only a small number of particles accelerate after only a few shock traversals; the acceleration of electrons in the same collisionless shock that accelerates ions is difficult to reconcile with the theoretical picture of strong hydromagnetic turbulence that reflects the ions. The hydromagnetic turbulence will appear adiabatic to the electrons at their much higher Larmor frequency and so the electrons should not be scattered incoherently as they must be for acceleration. Therefore the electrons must be accelerated by a different mechanism. This is unsatisfactory, because wherever electrons are accelerated these sites, observed in radio emission, may accelerate ions more favorably. The acceleration is coherent provided the reconnection is coherent, in which case the total flux, as for example of collimated radio sources, predicts single charge accelerated energies much greater than observed.

  9. Molecular Imaging in Breast Cancer: From Whole-Body PET/CT to Dedicated Breast PET

    Directory of Open Access Journals (Sweden)

    B. B. Koolen

    2012-01-01

    Full Text Available Positron emission tomography (PET, with or without integrated computed tomography (CT, using 18F-fluorodeoxyglucose (FDG is based on the principle of elevated glucose metabolism in malignant tumors, and its use in breast cancer patients is frequently being investigated. It has been shown useful for classification, staging, and response monitoring, both in primary and recurrent disease. However, because of the partial volume effect and limited resolution of most whole-body PET scanners, sensitivity for the visualization of small tumors is generally low. To improve the detection and quantification of primary breast tumors with FDG PET, several dedicated breast PET devices have been developed. In this nonsystematic review, we shortly summarize the value of whole-body PET/CT in breast cancer and provide an overview of currently available dedicated breast PETs.

  10. Dosimetric evaluation in teletherapy for male breast cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Nilmara Almeida; Crispim, Verginia Reis, E-mail: nguimaraes@con.ufrj.br, E-mail: verginia@nuclear.ufrj.br [Coordenacao dos Cursos de Pos-Graduacao em Engenharia (COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear

    2013-07-01

    The present study evaluated dose distribution in the male breast using thermoluminescent dosimeters (TLDs). The rate of male breast cancers has increased in recent years, due to the deficiency of preventive examinations (male mammography). Still, male breasts have smaller volumes than female breasts, thus, from the point of view of radiation protection, it is essential to monitor the doses received by the male breast, as well as those received by healthy and critical organs in order to evaluate radiotherapy performance and aid treatment planning. For this reason, the treatment of male breast cancer was simulated with the radiation by linear accelerator in Alderson Rando phantom and doses were measured with thermoluminescent dosimeters. The results of the treatment planning and measured were compared. (author)

  11. Particle-accelerator decommissioning

    Energy Technology Data Exchange (ETDEWEB)

    Opelka, J.H.; Mundis, R.L.; Marmer, G.J.; Peterson, J.M.; Siskind, B.; Kikta, M.J.

    1979-12-01

    Generic considerations involved in decommissioning particle accelerators are examined. There are presently several hundred accelerators operating in the United States that can produce material containing nonnegligible residual radioactivity. Residual radioactivity after final shutdown is generally short-lived induced activity and is localized in hot spots around the beam line. The decommissioning options addressed are mothballing, entombment, dismantlement with interim storage, and dismantlement with disposal. The recycle of components or entire accelerators following dismantlement is a definite possibility and has occurred in the past. Accelerator components can be recycled either immediately at accelerator shutdown or following a period of storage, depending on the nature of induced activation. Considerations of cost, radioactive waste, and radiological health are presented for four prototypic accelerators. Prototypes considered range from small accelerators having minimal amounts of radioactive mmaterial to a very large accelerator having massive components containing nonnegligible amounts of induced activation. Archival information on past decommissionings is presented, and recommendations concerning regulations and accelerator design that will aid in the decommissioning of an accelerator are given.

  12. Hierarchical clustering of breast cancer methylomes revealed differentially methylated and expressed breast cancer genes.

    Directory of Open Access Journals (Sweden)

    I-Hsuan Lin

    Full Text Available Oncogenic transformation of normal cells often involves epigenetic alterations, including histone modification and DNA methylation. We conducted whole-genome bisulfite sequencing to determine the DNA methylomes of normal breast, fibroadenoma, invasive ductal carcinomas and MCF7. The emergence, disappearance, expansion and contraction of kilobase-sized hypomethylated regions (HMRs and the hypomethylation of the megabase-sized partially methylated domains (PMDs are the major forms of methylation changes observed in breast tumor samples. Hierarchical clustering of HMR revealed tumor-specific hypermethylated clusters and differential methylated enhancers specific to normal or breast cancer cell lines. Joint analysis of gene expression and DNA methylation data of normal breast and breast cancer cells identified differentially methylated and expressed genes associated with breast and/or ovarian cancers in cancer-specific HMR clusters. Furthermore, aberrant patterns of X-chromosome inactivation (XCI was found in breast cancer cell lines as well as breast tumor samples in the TCGA BRCA (breast invasive carcinoma dataset. They were characterized with differentially hypermethylated XIST promoter, reduced expression of XIST, and over-expression of hypomethylated X-linked genes. High expressions of these genes were significantly associated with lower survival rates in breast cancer patients. Comprehensive analysis of the normal and breast tumor methylomes suggests selective targeting of DNA methylation changes during breast cancer progression. The weak causal relationship between DNA methylation and gene expression observed in this study is evident of more complex role of DNA methylation in the regulation of gene expression in human epigenetics that deserves further investigation.

  13. Detecting Energy Modulation in a Dielectric Laser Accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Lukaczyk, Louis [Univ. of Virginia, Charlottesville, VA (United States)

    2015-08-21

    The Dielectric Laser Acceleration group at SLAC uses micro-fabricated dielectric grating structures and conventional infrared lasers to accelerator electrons. These structures have been estimated to produce an accelerating gradient up to 2 orders of magnitude greater than that produced by conventional RF accelerators. The success of the experiment depends on both the laser damage threshold of the structure and the timing overlap of femtosecond duration laser pulses with the electron bunch. In recent dielectric laser acceleration experiments, the laser pulse was shorter both temporally and spatially than the electron bunch. As a result, the laser is theorized to have interacted with only a small portion of the electron bunch. The detection of this phenomenon, referred to as partial population modulation, required a new approach to the data analysis of the electron energy spectra. A fitting function was designed to separate the accelerated electron population from the un-accelerated electron population. The approach was unsuccessful in detecting acceleration in the partial population modulation data. However, the fitting functions provide an excellent figure of merit for previous data known to contain signatures of acceleration.

  14. Diagnostics for advanced laser acceleration experiments

    Energy Technology Data Exchange (ETDEWEB)

    Misuri, Alessio [Univ. of Pisa (Italy)

    2002-01-01

    The first proposal for plasma based accelerators was suggested by 1979 by Tajima and Dawson. Since then there has been a tremendous progress both theoretically and experimentally. The theoretical progress is particularly due to the growing interest in the subject and to the development of more accurate numerical codes for the plasma simulations (especially particle-in-cell codes). The experimental progress follows from the development of multi-terawatt laser systems based on the chirped-pulse amplification technique. These efforts have produced results in several experiments world-wide, with the detection of accelerated electrons of tens of MeV. The peculiarity of these advanced accelerators is their ability to sustain extremely large acceleration gradients. In the conventional radio frequency linear accelerators (RF linacs) the acceleration gradients are limited roughly to 100 MV/m; this is partially due to breakdown which occurs on the walls of the structure. The electrical breakdown is originated by the emission of the electrons from the walls of the cavity. The electrons cause an avalanche breakdown when they reach other metal parts of the RF linacs structure.

  15. Diagnostics for advanced laser acceleration experiments

    Energy Technology Data Exchange (ETDEWEB)

    Misuri, Alessio

    2002-06-01

    The first proposal for plasma based accelerators was suggested by 1979 by Tajima and Dawson. Since then there has been a tremendous progress both theoretically and experimentally. The theoretical progress is particularly due to the growing interest in the subject and to the development of more accurate numerical codes for the plasma simulations (especially particle-in-cell codes). The experimental progress follows from the development of multi-terawatt laser systems based on the chirped-pulse amplification technique. These efforts have produced results in several experiments world-wide, with the detection of accelerated electrons of tens of MeV. The peculiarity of these advanced accelerators is their ability to sustain extremely large acceleration gradients. In the conventional radio frequency linear accelerators (RF linacs) the acceleration gradients are limited roughly to 100 MV/m; this is partially due to breakdown which occurs on the walls of the structure. The electrical breakdown is originated by the emission of the electrons from the walls of the cavity. The electrons cause an avalanche breakdown when they reach other metal parts of the RF linacs structure.

  16. Breast Cancer Surgery

    Science.gov (United States)

    FACTS FOR LIFE Breast Cancer Surgery The goal of breast cancer surgery is to remove the whole tumor from the breast. Some lymph nodes ... might still be in the body. Types of breast cancer surgery There are two types of breast cancer ...

  17. Breast Lift (Mastopexy)

    Science.gov (United States)

    Tests and Procedures Breast lift By Mayo Clinic Staff A breast lift — also known as mastopexy — is a surgical procedure to change the shape of your breasts. During a breast lift, excess skin is removed and breast tissue is ...

  18. Breast awareness and screening.

    Science.gov (United States)

    Harmer, Victoria

    Breast cancer is the most commonly diagnosed cancer in the UK. Breast awareness and screening, along with better treatment, can significantly improve outcomes, and more women than ever are now surviving the disease. This article discusses breast awareness and screening, symptoms and risk factors for breast cancer, and how nurses can raise breast awareness and screening uptake.

  19. Leaky Fermi accelerators

    CERN Document Server

    Shah, Kushal; Rom-Kedar, Vered; Turaev, Dmitry

    2015-01-01

    A Fermi accelerator is a billiard with oscillating walls. A leaky accelerator interacts with an environment of an ideal gas at equilibrium by exchange of particles through a small hole on its boundary. Such interaction may heat the gas: we estimate the net energy flow through the hole under the assumption that the particles inside the billiard do not collide with each other and remain in the accelerator for sufficiently long time. The heat production is found to depend strongly on the type of the Fermi accelerator. An ergodic accelerator, i.e. one which has a single ergodic component, produces a weaker energy flow than a multi-component accelerator. Specifically, in the ergodic case the energy gain is independent of the hole size, whereas in the multi-component case the energy flow may be significantly increased by shrinking the hole size.

  20. Accelerator reliability workshop

    Energy Technology Data Exchange (ETDEWEB)

    Hardy, L.; Duru, Ph.; Koch, J.M.; Revol, J.L.; Van Vaerenbergh, P.; Volpe, A.M.; Clugnet, K.; Dely, A.; Goodhew, D

    2002-07-01

    About 80 experts attended this workshop, which brought together all accelerator communities: accelerator driven systems, X-ray sources, medical and industrial accelerators, spallation sources projects (American and European), nuclear physics, etc. With newly proposed accelerator applications such as nuclear waste transmutation, replacement of nuclear power plants and others. Reliability has now become a number one priority for accelerator designers. Every part of an accelerator facility from cryogenic systems to data storage via RF systems are concerned by reliability. This aspect is now taken into account in the design/budget phase, especially for projects whose goal is to reach no more than 10 interruptions per year. This document gathers the slides but not the proceedings of the workshop.

  1. Accelerator and radiation physics

    CERN Document Server

    Basu, Samita; Nandy, Maitreyee

    2013-01-01

    "Accelerator and radiation physics" encompasses radiation shielding design and strategies for hadron therapy accelerators, neutron facilities and laser based accelerators. A fascinating article describes detailed transport theory and its application to radiation transport. Detailed information on planning and design of a very high energy proton accelerator can be obtained from the article on radiological safety of J-PARC. Besides safety for proton accelerators, the book provides information on radiological safety issues for electron synchrotron and prevention and preparedness for radiological emergencies. Different methods for neutron dosimetry including LET based monitoring, time of flight spectrometry, track detectors are documented alongwith newly measured experimental data on radiation interaction with dyes, polymers, bones and other materials. Design of deuteron accelerator, shielding in beam line hutches in synchrotron and 14 MeV neutron generator, various radiation detection methods, their characteriza...

  2. DEGRO practical guidelines: radiotherapy of breast cancer II. Radiotherapy of non-invasive neoplasia of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Souchon, R. [University Hospital Tuebingen, Klinik fuer Radioonkologie, Tuebingen (Germany); Sautter-Bihl, M.L. [Municipal Hospital Karlsruhe, Karlsruhe (Germany); Sedlmayer, F. [LKH Salzburg, Paracelsus Medical University Hospital, Salzburg (Austria); Budach, W. [University Hospital Duesseldorf, Duesseldorf (Germany); Dunst, J. [University Hospital Schleswig-Holstein, Luebeck (Germany); Feyer, P. [Klinikum Neukoelln, Berlin (Germany); Fietkau, R.; Sauer, R. [University Hospital Erlangen, Erlangen (Germany); Harms, W. [St. Clara Hospital, Basel (Switzerland); Wenz, F. [University Hospital Mannheim, Mannheim (Germany); Haase, W.

    2014-01-15

    . Randomized clinical trials and a huge number of mostly observational studies have unanimously demonstrated that RT significantly reduces recurrence risks of ipsilateral DCIS as well as invasive breast cancer independent of patient age in all subgroups. The recommended total dose is 50 Gy administered as whole breast irradiation (WBI) in single fractions of 1.8 or 2.0 Gy given on 5 days weekly. Retrospective data indicate a possible beneficial effect of an additional tumor bed boost for younger patients. Prospective clinical trials of different dose-volume concepts (hypofractionation, accelerated partial breast irradiation, boost radiotherapy) are still ongoing. Postoperative radiotherapy permits breast conservation for the majority of women by halving local recurrence as well as reducing progression rates into invasive cancer. New data confirmed this effect in all patient subsets - even in low risk subgroups (LoE 1a). (orig.) [German] Aktualisierung und Ergaenzung der 2007 von der DEGRO-Expertengruppe Mammakarzinom publizierten Leitlinie zur Radiotherapie (RT) des Mammakarzinoms. Aufgrund der zunehmenden klinischen Relevanz nicht-invasiver epithelialer Neoplasien der Brust wurde diesen in der aktuellen Version ein eigenes Kapitel gewidmet. Schwerpunkte der hier vorgelegten Empfehlungen sind - in Ergaenzung zu den S3-Leitlinien der Deutschen Krebsgesellschaft von 2012 - die Indikation und Technik der postoperativen RT nach brusterhaltender Operation. Die DEGRO-Expertengruppe fuehrte eine Literaturrecherche aktueller klinisch kontrollierter Studien, systematischer Reviews und Metaanalysen, orientiert an den Kriterien der evidenzbasierten Medizin, im Hinblick auf neue Aspekte gegenueber 2005 und 2007 durch. Die Recherche umfasst die Zeitspanne 2008 bis September 2012 und erstreckte sich auf in PubMed und Guidelines International Network (G-I-N) gelisteten Publikationen. Suchbegriffe waren ''non invasive breast cancer'', ''ductal carcinoma in situ

  3. Power Converters for Accelerators

    CERN Document Server

    Visintini, R

    2015-01-01

    Particle accelerators use a great variety of power converters for energizing their sub-systems; while the total number of power converters usually depends on the size of the accelerator or combination of accelerators (including the experimental setup), the characteristics of power converters depend on their loads and on the particle physics requirements: this paper aims to provide an overview of the magnet power converters in use in several facilities worldwide.

  4. Miniaturization Techniques for Accelerators

    Energy Technology Data Exchange (ETDEWEB)

    Spencer, James E.

    2003-05-27

    The possibility of laser driven accelerators [1] suggests the need for new structures based on micromachining and integrated circuit technology because of the comparable scales. Thus, we are exploring fully integrated structures including sources, optics (for both light and particle) and acceleration in a common format--an accelerator-on-chip (AOC). Tests suggest a number of preferred materials and techniques but no technical or fundamental roadblocks at scales of order 1 {micro}m or larger.

  5. Quantification of intra-fraction motion in breast radiotherapy using supine magnetic resonance imaging

    Science.gov (United States)

    van Heijst, Tristan C. F.; Philippens, Mariëlle E. P.; Charaghvandi, Ramona K.; den Hartogh, Mariska D.; Lagendijk, Jan J. W.; Desirée van den Bongard, H. J. G.; van Asselen, Bram

    2016-02-01

    In early-stage breast-cancer patients, accelerated partial-breast irradiation techniques (APBI) and hypofractionation are increasingly implemented after breast-conserving surgery (BCS). For a safe and effective radiation therapy (RT), the influence of intra-fraction motion during dose delivery becomes more important as associated fraction durations increase and targets become smaller. Current image-guidance techniques are insufficient to characterize local target movement in high temporal and spatial resolution for extended durations. Magnetic resonance imaging (MRI) can provide high soft-tissue contrast, allow fast imaging, and acquire images during longer periods. The goal of this study was to quantify intra-fraction motion using MRI scans from 21 breast-cancer patients, before and after BCS, in supine RT position, on two time scales. High-temporal 2-dimensional (2D) MRI scans (cine-MRI), acquired every 0.3 s during 2 min, and three 3D MRI scans, acquired over 20 min, were performed. The tumor (bed) and whole breast were delineated on 3D scans and delineations were transferred to the cine-MRI series. Consecutive scans were rigidly registered and delineations were transformed accordingly. Motion in sub-second time-scale (derived from cine-MRI) was generally regular and limited to a median of 2 mm. Infrequently, large deviations were observed, induced by deep inspiration, but these were temporary. Movement on multi-minute scale (derived from 3D MRI) varied more, although medians were restricted to 2.2 mm or lower. Large whole-body displacements (up to 14 mm over 19 min) were sparsely observed. The impact of motion on standard RT techniques is likely small. However, in novel hypofractionated APBI techniques, whole-body shifts may affect adequate RT delivery, given the increasing fraction durations and smaller targets. Motion management may thus be required. For this, on-line MRI guidance could be provided by a hybrid MRI/RT modality, such as the

  6. Methanol partial oxidation reformer

    Science.gov (United States)

    Ahmed, Shabbir; Kumar, Romesh; Krumpelt, Michael

    1999-01-01

    A partial oxidation reformer comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell.

  7. Partial differential equations

    CERN Document Server

    Evans, Lawrence C

    2010-01-01

    This text gives a comprehensive survey of modern techniques in the theoretical study of partial differential equations (PDEs) with particular emphasis on nonlinear equations. The exposition is divided into three parts: representation formulas for solutions; theory for linear partial differential equations; and theory for nonlinear partial differential equations. Included are complete treatments of the method of characteristics; energy methods within Sobolev spaces; regularity for second-order elliptic, parabolic, and hyperbolic equations; maximum principles; the multidimensional calculus of variations; viscosity solutions of Hamilton-Jacobi equations; shock waves and entropy criteria for conservation laws; and, much more.The author summarizes the relevant mathematics required to understand current research in PDEs, especially nonlinear PDEs. While he has reworked and simplified much of the classical theory (particularly the method of characteristics), he primarily emphasizes the modern interplay between funct...

  8. FFAGS for rapid acceleration

    Energy Technology Data Exchange (ETDEWEB)

    Carol J. Johnstone and Shane Koscielniak

    2002-09-30

    When large transverse and longitudinal emittances are to be transported through a circular machine, extremely rapid acceleration holds the advantage that the beam becomes immune to nonlinear resonances because there is insufficient time for amplitudes to build up. Uncooled muon beams exhibit large emittances and require fast acceleration to avoid decay losses and would benefit from this style of acceleration. The approach here employs a fixed-field alternating gradient or FFAG magnet structure and a fixed frequency acceleration system. Acceptance is enhanced by the use only of linear lattice elements, and fixed-frequency rf enables the use of cavities with large shunt resistance and quality factor.

  9. FFAGS FOR MUON ACCELERATION.

    Energy Technology Data Exchange (ETDEWEB)

    BERG,J.S.KAHN,S.PALMER,R.TRBOJEVIC,D.JOHNSTONE,C.KEIL,Y.OGITSU,T.OHMORI,C.SESSLER,A.KOSCIELNIAK,S.

    2003-06-26

    Due to their finite lifetime, muons must be accelerated very rapidly. It is challenging to make the magnets ramp fast enough to accelerate in a synchrotron, and accelerating in a linac is very expensive. One can use a recirculating accelerator (like CEBAF), but one needs a different arc for each turn, and this limits the number of turns one can use to accelerate, and therefore requires significant amounts of RF to achieve the desired energy gain. An alternative method for muon acceleration is using a fixed field alternating gradient (FFAG) accelerator. Such an accelerator has a very large energy acceptance (a factor of two or three), allowing one to use the same arc with a magnetic field that is constant over time. Thus, one can in principle make as many turns as one can tolerate due to muon decay, therefore reducing the RF cost without increasing the arc cost. This paper reviews the current status of research into the design of FFAGs for muon acceleration. Several current designs are described and compared. General design considerations are also discussed.

  10. High Gradient Accelerator Research

    Energy Technology Data Exchange (ETDEWEB)

    Temkin, Richard [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States). Dept. of Physics. Plasma Science and Fusion Center

    2016-07-12

    The goal of the MIT program of research on high gradient acceleration is the development of advanced acceleration concepts that lead to a practical and affordable next generation linear collider at the TeV energy level. Other applications, which are more near-term, include accelerators for materials processing; medicine; defense; mining; security; and inspection. The specific goals of the MIT program are: • Pioneering theoretical research on advanced structures for high gradient acceleration, including photonic structures and metamaterial structures; evaluation of the wakefields in these advanced structures • Experimental research to demonstrate the properties of advanced structures both in low-power microwave cold test and high-power, high-gradient test at megawatt power levels • Experimental research on microwave breakdown at high gradient including studies of breakdown phenomena induced by RF electric fields and RF magnetic fields; development of new diagnostics of the breakdown process • Theoretical research on the physics and engineering features of RF vacuum breakdown • Maintaining and improving the Haimson / MIT 17 GHz accelerator, the highest frequency operational accelerator in the world, a unique facility for accelerator research • Providing the Haimson / MIT 17 GHz accelerator facility as a facility for outside users • Active participation in the US DOE program of High Gradient Collaboration, including joint work with SLAC and with Los Alamos National Laboratory; participation of MIT students in research at the national laboratories • Training the next generation of Ph. D. students in the field of accelerator physics.

  11. Breast reconstruction following amputation for cancer

    Directory of Open Access Journals (Sweden)

    Višnjić Milan

    2009-01-01

    Full Text Available Background/Aim. Today, breast reconstruction is a widely accepted method in the treatment of breast cancer after modified radical mastectomy. Reconstruction methods are associated with an acceptable number of complications and reconstruction favorably impacts quality of life. The aim of the study was to present our experience in breast reconstruction. Methods. We presented here a four-year experience with 84 patients with breast reconstruction after modified radical mastectomy. Results. Implant reconstructions were most common, 44 (52.3%, with primary reconstruction in 31(70.4% and secondary in 13 (29.5% women. Lattisimus dorsi flap (LDF and implant were utilized in 32 (38% of the patients, with primary reconstruction in 24 (75% and secondary in 8 (25% women. Transversal rectus abdominis myocutaneous (TRAM flap was rarely used - just in 8 (9.5% patients and only for secondary breast reconstruction. Postoperatively, some early complications such as hematoma, seroma, infections and partial flap necrosis were observed in 10 (11.9% patients. Late complications, such as implant rejection, hypertrophic scarring and hernias at the flap elevation site, were noted in 10 (11.9% cases. Implant loss occurred in 5 (5.9% cases. All the complications were successfully managed, and patients rated their reconstruction as follows: excellent, 49 (59% cases; very good, 20 (24%, and good, 14 (16.8%. In one case, disease progression was observed 6 months after the primary breast reconstruction. Conclusion. Breast reconstruction is an acceptable method in the treatment of breast cancer in patients in the need for or with already performed mastectomy. The choice of reconstruction approach depends on the breast volume, patient's wish and experience of surgical team. Our results suggest the advantage of breast reconstruction with LDF with implant, since the technique is safe, complications relatively rare and easily manageable, and the results are excellent or very good

  12. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy uses sound waves ... Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the breast are often ...

  13. Stereotactic (Mammographically Guided) Breast Biopsy

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type ... Breast Biopsy? What is Stereotactic (Mammographically Guided) Breast Biopsy? Lumps or abnormalities in the breast are often ...

  14. [Breast ductoscopy].

    Science.gov (United States)

    Sharon, Eran; Avin, Ilan D; Leong, Wey

    2011-02-01

    The majority of benign and malignant breast diseases originate in the ductal system. Breast ductoscopy (BD) allows direct access to this ductal system and thus holds great promise in the diagnosis and surgical management of a number of breast diseases. BD was first developed over 20 years ago to investigate nipple discharge. Indeed, till now, this remains the most common indication. However, BD technology has been further developed for a variety of new clinical applications. For example, BD-guided ductal ravage combined with molecular and genetic analysis can be a powerful screening tool for women at high-risk of breast cancer. BD can also be used during lumpectomy to identify additional radiographically occult disease. This refined intraoperative margin assessment can help surgeons to achieve clear margins at the first excision while optimizing the extent of resection. In the future, this same precise intraoperative margin assessment may facilitate a variety of local ablative techniques including laser Over time, BD is likely to evolve beyond its current technological limitations to realize its full diagnostic and therapeutic potential. The article describes the technique of BD, reviews its evolution and discusses current and future applications.

  15. Breast cancer

    CERN Multimedia

    2002-01-01

    "Cancer specialists will soon be able to compare mammograms with computerized images of breast cancer from across Europe, in a bid to improve diagnosis and treatment....The new project, known as MammoGrid, brings together computer and medical imaging experts, cancer specialists, radiologists and epidemiologists from Bristol, Oxford, Cambridge, France and Italy" (1 page).

  16. Breast reduction

    Science.gov (United States)

    ... may need a mammogram before the surgery. Your plastic surgeon will do a routine breast exam. You may ... the first year, but will then fade. The surgeon will make every ... the scars should not be noticeable, even in low-cut clothing.

  17. The future of partial nephrectomy.

    Science.gov (United States)

    Malthouse, Theo; Kasivisvanathan, Veeru; Raison, Nicholas; Lam, Wayne; Challacombe, Ben

    2016-12-01

    Innovation in recent times has accelerated due to factors such as the globalization of communication; but there are also more barriers/safeguards in place than ever before as we strive to streamline this process. From the first planned partial nephrectomy completed in 1887, it took over a century to become recommended practice for small renal tumours. At present, identified areas for improvement/innovation are 1) to preserve renal parenchyma, 2) to optimise pre-operative eGFR and 3) to reduce global warm ischaemia time. All 3 of these, are statistically significant predictors of post-operative renal function. Urologists, have a proud history of embracing innovation & have experimented with different clamping techniques of the renal vasculature, image guidance in robotics, renal hypothermia, lasers and new robots under development. The DaVinci model may soon no longer have a monopoly on this market, as it loses its stranglehold with novel technology emerging including added features, such as haptic feedback with reduced costs. As ever, our predictions of the future may well fall wide of the mark, but in order to progress, one must open the mind to the possibilities that already exist, as evolution of existing technology often appears to be a revolution in hindsight.

  18. Breast reconstruction - implants

    Science.gov (United States)

    ... After a mastectomy , some women choose to have cosmetic surgery to remake their breast. This type of surgery ... to the breast or the new nipple. Having cosmetic surgery after breast cancer can improve your sense of ...

  19. Breast lift (mastopexy) - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100188.htm Breast lift (mastopexy) - series—Incisions To use the sharing features ... to slide 3 out of 3 Overview Breast lift (mastopexy) is usually performed for drooping breasts, which ...

  20. Breast Cancer Disparities

    Science.gov (United States)

    ... 2.65 MB] Read the MMWR Science Clips Breast Cancer Black Women Have Higher Death Rates from Breast ... of Page U.S. State Info Number of Additional Breast Cancer Deaths Among Black Women, By State SOURCE: National ...

  1. Male Breast Cancer

    Science.gov (United States)

    ... breast cancer include exposure to radiation, a family history of breast cancer, and having high estrogen levels, which can happen with diseases like cirrhosis or Klinefelter's syndrome. Treatment for male breast cancer is usually ...

  2. Partially Hidden Markov Models

    DEFF Research Database (Denmark)

    Forchhammer, Søren Otto; Rissanen, Jorma

    1996-01-01

    Partially Hidden Markov Models (PHMM) are introduced. They differ from the ordinary HMM's in that both the transition probabilities of the hidden states and the output probabilities are conditioned on past observations. As an illustration they are applied to black and white image compression wher...

  3. Fundamental partial compositeness

    DEFF Research Database (Denmark)

    Sannino, Francesco; Strumia, Alessandro; Tesi, Andrea

    2016-01-01

    We construct renormalizable Standard Model extensions, valid up to the Planck scale, that give a composite Higgs from a new fundamental strong force acting on fermions and scalars. Yukawa interactions of these particles with Standard Model fermions realize the partial compositeness scenario. Unde...

  4. Partial Ileal Bypass Undone

    NARCIS (Netherlands)

    Beynen, A.C.; Schouten, J.A.; Hoitsma, H.F.W.

    1984-01-01

    Partial ileal bypass (PIB) for the treatment of hypercholesterolaemia was introduced 20 years ago. About 110 cases have been described. We know of only 1 case of restoration of intestinal continuity; no details were given. We report here the second case of PIB in the Netherlands; the operation was r

  5. Dilemmas of partial cooperation.

    Science.gov (United States)

    Stark, Hans-Ulrich

    2010-08-01

    Related to the often applied cooperation models of social dilemmas, we deal with scenarios in which defection dominates cooperation, but an intermediate fraction of cooperators, that is, "partial cooperation," would maximize the overall performance of a group of individuals. Of course, such a solution comes at the expense of cooperators that do not profit from the overall maximum. However, because there are mechanisms accounting for mutual benefits after repeated interactions or through evolutionary mechanisms, such situations can constitute "dilemmas" of partial cooperation. Among the 12 ordinally distinct, symmetrical 2 x 2 games, three (barely considered) variants are correspondents of such dilemmas. Whereas some previous studies investigated particular instances of such games, we here provide the unifying framework and concisely relate it to the broad literature on cooperation in social dilemmas. Complementing our argumentation, we study the evolution of partial cooperation by deriving the respective conditions under which coexistence of cooperators and defectors, that is, partial cooperation, can be a stable outcome of evolutionary dynamics in these scenarios. Finally, we discuss the relevance of such models for research on the large biodiversity and variation in cooperative efforts both in biological and social systems.

  6. Comparison of Patient-reported Outcomes after Implant Versus Autologous Tissue Breast Reconstruction Using the BREAST-Q

    Science.gov (United States)

    Pirro, Ortensia; Vindigni, Vincenzo; Sukop, Andrej; Hromadkova, Veronika; Nguyenova, Alena; Vitova, Lenka; Bassetto, Franco

    2017-01-01

    Background: The demand for reconstructive breast procedures of various types has accelerated in recent years. Coupled with increased patient expectations, it has fostered the development of oncoplastic and reconstructive techniques in breast surgery. In the setting of postmastectomy reconstruction, patient satisfaction and quality of life are the most significant outcome variables when evaluating surgical success. The aim of this study was to evaluate the quality of life after implant breast reconstruction compared with autologous breast reconstruction. Materials and Methods: A cross-sectional study design was used. A total of 65 women who had completed postmastectomy implant-based or autologous reconstruction in the participating center were asked to complete the BREAST-Q (Reconstruction Module). Results: Data analysis demonstrated that women with autologous breast reconstruction were significantly more satisfied with their breasts (P = 0.0003) and with the overall outcome (P = 0.0001) compared with women with implant breast reconstruction. All other BREAST-Q parameters that were considered and observed were not significantly different between the 2 patient groups. Conclusions: Through statistical analysis, our results showed that patients who underwent autologous tissue reconstruction had better satisfaction with the reconstructed breast and the outcome, while both techniques appear to equally improve psychosocial well-being, sexual well-being, and chest satisfaction. PMID:28203513

  7. Comparison of Patient-reported Outcomes after Implant Versus Autologous Tissue Breast Reconstruction Using the BREAST-Q.

    Science.gov (United States)

    Pirro, Ortensia; Mestak, Ondrej; Vindigni, Vincenzo; Sukop, Andrej; Hromadkova, Veronika; Nguyenova, Alena; Vitova, Lenka; Bassetto, Franco

    2017-01-01

    The demand for reconstructive breast procedures of various types has accelerated in recent years. Coupled with increased patient expectations, it has fostered the development of oncoplastic and reconstructive techniques in breast surgery. In the setting of postmastectomy reconstruction, patient satisfaction and quality of life are the most significant outcome variables when evaluating surgical success. The aim of this study was to evaluate the quality of life after implant breast reconstruction compared with autologous breast reconstruction. A cross-sectional study design was used. A total of 65 women who had completed postmastectomy implant-based or autologous reconstruction in the participating center were asked to complete the BREAST-Q (Reconstruction Module). Data analysis demonstrated that women with autologous breast reconstruction were significantly more satisfied with their breasts (P = 0.0003) and with the overall outcome (P = 0.0001) compared with women with implant breast reconstruction. All other BREAST-Q parameters that were considered and observed were not significantly different between the 2 patient groups. Through statistical analysis, our results showed that patients who underwent autologous tissue reconstruction had better satisfaction with the reconstructed breast and the outcome, while both techniques appear to equally improve psychosocial well-being, sexual well-being, and chest satisfaction.

  8. Breast cancer in pregnancy.

    Science.gov (United States)

    Krishna, Iris; Lindsay, Michael

    2013-09-01

    Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy or in the first postpartum year. Breast cancer is one of the more common malignancies to occur during pregnancy and, as more women delay childbearing, the incidence of breast cancer in pregnancy is expected to increase. This article provides an overview of diagnosis, staging, and treatment of pregnancy-associated breast cancer. Recommendations for management of breast cancer in pregnancy are discussed.

  9. Algebraic partial Boolean algebras

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Derek [Math Department, Lafayette College, Easton, PA 18042 (United States)

    2003-04-04

    Partial Boolean algebras, first studied by Kochen and Specker in the 1960s, provide the structure for Bell-Kochen-Specker theorems which deny the existence of non-contextual hidden variable theories. In this paper, we study partial Boolean algebras which are 'algebraic' in the sense that their elements have coordinates in an algebraic number field. Several of these algebras have been discussed recently in a debate on the validity of Bell-Kochen-Specker theorems in the context of finite precision measurements. The main result of this paper is that every algebraic finitely-generated partial Boolean algebra B(T) is finite when the underlying space H is three-dimensional, answering a question of Kochen and showing that Conway and Kochen's infinite algebraic partial Boolean algebra has minimum dimension. This result contrasts the existence of an infinite (non-algebraic) B(T) generated by eight elements in an abstract orthomodular lattice of height 3. We then initiate a study of higher-dimensional algebraic partial Boolean algebras. First, we describe a restriction on the determinants of the elements of B(T) that are generated by a given set T. We then show that when the generating set T consists of the rays spanning the minimal vectors in a real irreducible root lattice, B(T) is infinite just if that root lattice has an A{sub 5} sublattice. Finally, we characterize the rays of B(T) when T consists of the rays spanning the minimal vectors of the root lattice E{sub 8}.

  10. Asia honours accelerator physicists

    CERN Multimedia

    2010-01-01

    "Steve Meyers of Cern and Jie Wei of Beijing's Tsinghua University are the first recipients of a new prize for particle physics. The pair were honoured for their contributions to numerous particle-accelerator projects - including Cern's Large Hadron Collider - by the Asian Committee for Future Accelerators (ACFA)..." (1 paragraph)

  11. COLLECTIVE-FIELD ACCELERATION

    Energy Technology Data Exchange (ETDEWEB)

    Sessler, Andrew M.

    1969-07-04

    Diverse methods proposed for the acceleration of particles by means of collective fields are reviewed. A survey is made of the various currently active experimental programs devoted to investigating collective acceleration, and the present status of the research is briefly noted.

  12. Accelerators Beyond The Tevatron?

    Energy Technology Data Exchange (ETDEWEB)

    Lach, Joseph; /Fermilab

    2010-07-01

    Following the successful operation of the Fermilab superconducting accelerator three new higher energy accelerators were planned. They were the UNK in the Soviet Union, the LHC in Europe, and the SSC in the United States. All were expected to start producing physics about 1995. They did not. Why?

  13. KEK digital accelerator

    Science.gov (United States)

    Iwashita, T.; Adachi, T.; Takayama, K.; Leo, K. W.; Arai, T.; Arakida, Y.; Hashimoto, M.; Kadokura, E.; Kawai, M.; Kawakubo, T.; Kubo, Tomio; Koyama, K.; Nakanishi, H.; Okazaki, K.; Okamura, K.; Someya, H.; Takagi, A.; Tokuchi, A.; Wake, M.

    2011-07-01

    The High Energy Accelerator Research Organization KEK digital accelerator (KEK-DA) is a renovation of the KEK 500 MeV booster proton synchrotron, which was shut down in 2006. The existing 40 MeV drift tube linac and rf cavities have been replaced by an electron cyclotron resonance (ECR) ion source embedded in a 200 kV high-voltage terminal and induction acceleration cells, respectively. A DA is, in principle, capable of accelerating any species of ion in all possible charge states. The KEK-DA is characterized by specific accelerator components such as a permanent magnet X-band ECR ion source, a low-energy transport line, an electrostatic injection kicker, an extraction septum magnet operated in air, combined-function main magnets, and an induction acceleration system. The induction acceleration method, integrating modern pulse power technology and state-of-art digital control, is crucial for the rapid-cycle KEK-DA. The key issues of beam dynamics associated with low-energy injection of heavy ions are beam loss caused by electron capture and stripping as results of the interaction with residual gas molecules and the closed orbit distortion resulting from relatively high remanent fields in the bending magnets. Attractive applications of this accelerator in materials and biological sciences are discussed.

  14. KEK digital accelerator

    Directory of Open Access Journals (Sweden)

    T. Iwashita

    2011-07-01

    Full Text Available The High Energy Accelerator Research Organization KEK digital accelerator (KEK-DA is a renovation of the KEK 500 MeV booster proton synchrotron, which was shut down in 2006. The existing 40 MeV drift tube linac and rf cavities have been replaced by an electron cyclotron resonance (ECR ion source embedded in a 200 kV high-voltage terminal and induction acceleration cells, respectively. A DA is, in principle, capable of accelerating any species of ion in all possible charge states. The KEK-DA is characterized by specific accelerator components such as a permanent magnet X-band ECR ion source, a low-energy transport line, an electrostatic injection kicker, an extraction septum magnet operated in air, combined-function main magnets, and an induction acceleration system. The induction acceleration method, integrating modern pulse power technology and state-of-art digital control, is crucial for the rapid-cycle KEK-DA. The key issues of beam dynamics associated with low-energy injection of heavy ions are beam loss caused by electron capture and stripping as results of the interaction with residual gas molecules and the closed orbit distortion resulting from relatively high remanent fields in the bending magnets. Attractive applications of this accelerator in materials and biological sciences are discussed.

  15. Acceleration of polarized protons in the AGS

    Energy Technology Data Exchange (ETDEWEB)

    Tsoupas, N.; Ahrens, L.; Bai, M.; Brown, K.; Courant, E.; Glenn, J.W.; Huang, H.; Luccio, A.; MacKay, W.W.; Roser, T.; Schoefer, V.; Zeno, K.

    2010-02-25

    The high energy (s{sup 1/2} = 500 GeV) polarized proton beam experiments performed in RHIC, require high polarization of the proton beam. With the AGS used as the pre-injector to RHIC, one of the main tasks is to preserve the polarization of the proton beam, during the beam acceleration in the AGS. The polarization preservation is accomplished by the two partial helical magnets [1,2,3,4,5,6,7] which have been installed in AGS, and help overcome the imperfection and the intrinsic spin resonances which occur during the acceleration of protons. This elimination of the intrinsic resonances is accomplished by placing the vertical tune Q{sub y} at a value close to 8.98, within the spin-tune stop-band created by the snake. At this near integer tune the perturbations caused by the partial helical magnets is large resulting in large beta and dispersion waves. To mitigate the adverse effect of the partial helices on the optics of the AGS, we have introduced compensation quads[2] in the AGS. In this paper we present the beam optics of the AGS which ameliorates this effect of the partial helices.

  16. Breast reconstruction after breast cancer.

    Science.gov (United States)

    Serletti, Joseph M; Fosnot, Joshua; Nelson, Jonas A; Disa, Joseph J; Bucky, Louis P

    2011-06-01

    After reading this article, the participant should be able to: 1. Describe the mental, emotional, and physical benefits of reconstruction in breast cancer patients. 2. Compare the most common techniques of reconstruction in patients and detail benefits and risks associated with each. 3. Outline different methods of reconstruction and identify the method considered best for the patient based on timing of the procedures, body type, adjuvant therapies, and other coexisting conditions. 4. Distinguish between some of the different flaps that can be considered for autologous reconstruction. Breast cancer is unfortunately a common disease affecting millions of women, often at a relatively young age. Reconstruction following mastectomy offers women an opportunity to mollify some of the emotional and aesthetic effects of this devastating disease. Although varying techniques of alloplastic and autologous techniques are available, all strive to achieve the same goal: the satisfactory reformation of a breast mound that appears as natural as possible without clothing and at the very least is normal in appearance under clothing. This article summarizes the various approaches to breast reconstruction and offers a balanced view of the risks and benefits of each, all of which in the end offer the opportunity for excellent and predictable results with a high degree of patient satisfaction.

  17. Accelerators, Beams And Physical Review Special Topics - Accelerators And Beams

    Energy Technology Data Exchange (ETDEWEB)

    Siemann, R.H.; /SLAC

    2011-10-24

    Accelerator science and technology have evolved as accelerators became larger and important to a broad range of science. Physical Review Special Topics - Accelerators and Beams was established to serve the accelerator community as a timely, widely circulated, international journal covering the full breadth of accelerators and beams. The history of the journal and the innovations associated with it are reviewed.

  18. Second cancer incidence risk estimates using BEIR VII models for standard and complex external beam radiotherapy for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Donovan, E. M.; James, H.; Bonora, M.; Yarnold, J. R.; Evans, P. M. [Joint Department of Physics, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton SM2 5PT (United Kingdom); Physics Department, Ipswich Hospital NHS Foundation Trust, Ipswich IP4 5PD (United Kingdom); Department of Academic Radiotherapy, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton SM2 5PT, United Kingdom and School of Radiotherapy, University of Milan, Milan 20122 (Italy); Department of Academic Radiotherapy, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton SM2 5PT (United Kingdom); Centre for Vision Speech and Signal Processing, University of Surrey, Guildford GU2 7XH (United Kingdom)

    2012-10-15

    Purpose: To compare organ specific cancer incidence risks for standard and complex external beam radiotherapy (including cone beam CT verification) following breast conservation surgery for early breast cancer.Method: Doses from breast radiotherapy and kilovoltage cone beam CT (CBCT) exposures were obtained from thermoluminescent dosimeter measurements in an anthropomorphic phantom in which the positions of radiosensitive organs were delineated. Five treatment deliveries were investigated: (i) conventional tangential field whole breast radiotherapy (WBRT), (ii) noncoplanar conformal delivery applicable to accelerated partial beast irradiation (APBI), (iii) two-volume simultaneous integrated boost (SIB) treatment, (iv) forward planned three-volume SIB, and (v) inverse-planned three volume SIB. Conformal and intensity modulated radiotherapy methods were used to plan the complex treatments. Techniques spanned the range from simple methods appropriate for patient cohorts with a low cancer recurrence risk to complex plans relevant to cohorts with high recurrence risk. Delineated organs at risk included brain, salivary glands, thyroid, contralateral breast, left and right lung, esophagus, stomach, liver, colon, and bladder. Biological Effects of Ionizing Radiation (BEIR) VII cancer incidence models were applied to the measured mean organ doses to determine lifetime attributable risk (LAR) for ages at exposure from 35 to 80 yr according to radiotherapy techniques, and included dose from the CBCT imaging. Results: All LAR decreased with age at exposure and were lowest for brain, thyroid, liver, and bladder (<0.1%). There was little dependence of LAR on radiotherapy technique for these organs and for colon and stomach. LAR values for the lungs for the three SIB techniques were two to three times those from WBRT and APBI. Uncertainties in the LAR models outweigh any differences in lung LAR between the SIB methods. Constraints in the planning of the SIB methods ensured that

  19. The Accelerated Kepler Problem

    CERN Document Server

    Namouni, Fathi

    2007-01-01

    The accelerated Kepler problem is obtained by adding a constant acceleration to the classical two-body Kepler problem. This setting models the dynamics of a jet-sustaining accretion disk and its content of forming planets as the disk loses linear momentum through the asymmetric jet-counterjet system it powers. The dynamics of the accelerated Kepler problem is analyzed using physical as well as parabolic coordinates. The latter naturally separate the problem's Hamiltonian into two unidimensional Hamiltonians. In particular, we identify the origin of the secular resonance in the accelerated Kepler problem and determine analytically the radius of stability boundary of initially circular orbits that are of particular interest to the problem of radial migration in binary systems as well as to the truncation of accretion disks through stellar jet acceleration.

  20. On Accelerated Black Holes

    CERN Document Server

    Letelier, P S; Letelier, Patricio S.; Oliveira, Samuel R.

    1998-01-01

    The C-metric is revisited and global interpretation of some associated spacetimes are studied in some detail. Specially those with two event horizons, one for the black hole and another for the acceleration. We found that the spacetime fo an accelerated Schwarzschild black hole is plagued by either conical singularities or lack of smoothness and compactness of the black hole horizon. By using standard black hole thermodynamics we show that accelerated black holes have higher Hawking temperature than Unruh temperature. We also show that the usual upper bound on the product of the mass and acceleration parameters (<1/sqrt(27)) is just a coordinate artifact. The main results are extended to accelerated Kerr black holes. We found that they are not changed by the black hole rotation.

  1. Overcoming Depolarizing Resonances with Dual Helical Partial Siberian Snakes

    Science.gov (United States)

    Huang, H.; Ahrens, L. A.; Bai, M.; Brown, K.; Courant, E. D.; Gardner, C.; Glenn, J. W.; Lin, F.; Luccio, A. U.; Mackay, W. W.; Okamura, M.; Ptitsyn, V.; Roser, T.; Takano, J.; Tepikian, S.; Tsoupas, N.; Zelenski, A.; Zeno, K.

    2007-10-01

    Acceleration of polarized protons in the energy range of 5 to 25 GeV is challenging. In a medium energy accelerator, the depolarizing spin resonances are strong enough to cause significant polarization loss but full Siberian snakes cause intolerably large orbit excursions and are also not feasible since straight sections usually are too short. Recently, two helical partial Siberian snakes with double pitch design have been installed in the Brookhaven Alternating Gradient Synchrotron (AGS). With a careful setup of optics at injection and along the energy ramp, this combination can eliminate the intrinsic and imperfection depolarizing resonances otherwise encountered during acceleration to maintain a high intensity polarized beam in medium energy synchrotrons. The observation of partial snake resonances of higher than second order will also be described.

  2. Overcoming depolarizing resonances with dual helical partial Siberian snakes.

    Science.gov (United States)

    Huang, H; Ahrens, L A; Bai, M; Brown, K; Courant, E D; Gardner, C; Glenn, J W; Lin, F; Luccio, A U; Mackay, W W; Okamura, M; Ptitsyn, V; Roser, T; Takano, J; Tepikian, S; Tsoupas, N; Zelenski, A; Zeno, K

    2007-10-12

    Acceleration of polarized protons in the energy range of 5 to 25 GeV is challenging. In a medium energy accelerator, the depolarizing spin resonances are strong enough to cause significant polarization loss but full Siberian snakes cause intolerably large orbit excursions and are also not feasible since straight sections usually are too short. Recently, two helical partial Siberian snakes with double pitch design have been installed in the Brookhaven Alternating Gradient Synchrotron (AGS). With a careful setup of optics at injection and along the energy ramp, this combination can eliminate the intrinsic and imperfection depolarizing resonances otherwise encountered during acceleration to maintain a high intensity polarized beam in medium energy synchrotrons. The observation of partial snake resonances of higher than second order will also be described.

  3. INDIVIDUAL BREAST MILK «BANKING»: NEEDS AND MEANS

    Directory of Open Access Journals (Sweden)

    O. L. Lukoyanova

    2014-01-01

    Full Text Available Breastfeeding is the most important postnatal factor in metabolic and immunogenic programming of newborns’ health. When it is impossible to breastfeed the baby best efforts should be applied to maintain lactation in mother in order to feed the baby with expressed breast milk. Feeding with frozen expressed breast milk is as good as breastfeeding in its nutritional and biological values. Expressed breast milk (both native and thawed in 3–6 months is testified to be safe nutrition in its microbiological features for a breastfed child. The article presents recent capabilities to maintain milk production in a nursing mother, sets forth conditions requiring a baby to be breastfed with expressed milk, either partial or exclisive, indicates medical alerts for breastfeeding. Data for safe and effective baby nursing with expressed breast milk is considered. The ways for creation individual breast milk “bank” and rules for storage of frozen milk are indicated. Authors present results of introduction of new technologies for breastfeeding maintenance. The use of up-to-date breast pumps created on the basis of the studies of lactation physiology and mechanisms by which a baby takes the milk from his mother’s breast, helps to improve efficiency of milk expression, simplifies this process a lot making it more comfortable and effective.Key words: newborns, breastfeeding, expressed breast milk, breast pumps, Individual breast milk «banking».

  4. Ultrasound-Based Guidance for Partial Breast Irradiation Therapy

    Science.gov (United States)

    2012-01-01

    displace- 0278-0062/$20.00 © IEEE Authorized licensed use limited to: IEEE Xplore . Downloaded on January 5, 2009 at 17:37 from IEEE Xplore . Restrictions...Authorized licensed use limited to: IEEE Xplore . Downloaded on January 5, 2009 at 17:37 from IEEE Xplore . Restrictions apply. RIVAZ et al...better CNR values: the Authorized licensed use limited to: IEEE Xplore . Downloaded on January 5, 2009 at 17:37 from IEEE Xplore . Restrictions apply

  5. Acceleration-Induced Nonlocal Electrodynamics in Minkowski Spacetime

    CERN Document Server

    Muench, U; Mashhoon, B; Muench, Uwe; Hehl, Friedrich W.; Mashhoon, Bahram

    2000-01-01

    We discuss two nonlocal models of electrodynamics in which the nonlocality is induced by the acceleration of the observer. Such an observer actually measures an electromagnetic field that exhibits persistent memory effects. We compare Mashhoon's model with a new ansatz developed here in the framework of charge & flux electrodynamics with a constitutive law involving the Levi-Civita connection as seen from the observer's local frame and conclude that they are in partial agreement only for the case of constant acceleration.

  6. Six cases showing radial scar/complex sclerosing lesions of the breast detected by breast cancer screening.

    Science.gov (United States)

    Inoue, Shingo; Inoue, Masayuki; Kawasaki, Tomonori; Takahashi, Hifumi; Inoue, Ayako; Maruyama, Takanori; Matsuda, Kei; Kunitomo, Kazuyoshi; Murata, Shinichi; Fujii, Hideki

    2008-01-01

    Recently, the number of radial scars (RS)/complex sclerosing lesions (CSL) of the breast has been increasingly detected by mammography screening. Six RS/CSL cases encountered clinicopathologically in the last 2 years are presented. All patients were pre-menopausal. Three cases were detected by ultrasonography (US) screening, and the others were detected by mammography (MG) screening. Partial mastectomy was carried out for both diagnosis and treatment, since it was difficult to discriminate whether RS/CSL accompanied breast cancer even by US, MG, MRI, aspiration cytology, and spring-loaded core needle biopsy (CNB). RS/CSL was histologically confirmed in all cases, and atypical ductal hyperplasia (ADH) or ductal carcinoma in situ (DCIS) accompanied RS/CSL in each case. At present, the clinical diagnosis of complicated breast cancer is difficult. Therefore, we selected partial mastectomy that resects a wider area than surgical biopsy to adequately diagnose breast cancer and to achieve a resected margin that is free from breast cancer. But it may be that partial resection should be performed in case of older age with larger RS/CSL, since it is over-surgery for RS/CSL without breast cancer. Further studies where complicated breast cancer is certainly identified are necessary.

  7. Hierarchical partial order ranking.

    Science.gov (United States)

    Carlsen, Lars

    2008-09-01

    Assessing the potential impact on environmental and human health from the production and use of chemicals or from polluted sites involves a multi-criteria evaluation scheme. A priori several parameters are to address, e.g., production tonnage, specific release scenarios, geographical and site-specific factors in addition to various substance dependent parameters. Further socio-economic factors may be taken into consideration. The number of parameters to be included may well appear to be prohibitive for developing a sensible model. The study introduces hierarchical partial order ranking (HPOR) that remedies this problem. By HPOR the original parameters are initially grouped based on their mutual connection and a set of meta-descriptors is derived representing the ranking corresponding to the single groups of descriptors, respectively. A second partial order ranking is carried out based on the meta-descriptors, the final ranking being disclosed though average ranks. An illustrative example on the prioritization of polluted sites is given.

  8. Partially coherent ultrafast spectrography.

    Science.gov (United States)

    Bourassin-Bouchet, C; Couprie, M-E

    2015-03-06

    Modern ultrafast metrology relies on the postulate that the pulse to be measured is fully coherent, that is, that it can be completely described by its spectrum and spectral phase. However, synthesizing fully coherent pulses is not always possible in practice, especially in the domain of emerging ultrashort X-ray sources where temporal metrology is strongly needed. Here we demonstrate how frequency-resolved optical gating (FROG), the first and one of the most widespread techniques for pulse characterization, can be adapted to measure partially coherent pulses even down to the attosecond timescale. No modification of experimental apparatuses is required; only the processing of the measurement changes. To do so, we take our inspiration from other branches of physics where partial coherence is routinely dealt with, such as quantum optics and coherent diffractive imaging. This will have important and immediate applications, such as enabling the measurement of X-ray free-electron laser pulses despite timing jitter.

  9. Partially predictable chaos

    CERN Document Server

    Wernecke, Hendrik; Gros, Claudius

    2016-01-01

    For a chaotic system pairs of initially close-by trajectories become eventually fully uncorrelated on the attracting set. This process of decorrelation is split into an initial decrease characterized by the maximal Lyapunov exponent and a subsequent diffusive process on the chaotic attractor causing the final loss of predictability. The time scales of both processes can be either of the same or of very different orders of magnitude. In the latter case the two trajectories linger within a finite but small distance (with respect to the overall size of the attractor) for exceedingly long times and therefore remain partially predictable. We introduce a 0-1 indicator for chaos capable of describing this scenario, arguing, in addition, that the chaotic closed braids found close to a period-doubling transition are generically partially predictable.

  10. Partial Remission Definition

    DEFF Research Database (Denmark)

    Andersen, Marie Louise Max; Hougaard, Philip; Pörksen, Sven

    2014-01-01

    of type 1 diabetes (T1D). Receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive value of IDAA1c and age on partial C-peptide remission (stimulated C-peptide, SCP > 300 pmol/L). RESULTS: PR (IDAA1c ≤ 9) in the Danish and Hvidoere cohorts occurred in 62 vs. 61% (3 months......OBJECTIVE: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). SUBJECTS AND METHODS: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset...

  11. Arthroscopic partial medial meniscectomy

    Directory of Open Access Journals (Sweden)

    Dašić Žarko

    2011-01-01

    Full Text Available Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62% vertical complete bucket handle lesions, 19 (8.92% vertical incomplete lesions, 18 (8.45% longitudinal tears, 35 (16.43% oblique tears, 18 (8.45% complex degenerative lesions, 17 (7.98% radial lesions and 28 (13.14% horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49% of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57% patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93% patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.

  12. Unanticipated Partial Behavioral Reflection

    OpenAIRE

    Roethlisberger, David; Denker, Marcus; Tanter, Éric

    2006-01-01

    International audience; Dynamic, unanticipated adaptation of running systems is of interest in a variety of situations, ranging from functional upgrades to on-the-fly debugging or monitoring of critical applications. In this paper we study a particular form of computational reflection, called unanticipated partial behavioral reflection, which is particularly well-suited for unanticipated adaptation of real-world systems. Our proposal combines the dynamicity of unanticipated reflection, i.e., ...

  13. Renormalizing Partial Differential Equations

    OpenAIRE

    Bricmont, J.; Kupiainen, A.

    1994-01-01

    In this review paper, we explain how to apply Renormalization Group ideas to the analysis of the long-time asymptotics of solutions of partial differential equations. We illustrate the method on several examples of nonlinear parabolic equations. We discuss many applications, including the stability of profiles and fronts in the Ginzburg-Landau equation, anomalous scaling laws in reaction-diffusion equations, and the shape of a solution near a blow-up point.

  14. Arithmetic partial differential equations

    OpenAIRE

    Buium, Alexandru; Simanca, Santiago R.

    2006-01-01

    We develop an arithmetic analogue of linear partial differential equations in two independent ``space-time'' variables. The spatial derivative is a Fermat quotient operator, while the time derivative is the usual derivation. This allows us to ``flow'' integers or, more generally, points on algebraic groups with coordinates in rings with arithmetic flavor. In particular, we show that elliptic curves have certain canonical ``flows'' on them that are the arithmetic analogues of the heat and wave...

  15. Particle acceleration by plasma

    CERN Document Server

    Ogata, A

    2002-01-01

    Plasma acceleration is carried out by using potential of plasma wave. It is classified by generation method of plasma wave such as the laser wake-field acceleration and the beat wave acceleration. Other method using electron beam is named the plasma wake-field acceleration (or beam wake-field acceleration). In this paper, electron acceleration by laser wake-field in gas plasma, ion source by laser radiation of solid target and nanoion beam generation by one component of plasma in trap are explained. It is an applicable method that ions, which run out from the solid target irradiated by laser, are used as ion source of accelerator. The experimental system using 800 nm laser, 50 mJ pulse energy and 50 fs pulse width was studied. The laser intensity is 4x10 sup 1 sup 6 Wcm sup - sup 2 at the focus. The target film of metal and organic substance film was used. When laser irradiated Al target, two particles generated, in front and backward. It is new fact that the neutral particle was obtained in front, because it...

  16. The miniature accelerator

    CERN Multimedia

    Antonella Del Rosso

    2015-01-01

    The image that most people have of CERN is of its enormous accelerators and their capacity to accelerate particles to extremely high energies. But thanks to some cutting-edge studies on beam dynamics and radiofrequency technology, along with innovative construction techniques, teams at CERN have now created the first module of a brand-new accelerator, which will be just 2 metres long. The potential uses of this miniature accelerator will include deployment in hospitals for the production of medical isotopes and the treatment of cancer. It’s a real David-and-Goliath story.   Serge Mathot, in charge of the construction of the "mini-RFQ", pictured with the first of the four modules that will make up the miniature accelerator. The miniature accelerator consists of a radiofrequency quadrupole (RFQ), a component found at the start of all proton accelerator chains around the world, from the smallest to the largest. The LHC is designed to produce very high-intensity beams ...

  17. Cosmic particle acceleration

    Energy Technology Data Exchange (ETDEWEB)

    Zimbardo, Gaetano; Perri, Silvia [Universita della Calabria, Dipartimento di Fisica, 87036 Rende (Italy)

    2014-07-01

    The most popular mechanism for the acceleration of cosmic rays, which is thought to operate in supernova remnant shocks as well as at heliospheric shocks, is the diffusive shock acceleration, which is a Fermi mechanism based on normal diffusion. On the other hand, in the last few years it has been shown that the transport of plasma particles in the presence of electric and magnetic turbulence can be superdiffusive rather than normal diffusive. The term 'superdiffusive' refers to the mean square displacement of particle positions growing superlinearly with time, as compared to the normal linear growth. In particular, superdiffusion is characterized by a non Gaussian statistical process called Levy random walk. We show how diffusive shock acceleration is modified by superdiffusion, and how this yields new predictions for the cosmic ray spectral index, for the acceleration time, and for the spatial profile of energetic particles. A comparison with observations of particle acceleration at heliospheric shocks and at supernova remnant shocks is done. We discuss how superdiffusive shock acceleration allows to explain the observations of hard ion spectra at the solar wind termination shock detected by Voyager 2, of hard radio spectra due to synchrotron emission of electrons accelerated at supernova remnant shocks, and how it can help to explain the observations of 'thin rims' in the X-ray synchrotron emission.

  18. Multicavity proton cyclotron accelerator

    Directory of Open Access Journals (Sweden)

    J. L. Hirshfield

    2002-08-01

    Full Text Available A mechanism for acceleration of protons is described, in which energy gain occurs near cyclotron resonance as protons drift through a sequence of rotating-mode TE_{111} cylindrical cavities in a strong nearly uniform axial magnetic field. Cavity resonance frequencies decrease in sequence from one another with a fixed frequency interval Δf between cavities, so that synchronism can be maintained between the rf fields and proton bunches injected at intervals of 1/Δf. An example is presented in which a 122 mA, 1 MeV proton beam is accelerated to 961 MeV using a cascade of eight cavities in an 8.1 T magnetic field, with the first cavity resonant at 120 MHz and with Δf=8 MHz. Average acceleration gradient exceeds 40 MV/m, average effective shunt impedance is 223 MΩ/m, but maximum surface field in the cavities does not exceed 7.2 MV/m. These features occur because protons make many orbital turns in each cavity and thus experience acceleration from each cavity field many times. Longitudinal and transverse stability appear to be intrinsic properties of the acceleration mechanism, and an example to illustrate this is presented. This acceleration concept could be developed into a proton accelerator for a high-power neutron spallation source, such as that required for transmutation of nuclear waste or driving a subcritical fission burner, provided a number of significant practical issues can be addressed.

  19. Breast imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kopans, D.B.; Meyer, J.E.; Sadowsky, N.

    1984-04-12

    The majority of information available today indiates that the most efficient and accurate method of screening women to detect early-stage breast cancer is an aggressive program of patient self-examination, physical examination by well-trained, motivated personnel, and high-quality x-ray mammography. There are two important factors in the implementation of mammographic screening. The first is the availability of facilities to perform high-quality, low-dose mammography, which is directly related to the second factor: the expense to society for support of this large-scale effort. Cost-benefit analysis is beyond the scope of this review. In 1979 Moskowitz and Fox attempted to address this issue, using data from the Breast Cancer Detection Demonstration Project in Cincinnati, but additional analysis is required. The cost for each ''curable'' cancer that is detected must be compared with the psychological, social, and personal losses that accrue, as well as the numerous medical expenses incurred, in a frequently protracted death from breast cancer. All other imaging techniques that have been reviewed should be regarded as adjuncts to rather than replacements for mammographic screening. Ultrasound and computerized tomography are helpful when the physical examination and mammogram are equivocal. Other techniques, such as transillumination, thermography, and magnetic-resonance imaging, should be considered experimental. In patients with clinically evident lesions, x-ray mammography is helpful to evaluate the suspicious area, as well as to ''screen'' the remaining tissue in both breasts and to search for multicentric or bilateral lesions. Mammography is the only imaging technique that has been proved effective for screening.

  20. Application of Accelerators and Storage Rings: Accelerators in Medicine

    CERN Document Server

    Amaldi, U

    2013-01-01

    This document is part of Subvolume C 'Accelerators and Colliders' of Volume 21 'Elementary Particles' of Landolt-Börnstein - Group I 'Elementary Particles, Nuclei and Atoms'. It contains the the Section '11.3 Accelerators in Medicine' of the Chapter '11 Application of Accelerators and Storage Rings' with the content: 11.3 Accelerators in Medicine 11.3.1 Accelerators and Radiopharmaceuticals 11.3.2 Accelerators and Cancer Therapy

  1. Obesity and Prognostic Variables in Colombian Breast Cancer Patients: A Cross-Sectional Study

    OpenAIRE

    Javier Cuello-López; Ana Fidalgo-Zapata; Elsa Vásquez-Trespalacios

    2017-01-01

    Introduction. Obesity is an established risk factor for cancer and cancer-related deaths, including that of the breast. While the prevalence of female obesity has accelerated over the past decade in many developing countries, such as Colombia, the prevalence of overweight and obesity specifically in breast cancer populations has not been fully described. Methods. A cross-sectional study including 849 women diagnosed with breast cancer between 2009 and 2014. Based on body mass index, prevalenc...

  2. Can risk and illness perceptions predict breast cancer worry in healthy women?

    Science.gov (United States)

    Gibbons, Andrea; Groarke, AnnMarie

    2016-09-01

    Predictors of breast cancer worry in healthy women remain unclear. Healthy women less than 50 years (N = 857) completed measures of family history, anxiety, absolute and comparative risk perceptions, illness perceptions, and breast cancer worry. Regression analyses revealed that having a family history of breast cancer, greater anxiety, higher absolute risk perceptions and negative illness perceptions predicted 45 per cent of the variance in breast cancer worry. Risk perceptions also partially mediated the relationship between illness perceptions and worry. This study provides novel evidence that both illness and risk perceptions are predictors of breast cancer worry in younger women from the community.

  3. Confronting Twin Paradox Acceleration

    Science.gov (United States)

    Murphy, Thomas W.

    2016-05-01

    The resolution to the classic twin paradox in special relativity rests on the asymmetry of acceleration. Yet most students are not exposed to a satisfactory analysis of what exactly happens during the acceleration phase that results in the nonaccelerated observer's more rapid aging. The simple treatment presented here offers both graphical and quantitative solutions to the problem, leading to the correct result that the acceleration-induced age gap is 2Lβ years when the one-way distance L is expressed in light-years and velocity β ≡v/c .

  4. Breast ultrasound.

    Science.gov (United States)

    Ueno, E

    1996-03-01

    In ultrasound, ultrasonic images are formed by means of echoes among tissues with different acoustic impedance. Acoustic impedance is the product of sound speed and bulk modulus. The bulk modulus expresses the elasticity of an object, and in the human body, the value is increased by conditions such as fibrosis and calcification. The sound speed is usually high in elastic tissues and low in water. In the body, it is lowest in the fatty tissue. Ultrasound echoes are strong on the surface of bones which are hard and have a high sound speed. In organs filled with air such as the lungs, the bulk modulus is low and the sound speed is extremely low at 340 m/s, which produce strong echoes (the sound speed in solid tissues is 1,530 m/s). Human tissue is constructed of units smaller than the ultrasonic beam, and it is necessary to understand back-scattering in order to understand the ultrasonic images of these tissues. When ultrasound passes through tissue, it is absorbed as thermal energy and attenuated. Fiber is a tissue with a high absorption and attenuation rate. When the rate increases, the posterior echoes are attenuated. However, in masses with a high water content such as cysts, the posterior echoes are accentuated. This phenomenon is an important, basic finding for determining the properties of tumors. Breast cancer can be classified into two types: stellate carcinoma and circumscribed carcinoma. Since stellate carcinoma is rich in fiber, the posterior echoes are attenuated or lacking. However, circumscribed carcinoma has a high cellularity and the posterior echoes are accentuated. The same tendency is also seen in benign tumors. In immature fibroadenomas, posterior echoes are accentuated, while in fibroadenomas with hyalinosis, the posterior echoes are attenuated. Therefore, if the fundamentals of this tissue characterization and the histological features are understood, reading of ultrasound becomes easy. Color Doppler has also been developed and has contributed

  5. Vibration control in accelerators

    Energy Technology Data Exchange (ETDEWEB)

    Montag, C.

    2011-01-01

    In the vast majority of accelerator applications, ground vibration amplitudes are well below tolerable magnet jitter amplitudes. In these cases, it is necessary and sufficient to design a rigid magnet support structure that does not amplify ground vibration. Since accelerator beam lines are typically installed at an elevation of 1-2m above ground level, special care has to be taken in order to avoid designing a support structure that acts like an inverted pendulum with a low resonance frequency, resulting in untolerable lateral vibration amplitudes of the accelerator components when excited by either ambient ground motion or vibration sources within the accelerator itself, such as cooling water pumps or helium flow in superconducting magnets. In cases where ground motion amplitudes already exceed the required jiter tolerances, for instance in future linear colliders, passive vibration damping or active stabilization may be considered.

  6. Compact particle accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Elizondo-Decanini, Juan M.

    2017-08-29

    A compact particle accelerator having an input portion configured to receive power to produce particles for acceleration, where the input portion includes a switch, is provided. In a general embodiment, a vacuum tube receives particles produced from the input portion at a first end, and a plurality of wafer stacks are positioned serially along the vacuum tube. Each of the plurality of wafer stacks include a dielectric and metal-oxide pair, wherein each of the plurality of wafer stacks further accelerate the particles in the vacuum tube. A beam shaper coupled to a second end of the vacuum tube shapes the particles accelerated by the plurality of wafer stacks into a beam and an output portion outputs the beam.

  7. Rejuvenating CERN's Accelerators

    CERN Multimedia

    2004-01-01

    In the coming years and especially in 2005, CERN's accelerators are going to receive an extensive renovation programme to ensure they will perform reliably and effectively when the LHC comes into service.

  8. Joint International Accelerator School

    CERN Multimedia

    CERN Accelerator School

    2014-01-01

    The CERN and US Particle Accelerator Schools recently organised a Joint International Accelerator School on Beam Loss and Accelerator Protection, held at the Hyatt Regency Hotel, Newport Beach, California, USA from 5-14 November 2014. This Joint School was the 13th in a series of such schools, which started in 1985 and also involves the accelerator communities in Japan and Russia.   Photo courtesy of Alfonse Pham, Michigan State University.   The school attracted 58 participants representing 22 different nationalities, with around half from Europe and the other half from Asia and the Americas. The programme comprised 26 lectures, each of 90 minutes, and 13 hours of case study. The students were given homework each day and had an opportunity to sit a final exam, which counted towards university credit. Feedback from the participants was extremely positive, praising the expertise and enthusiasm of the lecturers, as well as the high standard and quality of their lectures. Initial dis...

  9. Dielectric assist accelerating structure

    Science.gov (United States)

    Satoh, D.; Yoshida, M.; Hayashizaki, N.

    2016-01-01

    A higher-order TM02 n mode accelerating structure is proposed based on a novel concept of dielectric loaded rf cavities. This accelerating structure consists of ultralow-loss dielectric cylinders and disks with irises which are periodically arranged in a metallic enclosure. Unlike conventional dielectric loaded accelerating structures, most of the rf power is stored in the vacuum space near the beam axis, leading to a significant reduction of the wall loss, much lower than that of conventional normal-conducting linac structures. This allows us to realize an extremely high quality factor and a very high shunt impedance at room temperature. A simulation of a 5 cell prototype design with an existing alumina ceramic indicates an unloaded quality factor of the accelerating mode over 120 000 and a shunt impedance exceeding 650 M Ω /m at room temperature.

  10. Performance Theory of Diagonal Conducting Wall MHD Accelerators

    Science.gov (United States)

    Litchford, R. J.

    2003-01-01

    The theoretical performance of diagonal conducting wall crossed field accelerators is examined on the basis of an infinite segmentation assumption using a cross-plane averaged generalized Ohm's law for a partially ionized gas, including ion slip. The desired accelerator performance relationships are derived from the cross-plane averaged Ohm's law by imposing appropriate configuration and loading constraints. A current dependent effective voltage drop model is also incorporated to account for cold-wall boundary layer effects including gasdynamic variations, discharge constriction, and electrode falls. Definition of dimensionless electric fields and current densities lead to the construction of graphical performance diagrams, which further illuminate the rudimentary behavior of crossed field accelerator operation.

  11. Breast cancer in men

    Science.gov (United States)

    ... in situ - male; Intraductal carcinoma - male; Inflammatory breast cancer - male; Paget disease of the nipple - male; Breast cancer - male ... The cause of breast cancer in men is not clear. But there are risk factors that make breast cancer more likely in men: Exposure to ...

  12. Breast Cancer -- Male

    Science.gov (United States)

    ... Home > Types of Cancer > Breast Cancer in Men Breast Cancer in Men This is Cancer.Net’s Guide to Breast Cancer in Men. Use the menu below to choose ... social workers, and patient advocates. Cancer.Net Guide Breast Cancer in Men Introduction Statistics Risk Factors and Prevention ...

  13. LHCb GPU Acceleration Project

    CERN Document Server

    AUTHOR|(SzGeCERN)744808; Campora Perez, Daniel Hugo; Neufeld, Niko; Vilasis Cardona, Xavier

    2016-01-01

    The LHCb detector is due to be upgraded for processing high-luminosity collisions, which will increase the load on its computation infrastructure from 100 GB/s to 4 TB/s, encouraging us to look for new ways of accelerating the Online reconstruction. The Coprocessor Manager is our new framework for integrating LHCb’s existing computation pipelines with massively parallel algorithms running on GPUs and other accelerators. This paper describes the system and analyzes its performance.

  14. Accelerating News Issue 2

    CERN Document Server

    Kahle, K; Wildner, E

    2012-01-01

    In this summer issue we look at how developments in collimator materials could have applications in aerospace and beyond, and how Polish researchers are harnessing accelerators for medical and industrial uses. We see how the LHC luminosity upgrade is linking with European industry and US researchers, and how the neutrino oscillation community is progressing. We find out the mid-term status of TIARA-PP and how it is mapping European accelerator education resources.

  15. Accelerating Cosmologies from Compactification

    CERN Document Server

    Townsend, P K; Townsend, Paul K.; Wohlfarth, Mattias N.R.

    2003-01-01

    A solution of the (4+n)-dimensional vacuum Einstein equations is found for which spacetime is compactified on a compact hyperbolic manifold of time-varying volume to a flat four-dimensional FLRW cosmology undergoing accelerated expansion in Einstein conformal frame. This shows that the `no-go' theorem forbidding acceleration in `standard' (time-independent) compactifications of string/M-theory does not apply to `cosmological' (time-dependent) hyperbolic compactifications.

  16. Biomedical accelerator mass spectrometry

    Science.gov (United States)

    Freeman, Stewart P. H. T.; Vogel, John S.

    1995-05-01

    Ultrasensitive SIMS with accelerator based spectrometers has recently begun to be applied to biomedical problems. Certain very long-lived radioisotopes of very low natural abundances can be used to trace metabolism at environmental dose levels ( [greater-or-equal, slanted] z mol in mg samples). 14C in particular can be employed to label a myriad of compounds. Competing technologies typically require super environmental doses that can perturb the system under investigation, followed by uncertain extrapolation to the low dose regime. 41Ca and 26Al are also used as elemental tracers. Given the sensitivity of the accelerator method, care must be taken to avoid contamination of the mass spectrometer and the apparatus employed in prior sample handling including chemical separation. This infant field comprises the efforts of a dozen accelerator laboratories. The Center for Accelerator Mass Spectrometry has been particularly active. In addition to collaborating with groups further afield, we are researching the kinematics and binding of genotoxins in-house, and we support innovative uses of our capability in the disciplines of chemistry, pharmacology, nutrition and physiology within the University of California. The field can be expected to grow further given the numerous potential applications and the efforts of several groups and companies to integrate more the accelerator technology into biomedical research programs; the development of miniaturized accelerator systems and ion sources capable of interfacing to conventional HPLC and GMC, etc. apparatus for complementary chemical analysis is anticipated for biomedical laboratories.

  17. Accelerators for America's Future

    Science.gov (United States)

    Bai, Mei

    2016-03-01

    Particle accelerator, a powerful tool to energize beams of charged particles to a desired speed and energy, has been the working horse for investigating the fundamental structure of matter and fundermental laws of nature. Most known examples are the 2-mile long Stanford Linear Accelerator at SLAC, the high energy proton and anti-proton collider Tevatron at FermiLab, and Large Hadron Collider that is currently under operation at CERN. During the less than a century development of accelerator science and technology that led to a dazzling list of discoveries, particle accelerators have also found various applications beyond particle and nuclear physics research, and become an indispensible part of the economy. Today, one can find a particle accelerator at almost every corner of our lives, ranging from the x-ray machine at the airport security to radiation diagnostic and therapy in hospitals. This presentation will give a brief introduction of the applications of this powerful tool in fundermental research as well as in industry. Challenges in accelerator science and technology will also be briefly presented

  18. PartialRC: A Partial Recomputing Method for Efficient Fault Recovery on GPGPUs

    Institute of Scientific and Technical Information of China (English)

    Xin-Hai Xu; Xue-Jun Yang; Jing-Ling Xue; Yu-Fei Lin; Yi-Song Lin

    2012-01-01

    GPGPUs are increasingly being used to as performance accelerators for HPC (High Performance Computing) applications in CPU/GPU heterogeneous computing systems,including TianHe-lA,the world's fastest supercomputer in the TOP500 list,built at NUDT (National University of Defense Technology) last year.However,despite their performance advantages,GPGPUs do not provide built-in fault-tolerant mechanisms to offer reliability guarantees required by many HPC applications.By analyzing the SIMT (single-instruction,multiple-thread) characteristics of programs running on GPGPUs,we have developed PartialRC,a new checkpoint-based compiler-directed partial recomputing method,for achieving efficient fault recovery by leveraging the phenomenal computing power of GPGPUs.In this paper,we introduce our PartialRC method that recovers from errors detected in a code region by partially re-computing the region,describe a checkpoint-based faulttolerance framework developed on PartialRC,and discuss an implementation on the CUDA platform.Validation using a range of representative CUDA programs on NVIDIA GPGPUs against FullRC (a traditional full-recomputing CheckpointRollback-Restart fault recovery method for CPUs) shows that PartialRC reduces significantly the fault recovery overheads incurred by FulIRC,by 73.5% when errors occur earlier during execution and 74.6% when errors occur later on average.In addition,PartialRC also reduces error detection overheads incurred by FullRC during fault recovery while incurring negligible performance overheads when no fault happens.

  19. DEGRO practical guidelines. Radiotherapy of breast cancer I. Radiotherapy following breast conserving therapy for invasive breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sedlmayer, F. [Paracelsus Medical Univ. Hospital, Salzburg (Austria). Dept. of Radiotherapy and Radiation Oncology; Sautter-Bihl, M.L. [Staedtisches Klinium Karlsruhe (Germany). Klinik fuer Radioonkologie und Strahlentherapie; Budach, W. [University Hospital Duesseldorf (Germany)] [and others

    2013-10-15

    research lies in partial breast irradiation strategies as well as WBI hypofractionation schedules. The potential of both in replacing normofractionated WBI has not yet been finally clarified. Conclusion: After breast conserving surgery, no subgroup even in low risk patients has yet been identified for whom radiotherapy can be safely omitted without compromising local control and, hence, cancer-specific survival. In most patients, this translates into an overall survival benefit. (orig.)

  20. Partial Splenic Artery Embolization

    Directory of Open Access Journals (Sweden)

    Gh. Shadmani

    2010-05-01

    Full Text Available Background/Objective: Hypersplenism often accompanies chronic liver disease and splenomegaly is one of the four cardinal signs of hypersplenism, the other three being cytopenia, normal or hyperplastic bone marrow and response splenectomy. Surgical splenectomy is the traditional treatment."nIn the recent years, partial splenic embolization has been widely used in patients with hypersplenism and cirrhosis.This study was conducted to assess the safety and efficacy of partial splenic embolization using PVA (poly vinyl alcohol and steel coil in the management of hypersplenism."nPatients and Methods: Between Aban 1387 and Aban 1388, ten patients with hypersplenism related hematologic abnormalities (leukopenia, thrombocytopenia, variceal hemorrhage or other sequels underwent partial splenic embolization with PVA and coil. A comparison between pre-procedure and post-procedure lab data, endoscopy and splenic volumetery was done."nResults: All patients showed dramatic improvement in platelet and leukocyte counts. Platelet and leukocyte counts remained at an appropriate level during the follow up period. In one patient after one year progressive decline in the platelet count was noted, however the values remained significantly higher than before PSE (70000 vs 15000."nAlmost all patients had problems related to post embolization syndrome. In one patient severe pain was noted that lasted nearly ten days, in the other patients, pain was less severe. No significant complication (splenic abscess, pancreatitis, portal vein thrombosis developed in this study."nConclusion: The efficacy of PSE observed in our study confirms the results of previous studies in pa-tients with hypersplenism. This safe, fast method can be used bridging therapy for cirrhotic patients waiting for liver transplantation. Hematological response is related to the extension of embolization.

  1. Partial differential equations

    CERN Document Server

    Sloan, D; Süli, E

    2001-01-01

    /homepage/sac/cam/na2000/index.html7-Volume Set now available at special set price ! Over the second half of the 20th century the subject area loosely referred to as numerical analysis of partial differential equations (PDEs) has undergone unprecedented development. At its practical end, the vigorous growth and steady diversification of the field were stimulated by the demand for accurate and reliable tools for computational modelling in physical sciences and engineering, and by the rapid development of computer hardware and architecture. At the more theoretical end, the analytical insight in

  2. Partial Dynamical Symmetries

    CERN Document Server

    Leviatan, A

    2010-01-01

    This overview focuses on the notion of partial dynamical symmetry (PDS), for which a prescribed symmetry is obeyed by a subset of solvable eigenstates, but is not shared by the Hamiltonian. General algorithms are presented to identify interactions, of a given order, with such intermediate-symmetry structure. Explicit bosonic and fermionic Hamiltonians with PDS are constructed in the framework of models based on spectrum generating algebras. PDSs of various types are shown to be relevant to nuclear spectroscopy, quantum phase transitions and systems with mixed chaotic and regular dynamics.

  3. Partial differential equations

    CERN Document Server

    Friedman, Avner

    2008-01-01

    This three-part treatment of partial differential equations focuses on elliptic and evolution equations. Largely self-contained, it concludes with a series of independent topics directly related to the methods and results of the preceding sections that helps introduce readers to advanced topics for further study. Geared toward graduate and postgraduate students of mathematics, this volume also constitutes a valuable reference for mathematicians and mathematical theorists.Starting with the theory of elliptic equations and the solution of the Dirichlet problem, the text develops the theory of we

  4. Partial differential equations

    CERN Document Server

    Levine, Harold

    1997-01-01

    The subject matter, partial differential equations (PDEs), has a long history (dating from the 18th century) and an active contemporary phase. An early phase (with a separate focus on taut string vibrations and heat flow through solid bodies) stimulated developments of great importance for mathematical analysis, such as a wider concept of functions and integration and the existence of trigonometric or Fourier series representations. The direct relevance of PDEs to all manner of mathematical, physical and technical problems continues. This book presents a reasonably broad introductory account of the subject, with due regard for analytical detail, applications and historical matters.

  5. Partially ordered algebraic systems

    CERN Document Server

    Fuchs, Laszlo

    2011-01-01

    Originally published in an important series of books on pure and applied mathematics, this monograph by a distinguished mathematician explores a high-level area in algebra. It constitutes the first systematic summary of research concerning partially ordered groups, semigroups, rings, and fields. The self-contained treatment features numerous problems, complete proofs, a detailed bibliography, and indexes. It presumes some knowledge of abstract algebra, providing necessary background and references where appropriate. This inexpensive edition of a hard-to-find systematic survey will fill a gap i

  6. Paschen is Partially Back

    CERN Document Server

    Stift, M J

    2008-01-01

    We present a discussion of the partial Paschen-Back (PB) effect in magnetic Ap stars. An overview of the theory is illustrated with examples of how splittings deviate non-linearly from the simple Zeeman picture; normally forbidden ``ghost lines'' appear in strong fields. Resulting asymmetric stellar Stokes profiles for a dipolar magnetic geometry are shown for the FeII 6149 line and it is established that PB lines may be subject to wavelength shifts. Modelling of Stokes profiles in the PB regime opens exciting new diagnostics.

  7. Paschen is Partially Back

    OpenAIRE

    Stift, M. J.; Leone, F.

    2008-01-01

    We present a discussion of the partial Paschen-Back (PB) effect in magnetic Ap stars. An overview of the theory is illustrated with examples of how splittings deviate non-linearly from the simple Zeeman picture; normally forbidden ``ghost lines'' appear in strong fields. Resulting asymmetric stellar Stokes profiles for a dipolar magnetic geometry are shown for the FeII 6149 line and it is established that PB lines may be subject to wavelength shifts. Modelling of Stokes profiles in the PB reg...

  8. Paschen is partially Back

    Science.gov (United States)

    Stift, M. J.; Leone, F.

    2008-04-01

    We present a discussion of the partial Paschen-Back (PB) effect in magnetic Ap stars. An overview of the theory is illustrated with examples of how splittings deviate non-linearly from the simple Zeeman picture; normally forbidden "ghost lines" appear in strong fields. Resulting asymmetric stellar Stokes profiles for a dipolar magnetic geometry are shown for the FeI λ6149 line and it is established that PB lines may be subject to wavelength shifts. Modelling of Stokes profiles in the PB regime opens exciting new diagnostics.

  9. Effects of β - sodium aescinate on edema of affected upper limbs in patients post breast cancer operations%β-七叶皂苷钠治疗乳腺癌术后患侧上肢水肿的疗效观

    Institute of Scientific and Technical Information of China (English)

    施怀杰; 王爱玉

    2001-01-01

    @@ Background: Edema has effect on rehabilitation of the patients post breast cancer operations . Objective: The study on effects of β - sodium aescinate on subduing edema and acceleration to regress swell in patients post breast cancer operations was reported.

  10. Diffusive Shock Acceleration and Reconnection Acceleration Processes

    Science.gov (United States)

    Zank, G. P.; Hunana, P.; Mostafavi, P.; Le Roux, J. A.; Li, Gang; Webb, G. M.; Khabarova, O.; Cummings, A.; Stone, E.; Decker, R.

    2015-12-01

    Shock waves, as shown by simulations and observations, can generate high levels of downstream vortical turbulence, including magnetic islands. We consider a combination of diffusive shock acceleration (DSA) and downstream magnetic-island-reconnection-related processes as an energization mechanism for charged particles. Observations of electron and ion distributions downstream of interplanetary shocks and the heliospheric termination shock (HTS) are frequently inconsistent with the predictions of classical DSA. We utilize a recently developed transport theory for charged particles propagating diffusively in a turbulent region filled with contracting and reconnecting plasmoids and small-scale current sheets. Particle energization associated with the anti-reconnection electric field, a consequence of magnetic island merging, and magnetic island contraction, are considered. For the former only, we find that (i) the spectrum is a hard power law in particle speed, and (ii) the downstream solution is constant. For downstream plasmoid contraction only, (i) the accelerated spectrum is a hard power law in particle speed; (ii) the particle intensity for a given energy peaks downstream of the shock, and the distance to the peak location increases with increasing particle energy, and (iii) the particle intensity amplification for a particular particle energy, f(x,c/{c}0)/f(0,c/{c}0), is not 1, as predicted by DSA, but increases with increasing particle energy. The general solution combines both the reconnection-induced electric field and plasmoid contraction. The observed energetic particle intensity profile observed by Voyager 2 downstream of the HTS appears to support a particle acceleration mechanism that combines both DSA and magnetic-island-reconnection-related processes.

  11. Experts' Understanding of Partial Derivatives Using the Partial Derivative Machine

    Science.gov (United States)

    Roundy, David; Weber, Eric; Dray, Tevian; Bajracharya, Rabindra R.; Dorko, Allison; Smith, Emily M.; Manogue, Corinne A.

    2015-01-01

    Partial derivatives are used in a variety of different ways within physics. Thermodynamics, in particular, uses partial derivatives in ways that students often find especially confusing. We are at the beginning of a study of the teaching of partial derivatives, with a goal of better aligning the teaching of multivariable calculus with the needs of…

  12. Imaging male breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Doyle, S., E-mail: sdoyle2@nhs.net [Primrose Breast Care Unit, Derriford Hospital, Plymouth (United Kingdom); Steel, J.; Porter, G. [Primrose Breast Care Unit, Derriford Hospital, Plymouth (United Kingdom)

    2011-11-15

    Male breast cancer is rare, with some pathological and radiological differences from female breast cancer. There is less familiarity with the imaging appearances of male breast cancer, due to its rarity and the more variable use of preoperative imaging. This review will illustrate the commonest imaging appearances of male breast cancer, with emphasis on differences from female breast cancer and potential pitfalls in diagnosis, based on a 10 year experience in our institution.

  13. Relaxed acceleration tolerance in female pilot trainees.

    Science.gov (United States)

    Navathe, P D; Gomez, G; Krishnamurthy, A

    2002-11-01

    Female pilots now fly many types of aircraft including military fighters capable of maneuvers that produce high, sustained acceleration in the +Gz axis. Although women have participated as subjects in various centrifuge studies, little is known about the acceleration tolerance of female pilots. Between April 1995 and December 1997, 17 female pilot trainees were studied at the Institute of Aerospace Medicine, Bangalore, India. The subjects were 23.2 +/- 1.4 yr old and led physically active lives. Their relaxed +Gz tolerance limits (defined as peripheral light loss) were tested using the High G and Disorientation Demonstrator. The protocol included a series of rapid onset runs (RORs) to tolerance followed by a single gradual onset run (GOR) to tolerance. The mean ROR tolerance was 4.2 +/- 0.4 G. The mean GOR tolerance was 5.2 +/- 0.6 G. Three of the subjects were unable to complete the GOR due to severe nausea. Two women reported breast discomfort at levels of 3.5 G and beyond. No other problems were reported. The acceleration tolerances for the female pilot trainees were comparable to those for male pilots previously studied in our laboratory.

  14. Is Titan Partially Differentiated?

    Science.gov (United States)

    Mitri, G.; Pappalardo, R. T.; Stevenson, D. J.

    2009-12-01

    The recent measurement of the gravity coefficients from the Radio Doppler data of the Cassini spacecraft has improved our knowledge of the interior structure of Titan (Rappaport et al. 2008 AGU, P21A-1343). The measured gravity field of Titan is dominated by near hydrostatic quadrupole components. We have used the measured gravitational coefficients, thermal models and the hydrostatic equilibrium theory to derive Titan's interior structure. The axial moment of inertia gives us an indication of the degree of the interior differentiation. The inferred axial moment of inertia, calculated using the quadrupole gravitational coefficients and the Radau-Darwin approximation, indicates that Titan is partially differentiated. If Titan is partially differentiated then the interior must avoid melting of the ice during its evolution. This suggests a relatively late formation of Titan to avoid the presence of short-lived radioisotopes (Al-26). This also suggests the onset of convection after accretion to efficiently remove the heat from the interior. The outer layer is likely composed mainly of water in solid phase. Thermal modeling indicates that water could be present also in liquid phase forming a subsurface ocean between an outer ice I shell and a high pressure ice layer. Acknowledgments: This work was conducted at the Jet Propulsion Laboratory, California Institute of Technology, under contract with the National Aeronautics and Space Administration.

  15. Unilateral removable partial dentures.

    Science.gov (United States)

    Goodall, W A; Greer, A C; Martin, N

    2017-01-27

    Removable partial dentures (RPDs) are widely used to replace missing teeth in order to restore both function and aesthetics for the partially dentate patient. Conventional RPD design is frequently bilateral and consists of a major connector that bridges both sides of the arch. Some patients cannot and will not tolerate such an extensive appliance. For these patients, bridgework may not be a predictable option and it is not always possible to provide implant-retained restorations. This article presents unilateral RPDs as a potential treatment modality for such patients and explores indications and contraindications for their use, including factors relating to patient history, clinical presentation and patient wishes. Through case examples, design, material and fabrication considerations will be discussed. While their use is not widespread, there are a number of patients who benefit from the provision of unilateral RPDs. They are a useful treatment to have in the clinician's armamentarium, but a highly-skilled dental team and a specific patient presentation is required in order for them to be a reasonable and predictable prosthetic option.

  16. Tutorial on Online Partial Evaluation

    Directory of Open Access Journals (Sweden)

    William R. Cook

    2011-09-01

    Full Text Available This paper is a short tutorial introduction to online partial evaluation. We show how to write a simple online partial evaluator for a simple, pure, first-order, functional programming language. In particular, we show that the partial evaluator can be derived as a variation on a compositionally defined interpreter. We demonstrate the use of the resulting partial evaluator for program optimization in the context of model-driven development.

  17. Tutorial on Online Partial Evaluation

    CERN Document Server

    Cook, William R; 10.4204/EPTCS.66.8

    2011-01-01

    This paper is a short tutorial introduction to online partial evaluation. We show how to write a simple online partial evaluator for a simple, pure, first-order, functional programming language. In particular, we show that the partial evaluator can be derived as a variation on a compositionally defined interpreter. We demonstrate the use of the resulting partial evaluator for program optimization in the context of model-driven development.

  18. Small type accelerator. Try for accelerator driven system

    CERN Document Server

    Mori, Y

    2003-01-01

    FFAG (Fixed-field alternating gradient) accelerator for accelerator driven subcritical reactor, which aims to change from long-lived radioactive waste to short-lived radioactivity, is introduced. It is ring accelerator. The performance needed is proton as accelerator particle, 10MW (total) beam power, about 1GeV beam energy, >30% power efficiency and continuous beam. The feature of FFAG accelerator is constant magnetic field. PoP (Proof-of-principle)-FFAG accelerator, radial type, was run at first in Japan in 2000. The excursion is about some ten cm. In principle, beam can be injected and extracted at any place of ring. The 'multi-fish' acceleration can accelerate beams to 100% duty by repeating acceleration. 150MeV-FFAG accelerator has been started since 2001. It tried to practical use, for example, treatment of cancer. (S.Y.)

  19. Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Danvy, Olivier

    1998-01-01

    Type-directed partial evaluation uses a normalization function to achieve partial evaluation. These lecture notes review its background, foundations, practice, and applications. Of specific interest is the modular technique of offline and online type-directed partial evaluation in Standard ML...

  20. Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Danvy, Olivier

    1998-01-01

    Type-directed partial evaluation uses a normalization function to achieve partial evaluation. These lecture notes review its background, foundations, practice, and applications. Of specific interest is the modular technique of offline and online type-directed partial evaluation in Standard ML of ...

  1. Should I Have Breast Reconstruction?

    Science.gov (United States)

    ... Reconstruction Surgery Breast Cancer Breast Reconstruction Surgery Should I Get Breast Reconstruction Surgery? Women who have surgery ... It usually responds well to treatment. What if I choose not to have breast reconstruction? Many women ...

  2. Risks of Breast Cancer Screening

    Science.gov (United States)

    ... of dying from breast cancer. MRI (magnetic resonance imaging) in women with a high risk of breast ... a mammogram , the breast is placed between 2 plates that are pressed together. Pressing the breast helps ...

  3. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy ... limitations of Ultrasound-Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the ...

  4. Dielectric laser accelerators

    Science.gov (United States)

    England, R. Joel; Noble, Robert J.; Bane, Karl; Dowell, David H.; Ng, Cho-Kuen; Spencer, James E.; Tantawi, Sami; Wu, Ziran; Byer, Robert L.; Peralta, Edgar; Soong, Ken; Chang, Chia-Ming; Montazeri, Behnam; Wolf, Stephen J.; Cowan, Benjamin; Dawson, Jay; Gai, Wei; Hommelhoff, Peter; Huang, Yen-Chieh; Jing, Chunguang; McGuinness, Christopher; Palmer, Robert B.; Naranjo, Brian; Rosenzweig, James; Travish, Gil; Mizrahi, Amit; Schachter, Levi; Sears, Christopher; Werner, Gregory R.; Yoder, Rodney B.

    2014-10-01

    The use of infrared lasers to power optical-scale lithographically fabricated particle accelerators is a developing area of research that has garnered increasing interest in recent years. The physics and technology of this approach is reviewed, which is referred to as dielectric laser acceleration (DLA). In the DLA scheme operating at typical laser pulse lengths of 0.1 to 1 ps, the laser damage fluences for robust dielectric materials correspond to peak surface electric fields in the GV /m regime. The corresponding accelerating field enhancement represents a potential reduction in active length of the accelerator between 1 and 2 orders of magnitude. Power sources for DLA-based accelerators (lasers) are less costly than microwave sources (klystrons) for equivalent average power levels due to wider availability and private sector investment. Because of the high laser-to-particle coupling efficiency, required pulse energies are consistent with tabletop microJoule class lasers. Combined with the very high (MHz) repetition rates these lasers can provide, the DLA approach appears promising for a variety of applications, including future high-energy physics colliders, compact light sources, and portable medical scanners and radiative therapy machines.

  5. Plasma-based accelerator structures

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, Carl B. [Univ. of California, Berkeley, CA (United States)

    1999-12-01

    Plasma-based accelerators have the ability to sustain extremely large accelerating gradients, with possible high-energy physics applications. This dissertation further develops the theory of plasma-based accelerators by addressing three topics: the performance of a hollow plasma channel as an accelerating structure, the generation of ultrashort electron bunches, and the propagation of laser pulses is underdense plasmas.

  6. Applied partial differential equations

    CERN Document Server

    Logan, J David

    2004-01-01

    This primer on elementary partial differential equations presents the standard material usually covered in a one-semester, undergraduate course on boundary value problems and PDEs. What makes this book unique is that it is a brief treatment, yet it covers all the major ideas: the wave equation, the diffusion equation, the Laplace equation, and the advection equation on bounded and unbounded domains. Methods include eigenfunction expansions, integral transforms, and characteristics. Mathematical ideas are motivated from physical problems, and the exposition is presented in a concise style accessible to science and engineering students; emphasis is on motivation, concepts, methods, and interpretation, rather than formal theory. This second edition contains new and additional exercises, and it includes a new chapter on the applications of PDEs to biology: age structured models, pattern formation; epidemic wave fronts, and advection-diffusion processes. The student who reads through this book and solves many of t...

  7. Fundamental partial compositeness

    CERN Document Server

    Sannino, Francesco

    2016-01-01

    We construct renormalizable Standard Model extensions, valid up to the Planck scale, that give a composite Higgs from a new fundamental strong force acting on fermions and scalars. Yukawa interactions of these particles with Standard Model fermions realize the partial compositeness scenario. Successful models exist because gauge quantum numbers of Standard Model fermions admit a minimal enough 'square root'. Furthermore, right-handed SM fermions have an SU(2)$_R$-like structure, yielding a custodially-protected composite Higgs. Baryon and lepton numbers arise accidentally. Standard Model fermions acquire mass at tree level, while the Higgs potential and flavor violations are generated by quantum corrections. We further discuss accidental symmetries and other dynamical features stemming from the new strongly interacting scalars. If the same phenomenology can be obtained from models without our elementary scalars, they would reappear as composite states.

  8. Inductance loop and partial

    CERN Document Server

    Paul, Clayton R

    2010-01-01

    "Inductance is an unprecedented text, thoroughly discussing "loop" inductance as well as the increasingly important "partial" inductance. These concepts and their proper calculation are crucial in designing modern high-speed digital systems. World-renowned leader in electromagnetics Clayton Paul provides the knowledge and tools necessary to understand and calculate inductance." "With the present and increasing emphasis on high-speed digital systems and high-frequency analog systems, it is imperative that system designers develop an intimate understanding of the concepts and methods in this book. Inductance is a much-needed textbook designed for senior and graduate-level engineering students, as well as a hands-on guide for working engineers and professionals engaged in the design of high-speed digital and high-frequency analog systems."--Jacket.

  9. Partial model checking

    DEFF Research Database (Denmark)

    Andersen, Henrik Reif

    1995-01-01

    A major obstacle in applying finite-state model checking to the verification of large systems is the combinatorial explosion of the state space arising when many loosely coupled parallel processes are considered. The problem also known as the state-explosion problem has been attacked from various...... sides. This paper presents a new approach based on partial model checking where parts of the concurrent system are gradually removed while transforming the specification accordingly. When the intermediate specifications constructed in this manner can be kept small, the state-explosion problem is avoided....... Experimental results with a prototype implemented in Standard ML, shows that for Milner's Scheduler-an often used benchmark-this approach improves on the published results on binary decision diagrams and is comparable to results obtained using generalized decision diagrams. Specifications are expressed...

  10. High-Gradient, Millimeter Wave Accelerating Structure

    CERN Document Server

    Kuzikov, S V; Peskov, N Yu

    2015-01-01

    The millimeter wave all-metallic accelerating structure, aimed to provide more than 100 MeV/m gradient and fed by feeding RF pulses of 20-30 ns duration, is proposed. The structure is based on a waveguide with small helical corrugation. Each section of 10-20 wavelengths long has big circular cross-section aperture comparable with wavelength. Because short wavelength structures are expected to be critical to wakefields excitation and emittance growth, we suggest to combine in one structure properties of a linear accelerator and a cooling damping ring simultaneously. It provides acceleration of straight on-axis beam as well as cooling of this beam due to the synchrotron radiation of particles in strong non-synchronous transverse fields. These properties are provided by specific slow eigen mode which consists of two partial waves, TM01 and TM11. Simulations show that shunt impedance can be as high as 100 MOhm/m. Results of the first low-power tests with 30 GHz accelerating section are analyzed.

  11. Radial acceleration relation from screening of fifth forces

    CERN Document Server

    Burrage, Clare; Millington, Peter

    2016-01-01

    We show that the radial acceleration relation for rotationally-supported galaxies may be explained, in the absence of cold dark matter, by a non-minimally coupled scalar field, whose fifth forces are partially screened on galactic scales by the symmetron mechanism. If realised in nature, this effect could have a significant impact on the inferred density of dark matter halos.

  12. Uniform Acceleration in General Relativity

    CERN Document Server

    Friedman, Yaakov

    2016-01-01

    We extend de la Fuente and Romero's defining equation for uniform acceleration in a general curved spacetime from linear acceleration to the full Lorentz covariant uniform acceleration. In a flat spacetime background, we have explicit solutions. We use generalized Fermi-Walker transport to parallel transport the Frenet basis along the trajectory. In flat spacetime, we obtain velocity and acceleration transformations from a uniformly accelerated system to an inertial system. We obtain the time dilation between accelerated clocks. We apply our acceleration transformations to the motion of a charged particle in a constant electromagnetic field and recover the Lorentz-Abraham-Dirac equation.

  13. Cosmic Plasma Wakefield Acceleration

    Energy Technology Data Exchange (ETDEWEB)

    Chen, P

    2004-04-26

    Recently we proposed a new cosmic acceleration mechanism which was based on the wakefields excited by the Alfven shocks in a relativistically owing plasma. In this paper we include some omitted details, and show that there exists a threshold condition for transparency below which the accelerating particle is collision-free and suffers little energy loss in the plasma medium. The stochastic encounters of the random accelerating-decelerating phases results in a power-law energy spectrum: f({epsilon}) {proportional_to} 1/{epsilon}{sup 2}. As an example, we discuss the possible production of super-GZK ultra high energy cosmic rays (UHECR) in the atmosphere of gamma ray bursts. The estimated event rate in our model agrees with that from UHECR observations.

  14. Superconducting Accelerator Magnets

    CERN Document Server

    Mess, K H; Wolff, S

    1996-01-01

    The main topic of the book are the superconducting dipole and quadrupole magnets needed in high-energy accelerators and storage rings for protons, antiprotons or heavy ions. The basic principles of low-temperature superconductivity are outlined with special emphasis on the effects which are relevant for accelerator magnets. Properties and fabrication methods of practical superconductors are described. Analytical methods for field calculation and multipole expansion are presented for coils without and with iron yoke. The effect of yoke saturation and geometric distortions on field quality is studied. Persistent magnetization currents in the superconductor and eddy currents the copper part of the cable are analyzed in detail and their influence on field quality and magnet performance is investigated. Superconductor stability, quench origins and propagation and magnet protection are addressed. Some important concepts of accelerator physics are introduced which are needed to appreciate the demanding requirements ...

  15. Particle accelerator physics

    CERN Document Server

    Wiedemann, Helmut

    2007-01-01

    Particle Accelerator Physics is an in-depth and comprehensive introduction to the field of high-energy particle acceleration and beam dynamics. Part I gathers the basic tools, recalling the essentials of electrostatics and electrodynamics as well as of particle dynamics in electromagnetic fields. Part II is an extensive primer in beam dynamics, followed in Part III by the introduction and description of the main beam parameters. Part IV is devoted to the treatment of perturbations in beam dynamics. Part V discusses the details of charged particle accleration. Part VI and Part VII introduce the more advanced topics of coupled beam dynamics and the description of very intense beams. Part VIII is an exhaustive treatment of radiation from accelerated charges and introduces important sources of coherent radiation such as synchrotrons and free-electron lasers. Part IX collects the appendices gathering useful mathematical and physical formulae, parameters and units. Solutions to many end-of-chapter problems are give...

  16. Periductal mastitis in a male breast

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chang Suk; Jung, Jung Im; Kang, Bong Joo; Lee, Ah Won; Park, Woo Chan; Hahn, Seong Tai [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2006-09-15

    Periductal mastitis and mammary duct ectasia are now considered as separate disease entities in the female breast, and these two disease affect different age groups and have different etiologies and clinical symptoms. These two entities have very rarely been reported in the male breast and they have long been considered as the same disease as that in the female breast without any differentiation. We report here on the radiologic findings of a rare case of periductal mastitis that developed during the course of chemotherapy for lung cancer in a 50-year-old male. On ultrasonography, there was a partially defined mass with adjacent duct dilatation and intraductal hypoechogenicity, and this correlated with an immature abscess with a pus-filled, dilated duct and periductal inflammation on the pathologic examination.

  17. Studies of accelerated compact toruses

    Energy Technology Data Exchange (ETDEWEB)

    Hartman, C.W.; Eddleman, J.; Hammer, J.H.

    1983-01-04

    In an earlier publication we considered acceleration of plasma rings (Compact Torus). Several possible accelerator configurations were suggested and the possibility of focusing the accelerated rings was discussed. In this paper we consider one scheme, acceleration of a ring between coaxial electrodes by a B/sub theta/ field as in a coaxial rail-gun. If the electrodes are conical, a ring accelerated towards the apex of the cone undergoes self-similar compression (focusing) during acceleration. Because the allowable acceleration force, F/sub a/ = kappaU/sub m//R where (kappa < 1), increases as R/sup -2/, the accelerating distance for conical electrodes is considerably shortened over that required for coaxial electrodes. In either case, however, since the accelerating flux can expand as the ring moves, most of the accelerating field energy can be converted into kinetic energy of the ring leading to high efficiency.

  18. Microelectromechanical acceleration-sensing apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Robb M. (Albuquerque, NM); Shul, Randy J. (Albuquerque, NM); Polosky, Marc A. (Albuquerque, NM); Hoke, Darren A. (Albuquerque, NM); Vernon, George E. (Rio Rancho, NM)

    2006-12-12

    An acceleration-sensing apparatus is disclosed which includes a moveable shuttle (i.e. a suspended mass) and a latch for capturing and holding the shuttle when an acceleration event is sensed above a predetermined threshold level. The acceleration-sensing apparatus provides a switch closure upon sensing the acceleration event and remains latched in place thereafter. Examples of the acceleration-sensing apparatus are provided which are responsive to an acceleration component in a single direction (i.e. a single-sided device) or to two oppositely-directed acceleration components (i.e. a dual-sided device). A two-stage acceleration-sensing apparatus is also disclosed which can sense two acceleration events separated in time. The acceleration-sensing apparatus of the present invention has applications, for example, in an automotive airbag deployment system.

  19. Accelerating time to benefit

    DEFF Research Database (Denmark)

    Svejvig, Per; Geraldi, Joana; Grex, Sara

    Despite the ubiquitous pressure for speed, our approaches to accelerate projects remain constrained to the old-fashioned understanding of the project as a vehicle to deliver products and services, not value. This article explores an attempt to accelerate time to benefit. We describe and deconstruct...... of the time. Although all cases valued speed and speed to benefit, and implemented most practices proposed by the methodology, only three of the five projects were more successful in decreasing time to speed. Based on a multi-case study comparison between these five different projects and their respective...

  20. Accelerating News Issue 4

    CERN Document Server

    Szeberenyi, A; Wildner, E

    2012-01-01

    In this winter issue, we are very pleased to announce the approval of EuCARD-2 by the European Commission. We look at the conclusions of EUROnu in proposing future neutrino facilities at CERN, a new milestone reached by CLIC and progress on the SPARC upgrade using C-band technology. We also report on recent events: second Joint HiLumi LHC-LARP Annual Meeting and workshop on Superconducting technologies for the Next Generation of Accelerators aiming at closer collaboration with industry. The launch of the Accelerators for Society brochure is also highlighted.

  1. Shielding high energy accelerators

    CERN Document Server

    Stevenson, Graham Roger

    2001-01-01

    After introducing the subject of shielding high energy accelerators, point source, line-of-sight models, and in particular the Moyer model. are discussed. Their use in the shielding of proton and electron accelerators is demonstrated and their limitations noted. especially in relation to shielding in the forward direction provided by large, flat walls. The limitations of reducing problems to those using it cylindrical geometry description are stressed. Finally the use of different estimators for predicting dose is discussed. It is suggested that dose calculated from track-length estimators will generally give the most satisfactory estimate. (9 refs).

  2. Breast metastases from rectal carcinoma

    Institute of Scientific and Technical Information of China (English)

    LI Jia; FANG Yu; LI Ang; LI Fei

    2011-01-01

    Metastases to the breast from extramammary neoplasms are very rare, constituting 2.7% of all malignant breast tumours. The most common primary tumor metastatic to the breast is primary breast cancer. Rectal cancer metastasizing to the breast is extremely rare. We report a case of aggressive rectal carcinoma with metastasis to the breast.

  3. Robot-assisted partial nephrectomy: Superiority over laparoscopic partial nephrectomy.

    Science.gov (United States)

    Shiroki, Ryoichi; Fukami, Naohiko; Fukaya, Kosuke; Kusaka, Mamoru; Natsume, Takahiro; Ichihara, Takashi; Toyama, Hiroshi

    2016-02-01

    Nephron-sparing surgery has been proven to positively impact the postoperative quality of life for the treatment of small renal tumors, possibly leading to functional improvements. Laparoscopic partial nephrectomy is still one of the most demanding procedures in urological surgery. Laparoscopic partial nephrectomy sometimes results in extended warm ischemic time and severe complications, such as open conversion, postoperative hemorrhage and urine leakage. Robot-assisted partial nephrectomy exploits the advantages offered by the da Vinci Surgical System to laparoscopic partial nephrectomy, equipped with 3-D vision and a better degree in the freedom of surgical instruments. The introduction of the da Vinci Surgical System made nephron-sparing surgery, specifically robot-assisted partial nephrectomy, safe with promising results, leading to the shortening of warm ischemic time and a reduction in perioperative complications. Even for complex and challenging tumors, robotic assistance is expected to provide the benefit of minimally-invasive surgery with safe and satisfactory renal function. Warm ischemic time is the modifiable factor during robot-assisted partial nephrectomy to affect postoperative kidney function. We analyzed the predictive factors for extended warm ischemic time from our robot-assisted partial nephrectomy series. The surface area of the tumor attached to the kidney parenchyma was shown to significantly affect the extended warm ischemic time during robot-assisted partial nephrectomy. In cases with tumor-attached surface area more than 15 cm(2) , we should consider switching robot-assisted partial nephrectomy to open partial nephrectomy under cold ischemia if it is imperative. In Japan, a nationwide prospective study has been carried out to show the superiority of robot-assisted partial nephrectomy to laparoscopic partial nephrectomy in improving warm ischemic time and complications. By facilitating robotic technology, robot-assisted partial nephrectomy

  4. Magnetic field amplification by collisionless shocks in partially ionized plasmas

    CERN Document Server

    Ohira, Yutaka

    2015-01-01

    In this paper, we study shock structures of collisionless shocks in partially ionized plasmas by means of two-dimensional hybrid simulations, where the shock is a perpendicular shock with shock velocity Vsh ~ 40 Va ~ 1333 km/s and the upstream ionization fraction is 0.5. We find that large density fluctuations and large magnetic fields fluctuations are generated both in the upstream and downstream regions. In addition, we find that the velocity distribution of downstream hydrogen atoms has three components. Observed shock structures suggest that diffusive shock acceleration can operate at perpendicular shocks propagating into partially ionized plasmas in real three-dimensional systems.

  5. Breast Imaging Artifacts.

    Science.gov (United States)

    Odle, Teresa G

    2015-01-01

    Artifacts appear on breast images for a number of reasons. Radiologic technologists play an important role in identifying artifacts that can help or hinder breast cancer diagnosis and in minimizing artifacts that degrade image quality. This article describes various artifacts that occur in breast imaging, along with their causes. The article focuses on artifacts in mammography, with a heavy emphasis on digital mammography, and on magnetic resonance imaging of the breast. Artifacts in ultrasonography of the breast, digital breast tomosynthesis, and positron emission mammography also are discussed.

  6. Breast cancer screening in Korean woman with dense breast tissue

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hee Jung [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Ko, Eun Sook [Dept. of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Yi, Ann [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-11-15

    Asian women, including Korean, have a relatively higher incidence of dense breast tissue, compared with western women. Dense breast tissue has a lower sensitivity for the detection of breast cancer and a higher relative risk for breast cancer, compared with fatty breast tissue. Thus, there were limitations in the mammographic screening for women with dense breast tissue, and many studies for the supplemental screening methods. This review included appropriate screening methods for Korean women with dense breasts. We also reviewed the application and limitation of supplemental screening methods, including breast ultrasound, digital breast tomosynthesis, and breast magnetic resonance imaging; and furthermore investigated the guidelines, as well as the study results.

  7. Experts' understanding of partial derivatives using the Partial Derivative Machine

    CERN Document Server

    Roundy, David; Dray, Tevian; Manogue, Corinne A; Weber, Eric

    2014-01-01

    Partial derivatives are used in a variety of different ways within physics. Most notably, thermodynamics uses partial derivatives in ways that students often find confusing. As part of a collaboration with mathematics faculty, we are at the beginning of a study of the teaching of partial derivatives, a goal of better aligning the teaching of multivariable calculus with the needs of students in STEM disciplines. As a part of this project, we have performed a pilot study of expert understanding of partial derivatives across three disciplines: physics, engineering and mathematics. Our interviews made use of the Partial Derivative Machine (PDM), which is a mechanical system featuring four observable and controllable properties, of which any two are independent. Using the PDM, we probed expert understanding of partial derivatives in an experimental context in which there is not a known functional form. Through these three interviews, we found that the mathematicians exhibited a striking difference in their underst...

  8. Obesity-associated Breast Cancer: Analysis of risk factors.

    Science.gov (United States)

    Engin, Atilla

    2017-01-01

    Several studies show that a significantly stronger association is obvious between increased body mass index (BMI) and higher breast cancer incidence. Furthermore, obese women are at higher risk of all-cause and breast cancer specific mortality when compared to non-obese women with breast cancer. In this context, increased levels of estrogens due to excessive aromatization activity of the adipose tissue, overexpression of pro-inflammatory cytokines, insulin resistance, hyperactivation of insulin-like growth factors (IGFs) pathways, adipocyte-derived adipokines, hypercholesterolemia and excessive oxidative stress contribute to the development of breast cancer in obese women. While higher breast cancer risk with hormone replacement therapy is particularly evident among lean women, in postmenopausal women who are not taking exogenous hormones, general obesity is a significant predictor for breast cancer. Moreover, increased plasma cholesterol leads to accelerated tumor formation and exacerbates their aggressiveness. In contrast to postmenopausal women, premenopausal women with high BMI are inversely associated with breast cancer risk. Nevertheless, life-style of women for breast cancer risk is regulated by avoiding the overweight and a high-fat diet. Estrogen-plus-progestin hormone therapy users for more than 5 years have elevated risks of both invasive ductal and lobular breast cancer. Additionally, these cases are more commonly node-positive and have a higher cancer-related mortality. Collectively, in this chapter, the impacts of obesity-related estrogen, cholesterol, saturated fatty acid, leptin and adiponectin concentrations, aromatase activity, leptin and insulin resistance on breast cancer patients are evaluated. Obesity-related prognostic factors of breast cancer also are discussed at molecular basis.

  9. Combined generating-accelerating buncher for compact linear accelerators

    Science.gov (United States)

    Savin, E. A.; Matsievskiy, S. V.; Sobenin, N. P.; Sokolov, I. D.; Zavadtsev, A. A.

    2016-09-01

    Described in the previous article [1] method of the power extraction from the modulated electron beam has been applied to the compact standing wave electron linear accelerator feeding system, which doesnt require any connection waveguides between the power source and the accelerator itself [2]. Generating and accelerating bunches meet in the hybrid accelerating cell operating at TM020 mode, thus the accelerating module is placed on the axis of the generating module, which consists from the pulsed high voltage electron sources and electrons dumps. This combination makes the accelerator very compact in size which is very valuable for the modern applications such as portable inspection sources. Simulations and geometry cold tests are presented.

  10. The CERN accelerator complex

    CERN Multimedia

    Christiane Lefèvre

    2008-01-01

    The LHC is the last ring (dark grey line) in a complex chain of particle accelerators. The smaller machines are used in a chain to help boost the particles to their final energies and provide beams to a whole set of smaller experiments, which also aim to uncover the mysteries of the Universe.

  11. The CERN Accelerator School

    CERN Multimedia

    2016-01-01

      Introduction to accelerator physics This course will take place in Istanbul, Turkey, from 18 to 30 September 2016. It is now open for registration, and further information can be found here: http://cas.web.cern.ch/cas/Turkey-2016/Turkey-advert.html

  12. The CERN Accelerator School

    CERN Multimedia

    2016-01-01

    Introduction to accelerator physics This course will take place in Budapest, Hungary, from 2 to 14 October 2016. It is now open for registration and further information can be found at: http://cas.web.cern.ch/cas/Hungary2016/Hungary-advert.html and http://indico.cern.ch/event/532397/.

  13. The CERN accelerator complex

    CERN Multimedia

    De Melis, Cinzia

    2016-01-01

    The LHC is the last ring (dark blue line) in a complex chain of particle accelerators. The smaller machines are used in a chain to help boost the particles to their final energies and provide beams to a whole set of smaller experiments, which also aim to uncover the mysteries of the Universe.

  14. Acceleration and Special Relativity

    CERN Document Server

    Yahalomi, E M

    2000-01-01

    The integration of acceleration over time before reaching the uniformvelocity turns out to be the source of all the special relativity effects. Itexplains physical phenomena like clocks comparisons. The equations forspace-time, mass and energy are presented. This phenomenon complements theexplanation for the twins paradox. A Universal reference frame is obtained.

  15. Prospects for Accelerator Technology

    Science.gov (United States)

    Todd, Alan

    2011-02-01

    Accelerator technology today is a greater than US$5 billion per annum business. Development of higher-performance technology with improved reliability that delivers reduced system size and life cycle cost is expected to significantly increase the total accelerator technology market and open up new application sales. Potential future directions are identified and pitfalls in new market penetration are considered. Both of the present big market segments, medical radiation therapy units and semiconductor ion implanters, are approaching the "maturity" phase of their product cycles, where incremental development rather than paradigm shifts is the norm, but they should continue to dominate commercial sales for some time. It is anticipated that large discovery-science accelerators will continue to provide a specialty market beset by the unpredictable cycles resulting from the scale of the projects themselves, coupled with external political and economic drivers. Although fraught with differing market entry difficulties, the security and environmental markets, together with new, as yet unrealized, industrial material processing applications, are expected to provide the bulk of future commercial accelerator technology growth.

  16. The CERN accelerator complex

    CERN Multimedia

    Haffner, Julie

    2013-01-01

    The LHC is the last ring (dark grey line) in a complex chain of particle accelerators. The smaller machines are used in a chain to help boost the particles to their final energies and provide beams to a whole set of smaller experiments, which also aim to uncover the mysteries of the Universe.

  17. SPS accelerating cavity

    CERN Multimedia

    1980-01-01

    One of the SPS acceleration cavities (200 MHz, travelling wave structure). On the ceiling one sees the coaxial transmission line which feeds the power from the amplifier, located in a surface building above, to the upstream end of the cavity. See 7603195 for more details, 7411032 for the travelling wave structure, and also 8104138, 8302397.

  18. The CERN accelerator complex

    CERN Multimedia

    Mobs, Esma Anais

    2016-01-01

    The LHC is the last ring (dark blue line) in a complex chain of particle accelerators. The smaller machines are used in a chain to help boost the particles to their final energies and provide beams to a whole set of smaller experiments, which also aim to uncover the mysteries of the Universe.

  19. Atmospheric and accelerator neutrinos

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Yoichiro [Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo Higashi-Mozumi, Kamioka, Hida-City, Gifu 506-1205 (Japan)

    2006-05-15

    Results from the atmospheric neutrino measurements are presented. Evidence for the {nu}{sub {tau}} appearance in the atmospheric neutrino events was shown by statistical methods. The long baseline oscillation experiment using man-made neutrinos has confirmed the atmospheric neutrino oscillation. The future accelerator experiments are briefly discussed.

  20. SPS accelerating cavity

    CERN Multimedia

    CERN PhotoLab

    1981-01-01

    One of the SPS accelerating cavities (200 MHz, travelling wave structure). The power that is fed into the upstream end of the cavity is extracted at the downstream end and sent into a dump load. See 7603195 for more details, 7411032 for the travelling wave structure, and also 8011289, 8302397.

  1. Angular Accelerating White Light

    CSIR Research Space (South Africa)

    Dudley, Angela L

    2015-08-01

    Full Text Available Shaping XVI, 958104, San Diego, California, United States, 09 August 2015 Angular Accelerating White Light Angela Dudley*a,b, Christian Vetterc , Alexander Szameitc , and Andrew Forbesa,b a CSIR National Laser Centre, PO Box 395, Pretoria 0001...

  2. Ocean acidification accelerates reef bioerosion.

    Science.gov (United States)

    Wisshak, Max; Schönberg, Christine H L; Form, Armin; Freiwald, André

    2012-01-01

    In the recent discussion how biotic systems may react to ocean acidification caused by the rapid rise in carbon dioxide partial pressure (pCO(2)) in the marine realm, substantial research is devoted to calcifiers such as stony corals. The antagonistic process - biologically induced carbonate dissolution via bioerosion - has largely been neglected. Unlike skeletal growth, we expect bioerosion by chemical means to be facilitated in a high-CO(2) world. This study focuses on one of the most detrimental bioeroders, the sponge Cliona orientalis, which attacks and kills live corals on Australia's Great Barrier Reef. Experimental exposure to lowered and elevated levels of pCO(2) confirms a significant enforcement of the sponges' bioerosion capacity with increasing pCO(2) under more acidic conditions. Considering the substantial contribution of sponges to carbonate bioerosion, this finding implies that tropical reef ecosystems are facing the combined effects of weakened coral calcification and accelerated bioerosion, resulting in critical pressure on the dynamic balance between biogenic carbonate build-up and degradation.

  3. Ocean acidification accelerates reef bioerosion.

    Directory of Open Access Journals (Sweden)

    Max Wisshak

    Full Text Available In the recent discussion how biotic systems may react to ocean acidification caused by the rapid rise in carbon dioxide partial pressure (pCO(2 in the marine realm, substantial research is devoted to calcifiers such as stony corals. The antagonistic process - biologically induced carbonate dissolution via bioerosion - has largely been neglected. Unlike skeletal growth, we expect bioerosion by chemical means to be facilitated in a high-CO(2 world. This study focuses on one of the most detrimental bioeroders, the sponge Cliona orientalis, which attacks and kills live corals on Australia's Great Barrier Reef. Experimental exposure to lowered and elevated levels of pCO(2 confirms a significant enforcement of the sponges' bioerosion capacity with increasing pCO(2 under more acidic conditions. Considering the substantial contribution of sponges to carbonate bioerosion, this finding implies that tropical reef ecosystems are facing the combined effects of weakened coral calcification and accelerated bioerosion, resulting in critical pressure on the dynamic balance between biogenic carbonate build-up and degradation.

  4. Removable partial denture occlusion.

    Science.gov (United States)

    Ivanhoe, John R; Plummer, Kevin D

    2004-07-01

    No single occlusal morphology, scheme, or material will successfully treat all patients. Many patients have been treated, both successfully and unsuccessfully, using widely varying theories of occlusion, choices of posterior tooth form, and restorative materials. Therefore, experience has demonstrated that there is no one righ r way to restore the occlusion of all patients. Partially edentulous patients have many and varied needs. Clinicians must understand the healthy physiologic gnathostomatic system and properly diagnose what is or may become pathologic. Henderson [3] stated that the occlusion of the successfully treated patient allows the masticating mechanism to carry out its physiologic functions while the temporomandibular joints, the neuromuscular mechanism, the teeth and their supporting structures remain in a good state of health. Skills in diagnosis and treatment planning are of utmost importance in treating these patients, for whom the clinician's goals are not only an esthetic and functional restoration but also a lasting harmonious state. Perhaps this was best state by DeVan [55] more than 60 years ago in his often-quoted objective. "The patient's fundamental need is the continued meticulous restoration of what is missing, since what is lost is in a sense irretrievably lost." Because it is clear that there is no one method, no one occlusal scheme, or one material that guarantees success for all patients, recommendations for consideration when establishing or reestablishing occlusal schemes have been presented. These recommendations must be used in conjunction with other diagnostic and technical skills.

  5. Neurodegeneration in accelerated aging.

    Science.gov (United States)

    Scheibye-Knudsen, Moren

    2016-11-01

    The growing proportion of elderly people represents an increasing economic burden, not least because of age-associated diseases that pose a significant cost to the health service. Finding possible interventions to age-associated disorders therefore have wide ranging implications. A number of genetically defined accelerated aging diseases have been characterized that can aid in our understanding of aging. Interestingly, all these diseases are associated with defects in the maintenance of our genome. A subset of these disorders, Cockayne syndrome, Xeroderma pigmentosum group A and ataxia-telangiectasia, show neurological involvement reminiscent of what is seen in primary human mitochondrial diseases. Mitochondria are the power plants of the cells converting energy stored in oxygen, sugar, fat, and protein into ATP, the energetic currency of our body. Emerging evidence has linked this organelle to aging and finding mitochondrial dysfunction in accelerated aging disorders thereby strengthens the mitochondrial theory of aging. This theory states that an accumulation of damage to the mitochondria may underlie the process of aging. Indeed, it appears that some accelerated aging disorders that show neurodegeneration also have mitochondrial dysfunction. The mitochondrial alterations may be secondary to defects in nuclear DNA repair. Indeed, nuclear DNA damage may lead to increased energy consumption, alterations in mitochondrial ATP production and defects in mitochondrial recycling, a term called mitophagy. These changes may be caused by activation of poly-ADP-ribose-polymerase 1 (PARP1), an enzyme that responds to DNA damage. Upon activation PARP1 utilizes key metabolites that attenuate pathways that are normally protective for the cell. Notably, pharmacological inhibition of PARP1 or reconstitution of the metabolites rescues the changes caused by PARP1 hyperactivation and in many cases reverse the phenotypes associated with accelerated aging. This implies that modulation

  6. [Immediate breast reconstruction for breast cancer].

    Science.gov (United States)

    Yamamoto, Daigo; Tanaka, Yoshihito; Tsubota, Yu; Sueoka, Noriko; Endo, Kayoko; Ogura, Tsunetaka; Nagumo, Yoshinori; Kwon, A-Hon

    2014-11-01

    We performed immediate breast reconstruction after nipple-sparing mastectomy or skin-sparing mastectomy and evaluated the reconstruction procedure, cosmesis, and complications. Among the 30 patients included in the study, 6 received latissimus dorsi flaps, 1 received a transverse rectus abdominis myocutaneous flap, 7 received deep inferior epigastric perforator flaps, 1 received an implant, and 15 received tissue expanders. In addition, the results were excellent in 25 patients, good in 3 patients, and poor in 2 patients. As the number of patients with breast cancer is increasing, the demand for breast reconstruction will increase. Therefore, it is essential to choose an appropriate method of breast reconstruction for each case.

  7. Dynamic MRI of the breast.

    Science.gov (United States)

    Ercolani, P; Valeri, G; Amici, F

    1998-05-01

    To describe the rationale, the technical requirements and the examination technique of dynamic magnetic resonance studies of the breast and to assess the role of this method in the clinical diagnostic protocol. We reviewed the relative literature and compared the results with our personal experience. The earliest reports on the possibility of differentiating carcinoma from benign tissue with magnetic resonance imaging came from Germany, where in 1986 Heywang and coworkers used T1-weighted spin-echo sequences before and after i.v. Gd-DTPA administration with an imaging time of approximately 5 mins and 5 mm slice thickness. With advances in magnetic resonance technology, Heywang Koebrunner adopted a static three-dimensional fast low-angle shot technique permitting advantages of three-dimensional imaging and permit dynamic studies (values over 95%. The time/signal intensity curves revealed the rapid and strong enhancement of malignancies, the gradual and strong enhancement of the only fibroadenoma studied, and the gradual and mild contrast uptake of benign dysplasia. In 1992, in nearly 1000 dynamic examinations, Kaiser and Reiser reported 98.3% sensitivity, 97.0% specificity, 82.1% predictive value and 97.2% accuracy. The combination of rapid acquisition with techniques that preserve high spatial resolution may improve specificity by allowing the study of lesion morphology as well as of enhancement patterns. A whole-breast imaging technique has been reported which permits acquisition times < 15 s by partial sampling of the central k-space region superimposed on high-resolution three-dimensional images. Dynamic magnetic resonance imaging of the breast is currently an important step of the clinical protocol of breast diseases, but there is no established study protocol yet.

  8. Stereotactic Image-Guided Navigation During Breast Reconstruction in Patients With Breast Cancer

    Science.gov (United States)

    2017-04-12

    Ductal Breast Carcinoma in Situ; Lobular Breast Carcinoma in Situ; Recurrent Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer

  9. Breast radiation - discharge

    Science.gov (United States)

    Radiation - breast - discharge ... away around 4 to 6 weeks after the radiation treatment is over. You may notice changes in ... breast looks or feels (if you are getting radiation after a lumpectomy). These changes include: Soreness or ...

  10. Learning about Breast Cancer

    Science.gov (United States)

    ... for the genetic terms used on this page Learning About Breast Cancer What do we know about ... for a small fraction of breast cancers. In Learning About the BRCAX Study , researchers discuss a recent ...

  11. Breast milk jaundice

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000995.htm Breast milk jaundice To use the sharing features on this ... otherwise healthy, the condition may be called "breast milk jaundice." Causes Bilirubin is a yellow pigment that ...

  12. Breastfeeding and Breast Milk

    Science.gov (United States)

    ... Clinical Trials Resources and Publications Breastfeeding and Breast Milk: Condition Information Skip sharing on social media links Share this: Page Content Breastfeeding and Breast Milk: Condition Information​ ​​Breastfeeding, also called nursing, is the ...

  13. Cosmetic breast surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000273.htm Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  14. Breast cancer staging

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000911.htm Breast cancer staging To use the sharing features on this ... Once your health care team knows you have breast cancer , they will do more tests to stage it. ...

  15. Breast Cancer in Men

    Science.gov (United States)

    ... Older age • B RCA2 gene mutation • F amily history of breast cancer • Gynecomastia (enlargement of the breast tissue) • Klinefelter’s syndrome (a genetic condition related to high levels ...

  16. Spinal Intramedullary Metastasis of Breast Cancer

    Directory of Open Access Journals (Sweden)

    Recep Basaran

    2014-01-01

    Full Text Available Objective. Breast cancer accounts for approximately one-third of all cancers in females. Approximately 8.5 % of all central nervous system metastases are located in the spinal cord. These patients have rapidly progressing neurological deficits and require immediate examination. The aim of surgery is decompression of neural tissue and histological evaluation of the tumor. In this paper, we present a case of breast cancer metastasis in thoracic spinal intramedullary area which had been partially excised and then given adjuvant radiotherapy. Case. A 43-year-old female patient with breast cancer for 8 years was admitted to our hospital with complaints of weakness in both legs. Eight years ago, she received chemotherapy and radiotherapy. On her neurological examination, she had paraparesis (left lower extremity: 2/5, right lower extremity: 3/5 and urinary incontinence. Spinal MRI revealed a gadolinium enhancing intramedullary lesion. Pathologic examination of the lesion was consistent with breast carcinoma metastasis. The patient has been taken into radiotherapy. Conclusion. Spinal intramedullary metastasis of breast cancer is an extremely rare situation, but it has a high morbidity and mortality rate. Microsurgical resection is necessary for preservation or amelioration of neurological state and also for increased life expectancy and quality.

  17. ANALYSES ON DIFFERENTIALLY EXPRESSED GENES ASSOCIATED WITH HUMAN BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    MENG Xu-li; DING Xiao-wen; XU Xiao-hong

    2006-01-01

    Objective: To investigate the molecular etiology of breast cancer by way of studying the differential expression and initial function of the related genes in the occurrence and development of breast cancer. Methods: Two hundred and eighty-eight human tumor related genes were chosen for preparation of the oligochips probe. mRNA was extracted from 16 breast cancer tissues and the corresponding normal breast tissues, and cDNA probe was prepared through reverse-transcription and hybridized with the gene chip. A laser focused fluorescent scanner was used to scan the chip. The different gene expressions were thereafter automatically compared and analyzed between the two sample groups. Cy3/Cy5>3.5 meant significant up-regulation. Cy3/Cy5<0.25 meant significant down-regulation. Results: The comparison between the breast cancer tissues and their corresponding normal tissues showed that 84 genes had differential expression in the Chip. Among the differently expressed genes, there were 4 genes with significant down-regulation and 6 with significant up-regulation. Compared with normal breast tissues, differentially expressed genes did partially exist in the breast cancer tissues. Conclusion: Changes in multi-gene expression regulations take place during the occurrence and development of breast cancer; and the research on related genes can help understanding the mechanism of tumor occurrence.

  18. Flexible boosting of accelerated failure time models

    Directory of Open Access Journals (Sweden)

    Hothorn Torsten

    2008-06-01

    Full Text Available Abstract Background When boosting algorithms are used for building survival models from high-dimensional data, it is common to fit a Cox proportional hazards model or to use least squares techniques for fitting semiparametric accelerated failure time models. There are cases, however, where fitting a fully parametric accelerated failure time model is a good alternative to these methods, especially when the proportional hazards assumption is not justified. Boosting algorithms for the estimation of parametric accelerated failure time models have not been developed so far, since these models require the estimation of a model-specific scale parameter which traditional boosting algorithms are not able to deal with. Results We introduce a new boosting algorithm for censored time-to-event data which is suitable for fitting parametric accelerated failure time models. Estimation of the predictor function is carried out simultaneously with the estimation of the scale parameter, so that the negative log likelihood of the survival distribution can be used as a loss function for the boosting algorithm. The estimation of the scale parameter does not affect the favorable properties of boosting with respect to variable selection. Conclusion The analysis of a high-dimensional set of microarray data demonstrates that the new algorithm is able to outperform boosting with the Cox partial likelihood when the proportional hazards assumption is questionable. In low-dimensional settings, i.e., when classical likelihood estimation of a parametric accelerated failure time model is possible, simulations show that the new boosting algorithm closely approximates the estimates obtained from the maximum likelihood method.

  19. Nonlinear dynamics in particle accelerators

    CERN Document Server

    Dilão, Rui

    1996-01-01

    This book is an introductory course to accelerator physics at the level of graduate students. It has been written for a large audience which includes users of accelerator facilities, accelerator physicists and engineers, and undergraduates aiming to learn the basic principles of construction, operation and applications of accelerators.The new concepts of dynamical systems developed in the last twenty years give the theoretical setting to analyse the stability of particle beams in accelerator. In this book a common language to both accelerator physics and dynamical systems is integrated and dev

  20. Partial Actions and Power Sets

    Directory of Open Access Journals (Sweden)

    Jesús Ávila

    2013-01-01

    Full Text Available We consider a partial action (X,α with enveloping action (T,β. In this work we extend α to a partial action on the ring (P(X,Δ,∩ and find its enveloping action (E,β. Finally, we introduce the concept of partial action of finite type to investigate the relationship between (E,β and (P(T,β.

  1. Algorithms over partially ordered sets

    DEFF Research Database (Denmark)

    Baer, Robert M.; Østerby, Ole

    1969-01-01

    in partially ordered sets, answer the combinatorial question of how many maximal chains might exist in a partially ordered set withn elements, and we give an algorithm for enumerating all maximal chains. We give (in § 3) algorithms which decide whether a partially ordered set is a (lower or upper) semi......-lattice, and whether a lattice has distributive, modular, and Boolean properties. Finally (in § 4) we give Algol realizations of the various algorithms....

  2. Breast Self- Examination Contradiction

    Directory of Open Access Journals (Sweden)

    Ayla Akkas Gursoy

    2008-06-01

    Full Text Available Breast cancer is very important health problem among women in the World and Turkey. Although treatment chance is very rising and survival is getting longer thanks to early diagnosis in breast cancer. Some discussion is making related to breast self examination which is one of the early detection methods in recent years. This article consider the discussions about breast self examination under the historical development light. [TAF Prev Med Bull 2008; 7(3.000: 257-260

  3. Breast Cancer and Infertility

    OpenAIRE

    2015-01-01

    Breast cancer is the most common malignancy among women and may accompany infertility. The relationship between infertility treatment and breast cancer has not yet been proven. However, estrogen exposure is well known to cause breast cancer. Recent advances in treatment options have provided young patients with breast cancer a chance of being mother [Archives Medical Review Journal 2015; 24(3.000): 317-323

  4. Mass spectrometry with accelerators.

    Science.gov (United States)

    Litherland, A E; Zhao, X-L; Kieser, W E

    2011-01-01

    As one in a series of articles on Canadian contributions to mass spectrometry, this review begins with an outline of the history of accelerator mass spectrometry (AMS), noting roles played by researchers at three Canadian AMS laboratories. After a description of the unique features of AMS, three examples, (14)C, (10)Be, and (129)I are given to illustrate the methods. The capabilities of mass spectrometry have been extended by the addition of atomic isobar selection, molecular isobar attenuation, further ion acceleration, followed by ion detection and ion identification at essentially zero dark current or ion flux. This has been accomplished by exploiting the techniques and accelerators of atomic and nuclear physics. In 1939, the first principles of AMS were established using a cyclotron. In 1977 the selection of isobars in the ion source was established when it was shown that the (14)N(-) ion was very unstable, or extremely difficult to create, making a tandem electrostatic accelerator highly suitable for assisting the mass spectrometric measurement of the rare long-lived radioactive isotope (14)C in the environment. This observation, together with the large attenuation of the molecular isobars (13)CH(-) and (12)CH 2(-) during tandem acceleration and the observed very low background contamination from the ion source, was found to facilitate the mass spectrometry of (14)C to at least a level of (14)C/C ~ 6 × 10(-16), the equivalent of a radiocarbon age of 60,000 years. Tandem Accelerator Mass Spectrometry, or AMS, has now made possible the accurate radiocarbon dating of milligram-sized carbon samples by ion counting as well as dating and tracing with many other long-lived radioactive isotopes such as (10)Be, (26)Al, (36)Cl, and (129)I. The difficulty of obtaining large anion currents with low electron affinities and the difficulties of isobar separation, especially for the heavier mass ions, has prompted the use of molecular anions and the search for alternative

  5. Removable partial dentures without rests.

    Science.gov (United States)

    Meinig, D A

    1994-04-01

    Ever since Bonwill recommended the use of rests on removable partial dentures in 1899, rests have been universally considered inviolate and have gone unchallenged and untested. The author claims that removable partial dentures without rests may not cause the adverse conditions usually predicted, such as gingival stripping, gingival inflammation, mutilated residual ridges, or extensive and rapid resorption of the alveolar ridges. In removable partial dentures made by the author for several patients, the residual ridge remained stable and in physiologic equilibrium when rests were not used. A history of the long-term effect on patients wearing partial dentures with and without rests is presented.

  6. Two Modes of Partially Screened Gap

    CERN Document Server

    Szary, Andrzej; Gil, Janusz

    2014-01-01

    The analysis of X-ray observations suggest an ultrastrong ($B\\gtrsim 10^{14} \\,{\\rm G}$) surface magnetic field at the polar cap of pulsars (Szary, 2013). On the other hand, the temperature of the polar caps is about a few millions Kelvin. Based on these two facts we use the Partially Screened Gap (PSG) model to describe the Inner Acceleration Region (IAR). The PSG model assumes that the temperature of the actual polar cap is equal to the so-called critical value, i.e. the temperature at which the outflow of thermal ions from the surface screens the gap completely. We have found that, depending on the conditions above the polar cap, the generation of high energetic photons in IAR can be caused either by Curvature Radiation (CR) or by Inverse Compton Scattering (ICS). Completely different properties of both processes result in two different scenarios of breaking the acceleration gap: the so-called PSG-off mode for the gap dominated by CR and the PSG-on mode for the gap dominated by ICS. The existence of two di...

  7. Extended abstract: Partial row projection methods

    Energy Technology Data Exchange (ETDEWEB)

    Bramley, R.; Lee, Y. [Indiana Univ., Bloomington, IN (United States)

    1996-12-31

    Accelerated row projection (RP) algorithms for solving linear systems Ax = b are a class of iterative methods which in theory converge for any nonsingular matrix. RP methods are by definition ones that require finding the orthogonal projection of vectors onto the null space of block rows of the matrix. The Kaczmarz form, considered here because it has a better spectrum for iterative methods, has an iteration matrix that is the product of such projectors. Because straightforward Kaczmarz method converges slowly for practical problems, typically an outer CG acceleration is applied. Definiteness, symmetry, or localization of the eigenvalues, of the coefficient matrix is not required. In spite of this robustness, work has generally been limited to structured systems such as block tridiagonal matrices because unlike many iterative solvers, RP methods cannot be implemented by simply supplying a matrix-vector multiplication routine. Finding the orthogonal projection of vectors onto the null space of block rows of the matrix in practice requires accessing the actual entries in the matrix. This report introduces a new partial RP algorithm which retains advantages of the RP methods.

  8. Chicken Breast Paste

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    Ingredients: 50 grams of chicken breast, 150 grams of egg white, ham, cucumber and water chestnuts, 50 grams of starch, 50 grams of oil, salt and MSG. Directions: 1. Chop up the chicken breast and water chestnuts. Mix with egg white and starch into chicken breast paste. 2. Heat the oil for a moment and then place chicken paste in pot.

  9. Breast Cancer (For Kids)

    Science.gov (United States)

    ... With Breast Cancer Breast Cancer Prevention en español Cáncer de mama You may have heard about special events, like walks or races, to raise money for breast cancer research. Or maybe you've seen people wear ...

  10. Breast sarcomas. Literature review

    Directory of Open Access Journals (Sweden)

    D. A. Ryabchikov

    2014-01-01

    Full Text Available The article presents an overview of the literature about breast sarcomas (nonepithelial malignances. Primary sarcomas are extremely rare, with less than 1 % of all malignant tumors of the breast. Breast carcinomas cause an increased interest of the scientists due to their unique clinical and pathological features and unpredictable prognosis.

  11. Breast cancer awareness

    OpenAIRE

    2012-01-01

    The incidence of breast cancer is rising among women in many European countries, affecting up to 1 in 16 women and has become the most common cause of cancer in European women. In Malta breast cancer is the commonest oncological cause of death in females. In fact 5.2% of all deaths in females in 2010 was from breast cancer.

  12. Tubercular breast abscess

    Directory of Open Access Journals (Sweden)

    Pradeep S Jadhav

    2013-01-01

    Full Text Available Tubercular breast abscess is a rare clinical entity and affects women from mainly the Indian subcontinent. It often mimics breast carcinoma and pyogenic breast abscess clinically. Routine laboratory investigations are not helpful in the diagnosis. Fine needle aspiration cytology (FNAC or biopsy is essential for diagnosis, and tuberculous culture when positive may be very useful to start antitubercular treatment.

  13. Acceleration of microparticle

    CERN Document Server

    Shibata, H

    2002-01-01

    A microparticle (dust) ion source has been installed at the high voltage terminal of the 3.75 MV single ended Van de Graaff electrostatic accelerator and a beam line for microparticle experiments has been build at High Fluence Irradiation Facility (HIT) of Research Center for Nuclear Science and Technology, the University of Tokyo. Microparticle acceleration has been successful in obtaining expected velocities of 1-20 km/s or more for micron or submicron sized particles. Development of in situ dust detectors and analyzers on board satellites and spacecraft in the expected mass and velocity range of micrometeoroids and investigation of hypervelocity impact phenomena by using time of flight mass spectrometry, impact flash or luminescence measurement and scanning electron or laser microscope observation for metals, ceramics, polymers and semiconductors bombarded by micron-sized particles were started three years ago. (author)

  14. Accelerated Parallel Texture Optimization

    Institute of Scientific and Technical Information of China (English)

    Hao-Da Huang; Xin Tong; Wen-Cheng Wang

    2007-01-01

    Texture optimization is a texture synthesis method that can efficiently reproduce various features of exemplar textures. However, its slow synthesis speed limits its usage in many interactive or real time applications. In this paper, we propose a parallel texture optimization algorithm to run on GPUs. In our algorithm, k-coherence search and principle component analysis (PCA) are used for hardware acceleration, and two acceleration techniques are further developed to speed up our GPU-based texture optimization. With a reasonable precomputation cost, the online synthesis speed of our algorithm is 4000+ times faster than that of the original texture optimization algorithm and thus our algorithm is capable of interactive applications. The advantages of the new scheme are demonstrated by applying it to interactive editing of flow-guided synthesis.

  15. accelerating cavity from LEP

    CERN Multimedia

    This is an accelerating cavity from LEP, with a layer of niobium on the inside. Operating at 4.2 degrees above absolute zero, the niobium is superconducting and carries an accelerating field of 6 million volts per metre with negligible losses. Each cavity has a surface of 6 m2. The niobium layer is only 1.2 microns thick, ten times thinner than a hair. Such a large area had never been coated to such a high accuracy. A speck of dust could ruin the performance of the whole cavity so the work had to be done in an extremely clean environment. These challenging requirements pushed European industry to new achievements. 256 of these cavities are now used in LEP to double the energy of the particle beams.

  16. Particle accelerator physics

    CERN Document Server

    Wiedemann, Helmut

    2015-01-01

    This book by Helmut Wiedemann is a well-established, classic text, providing an in-depth and comprehensive introduction to the field of high-energy particle acceleration and beam dynamics. The present 4th edition has been significantly revised, updated and expanded. The newly conceived Part I is an elementary introduction to the subject matter for undergraduate students. Part II gathers the basic tools in preparation of a more advanced treatment, summarizing the essentials of electrostatics and electrodynamics as well as of particle dynamics in electromagnetic fields. Part III is an extensive primer in beam dynamics, followed, in Part IV, by an introduction and description of the main beam parameters and including a new chapter on beam emittance and lattice design. Part V is devoted to the treatment of perturbations in beam dynamics. Part VI then discusses the details of charged particle acceleration. Parts VII and VIII introduce the more advanced topics of coupled beam dynamics and describe very intense bea...

  17. SUPERDIFFUSIVE SHOCK ACCELERATION

    Energy Technology Data Exchange (ETDEWEB)

    Perri, S.; Zimbardo, G. [Dipartimento di Fisica, Universita della Calabria, Ponte P. Bucci Cubo 31C, I-87036 Rende (Italy)

    2012-05-10

    The theory of diffusive shock acceleration is extended to the case of superdiffusive transport, i.e., when the mean square deviation grows proportionally to t{sup {alpha}}, with {alpha} > 1. Superdiffusion can be described by a statistical process called Levy random walk, in which the propagator is not a Gaussian but it exhibits power-law tails. By using the propagator appropriate for Levy random walk, it is found that the indices of energy spectra of particles are harder than those obtained where a normal diffusion is envisaged, with the spectral index decreasing with the increase of {alpha}. A new scaling for the acceleration time is also found, allowing substantially shorter times than in the case of normal diffusion. Within this framework we can explain a number of observations of flat spectra in various astrophysical and heliospheric contexts, for instance, for the Crab Nebula and the termination shock of the solar wind.

  18. Accelerating time to benefit

    DEFF Research Database (Denmark)

    Svejvig, Per; Geraldi, Joana; Grex, Sara

    Despite the ubiquitous pressure for speed, our approaches to accelerate projects remain constrained to the old-fashioned understanding of the project as a vehicle to deliver products and services, not value. This article explores an attempt to accelerate time to benefit. We describe and deconstruct...... the implementation of a large intervention undertaken in five project-based organizations in Denmark – the Project Half Double where the same project methodology has been applied in five projects, each of them in five distinct organizations in Denmark, as a bold attempt to realize double the benefit in half...... of the time. Although all cases valued speed and speed to benefit, and implemented most practices proposed by the methodology, only three of the five projects were more successful in decreasing time to speed. Based on a multi-case study comparison between these five different projects and their respective...

  19. Accelerating QDP++ using GPUs

    CERN Document Server

    Winter, Frank

    2011-01-01

    Graphic Processing Units (GPUs) are getting increasingly important as target architectures in scientific High Performance Computing (HPC). NVIDIA established CUDA as a parallel computing architecture controlling and making use of the compute power of GPUs. CUDA provides sufficient support for C++ language elements to enable the Expression Template (ET) technique in the device memory domain. QDP++ is a C++ vector class library suited for quantum field theory which provides vector data types and expressions and forms the basis of the lattice QCD software suite Chroma. In this work accelerating QDP++ expression evaluation to a GPU was successfully implemented leveraging the ET technique and using Just-In-Time (JIT) compilation. The Portable Expression Template Engine (PETE) and the C API for CUDA kernel arguments were used to build the bridge between host and device memory domains. This provides the possibility to accelerate Chroma routines to a GPU which are typically not subject to special optimisation. As an ...

  20. Accelerators for Cancer Therapy

    Science.gov (United States)

    Lennox, Arlene J.

    2000-05-30

    The vast majority of radiation treatments for cancerous tumors are given using electron linacs that provide both electrons and photons at several energies. Design and construction of these linacs are based on mature technology that is rapidly becoming more and more standardized and sophisticated. The use of hadrons such as neutrons, protons, alphas, or carbon, oxygen and neon ions is relatively new. Accelerators for hadron therapy are far from standardized, but the use of hadron therapy as an alternative to conventional radiation has led to significant improvements and refinements in conventional treatment techniques. This paper presents the rationale for radiation therapy, describes the accelerators used in conventional and hadron therapy, and outlines the issues that must still be resolved in the emerging field of hadron therapy.

  1. Hardware Accelerated Simulated Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Laney, D; Callahan, S; Max, N; Silva, C; Langer, S; Frank, R

    2005-04-12

    We present the application of hardware accelerated volume rendering algorithms to the simulation of radiographs as an aid to scientists designing experiments, validating simulation codes, and understanding experimental data. The techniques presented take advantage of 32 bit floating point texture capabilities to obtain validated solutions to the radiative transport equation for X-rays. An unsorted hexahedron projection algorithm is presented for curvilinear hexahedra that produces simulated radiographs in the absorption-only regime. A sorted tetrahedral projection algorithm is presented that simulates radiographs of emissive materials. We apply the tetrahedral projection algorithm to the simulation of experimental diagnostics for inertial confinement fusion experiments on a laser at the University of Rochester. We show that the hardware accelerated solution is faster than the current technique used by scientists.

  2. NEW ACCELERATION METHODS

    Energy Technology Data Exchange (ETDEWEB)

    Sessler, A.M.

    1984-07-01

    But a glance at the Livingston chart, Fig. 1, of accelerator particle energy as a function of time shows that the energy has steadily, exponentially, increased. Equally significant is the fact that this increase is the envelope of diverse technologies. If one is to stay on, or even near, the Livingston curve in future years then new acceleration techniques need to be developed. What are the new acceleration methods? In these two lectures I would like to sketch some of these new ideas. I am well aware that they will probably not result in high energy accelerators within this or the next decade, but conversely, it is likely that these ideas will form the basis for the accelerators of the next century. Anyway, the ideas are stimulating and suffice to show that accelerator physicists are not just 'engineers', but genuine scientists deserving to be welcomed into the company of high energy physicists. I believe that outsiders will find this field surprisingly fertile and, certainly fun. To put it more personally, I very much enjoy working in this field and lecturing on it. There are a number of review articles which should be consulted for references to the original literature. In addition there are three books on the subject. Given this material, I feel free to not completely reference the material in the remainder of this article; consultation of the review articles and books will be adequate as an introduction to the literature for references abound (hundreds are given). At last, by way of introduction, I should like to quote from the end of Ref. 2 for I think the remarks made there are most germane. Remember that the talk was addressed to accelerator physicists: 'Finally, it is often said, I think by physicists who are not well-informed, that accelerator builders have used up their capital and now are bereft of ideas, and as a result, high energy physics will eventually--rather soon, in fact--come to a halt. After all, one can't build too many

  3. Future Accelerator Magnet Needs

    CERN Document Server

    Devred, Arnaud; Yamamoto, A

    2005-01-01

    Superconducting magnet technology is continually evolving in order to meet the demanding needs of new accelerators and to provide necessary upgrades for existing machines. A variety of designs are now under development, including high fields and gradients, rapid cycling and novel coil configurations. This paper presents a summary of R&D programs in the EU, Japan and the USA. A performance comparison between NbTi and Nb3Sn along with fabrication and cost issues are also discussed.

  4. Accelerated plate tectonics.

    Science.gov (United States)

    Anderson, D L

    1975-03-21

    The concept of a stressed elastic lithospheric plate riding on a viscous asthenosphere is used to calculate the recurrence interval of great earthquakes at convergent plate boundaries, the separation of decoupling and lithospheric earthquakes, and the migration pattern of large earthquakes along an arc. It is proposed that plate motions accelerate after great decoupling earthquakes and that most of the observed plate motions occur during short periods of time, separated by periods of relative quiescence.

  5. LEP copper accelerating cavities

    CERN Multimedia

    Laurent Guiraud

    1999-01-01

    These copper cavities were used to generate the radio frequency electric field that was used to accelerate electrons and positrons around the 27-km Large Electron-Positron (LEP) collider at CERN, which ran from 1989 to 2000. The copper cavities were gradually replaced from 1996 with new superconducting cavities allowing the collision energy to rise from 90 GeV to 200 GeV by mid-1999.

  6. French nuclear physics accelerator opens

    Science.gov (United States)

    Dumé, Belle

    2016-12-01

    A new €140m particle accelerator for nuclear physics located at the French Large Heavy Ion National Accelerator (GANIL) in Caen was inaugurated last month in a ceremony attended by French president François Hollande.

  7. Accelerator mass spectrometry.

    Science.gov (United States)

    Hellborg, Ragnar; Skog, Göran

    2008-01-01

    In this overview the technique of accelerator mass spectrometry (AMS) and its use are described. AMS is a highly sensitive method of counting atoms. It is used to detect very low concentrations of natural isotopic abundances (typically in the range between 10(-12) and 10(-16)) of both radionuclides and stable nuclides. The main advantages of AMS compared to conventional radiometric methods are the use of smaller samples (mg and even sub-mg size) and shorter measuring times (less than 1 hr). The equipment used for AMS is almost exclusively based on the electrostatic tandem accelerator, although some of the newest systems are based on a slightly different principle. Dedicated accelerators as well as older "nuclear physics machines" can be found in the 80 or so AMS laboratories in existence today. The most widely used isotope studied with AMS is 14C. Besides radiocarbon dating this isotope is used in climate studies, biomedicine applications and many other fields. More than 100,000 14C samples are measured per year. Other isotopes studied include 10Be, 26Al, 36Cl, 41Ca, 59Ni, 129I, U, and Pu. Although these measurements are important, the number of samples of these other isotopes measured each year is estimated to be less than 10% of the number of 14C samples.

  8. Accelerated Profile HMM Searches.

    Directory of Open Access Journals (Sweden)

    Sean R Eddy

    2011-10-01

    Full Text Available Profile hidden Markov models (profile HMMs and probabilistic inference methods have made important contributions to the theory of sequence database homology search. However, practical use of profile HMM methods has been hindered by the computational expense of existing software implementations. Here I describe an acceleration heuristic for profile HMMs, the "multiple segment Viterbi" (MSV algorithm. The MSV algorithm computes an optimal sum of multiple ungapped local alignment segments using a striped vector-parallel approach previously described for fast Smith/Waterman alignment. MSV scores follow the same statistical distribution as gapped optimal local alignment scores, allowing rapid evaluation of significance of an MSV score and thus facilitating its use as a heuristic filter. I also describe a 20-fold acceleration of the standard profile HMM Forward/Backward algorithms using a method I call "sparse rescaling". These methods are assembled in a pipeline in which high-scoring MSV hits are passed on for reanalysis with the full HMM Forward/Backward algorithm. This accelerated pipeline is implemented in the freely available HMMER3 software package. Performance benchmarks show that the use of the heuristic MSV filter sacrifices negligible sensitivity compared to unaccelerated profile HMM searches. HMMER3 is substantially more sensitive and 100- to 1000-fold faster than HMMER2. HMMER3 is now about as fast as BLAST for protein searches.

  9. Berkeley Proton Linear Accelerator

    Science.gov (United States)

    Alvarez, L. W.; Bradner, H.; Franck, J.; Gordon, H.; Gow, J. D.; Marshall, L. C.; Oppenheimer, F. F.; Panofsky, W. K. H.; Richman, C.; Woodyard, J. R.

    1953-10-13

    A linear accelerator, which increases the energy of protons from a 4 Mev Van de Graaff injector, to a final energy of 31.5 Mev, has been constructed. The accelerator consists of a cavity 40 feet long and 39 inches in diameter, excited at resonance in a longitudinal electric mode with a radio-frequency power of about 2.2 x 10{sup 6} watts peak at 202.5 mc. Acceleration is made possible by the introduction of 46 axial "drift tubes" into the cavity, which is designed such that the particles traverse the distance between the centers of successive tubes in one cycle of the r.f. power. The protons are longitudinally stable as in the synchrotron, and are stabilized transversely by the action of converging fields produced by focusing grids. The electrical cavity is constructed like an inverted airplane fuselage and is supported in a vacuum tank. Power is supplied by 9 high powered oscillators fed from a pulse generator of the artificial transmission line type.

  10. Optimizing accelerator technology

    CERN Multimedia

    Katarina Anthony

    2012-01-01

    A new EU-funded research and training network, oPAC, is bringing together 22 universities, research centres and industry partners to optimize particle accelerator technology. CERN is one of the network’s main partners and will host 5 early-stage researchers in the BE department.   A diamond detector that will be used for novel beam diagnostics applications in the oPAC project based at CIVIDEC. (Image courtesy of CIVIDEC.) As one of the largest Marie Curie Initial Training Networks ever funded by the EU – to the tune of €6 million – oPAC extends well beyond the particle physics community. “Accelerator physics has become integral to research in almost every scientific discipline – be it biology and life science, medicine, geology and material science, or fundamental physics,” explains Carsten P. Welsch, oPAC co-ordinator based at the University of Liverpool. “By optimizing the operation of accelerators, all of these...

  11. Particle Accelerator Focus Automation

    Directory of Open Access Journals (Sweden)

    Lopes José

    2017-08-01

    Full Text Available The Laboratório de Aceleradores e Tecnologias de Radiação (LATR at the Campus Tecnológico e Nuclear, of Instituto Superior Técnico (IST has a horizontal electrostatic particle accelerator based on the Van de Graaff machine which is used for research in the area of material characterization. This machine produces alfa (He+ and proton (H+ beams of some μA currents up to 2 MeV/q energies. Beam focusing is obtained using a cylindrical lens of the Einzel type, assembled near the high voltage terminal. This paper describes the developed system that automatically focuses the ion beam, using a personal computer running the LabVIEW software, a multifunction input/output board and signal conditioning circuits. The focusing procedure consists of a scanning method to find the lens bias voltage which maximizes the beam current measured on a beam stopper target, which is used as feedback for the scanning cycle. This system, as part of a wider start up and shut down automation system built for this particle accelerator, brings great advantages to the operation of the accelerator by turning it faster and easier to operate, requiring less human presence, and adding the possibility of total remote control in safe conditions.

  12. Particle Accelerator Focus Automation

    Science.gov (United States)

    Lopes, José; Rocha, Jorge; Redondo, Luís; Cruz, João

    2017-08-01

    The Laboratório de Aceleradores e Tecnologias de Radiação (LATR) at the Campus Tecnológico e Nuclear, of Instituto Superior Técnico (IST) has a horizontal electrostatic particle accelerator based on the Van de Graaff machine which is used for research in the area of material characterization. This machine produces alfa (He+) and proton (H+) beams of some μA currents up to 2 MeV/q energies. Beam focusing is obtained using a cylindrical lens of the Einzel type, assembled near the high voltage terminal. This paper describes the developed system that automatically focuses the ion beam, using a personal computer running the LabVIEW software, a multifunction input/output board and signal conditioning circuits. The focusing procedure consists of a scanning method to find the lens bias voltage which maximizes the beam current measured on a beam stopper target, which is used as feedback for the scanning cycle. This system, as part of a wider start up and shut down automation system built for this particle accelerator, brings great advantages to the operation of the accelerator by turning it faster and easier to operate, requiring less human presence, and adding the possibility of total remote control in safe conditions.

  13. Introduction to Microwave Linear [Accelerators

    Energy Technology Data Exchange (ETDEWEB)

    Whittum, David H

    1999-01-04

    The elements of microwave linear accelerators are introduced starting with the principles of acceleration and accelerating structures. Considerations for microwave structure modeling and design are developed from an elementary point of view. Basic elements of microwave electronics are described for application to the accelerator circuit and instrumentation. Concepts of beam physics are explored together with examples of common beamline instruments. Charged particle optics and lattice diagnostics are introduced. Considerations for fixed-target and colliding-beam experimentation are summarized.

  14. Plasma accelerator experiments in Yugoslavia

    Science.gov (United States)

    Purić, J.; Astashynski, V. M.; Kuraica, M. M.; Dojčinovié, I. P.

    2002-12-01

    An overview is given of the results obtained in the Plasma Accelerator Experiments in Belgrade, using quasi-stationary high current plasma accelerators constructed within the framework of the Yugoslavia-Belarus Joint Project. So far, the following plasma accelerators have been realized: Magnetoplasma Compressor type (MPC); MPC Yu type; one stage Erosive Plasma Dynamic System (EPDS) and, in final stage of construction two stage Quasi-Stationary High Current Plasma Accelerator (QHPA).

  15. Brain network alterations and vulnerability to simulated neurodegeneration in breast cancer.

    Science.gov (United States)

    Kesler, Shelli R; Watson, Christa L; Blayney, Douglas W

    2015-08-01

    Breast cancer and its treatments are associated with mild cognitive impairment and brain changes that could indicate an altered or accelerated brain aging process. We applied diffusion tensor imaging and graph theory to measure white matter organization and connectivity in 34 breast cancer survivors compared with 36 matched healthy female controls. We also investigated how brain networks (connectomes) in each group responded to simulated neurodegeneration based on network attack analysis. Compared with controls, the breast cancer group demonstrated significantly lower fractional anisotropy, altered small-world connectome properties, lower brain network tolerance to systematic region (node), and connection (edge) attacks and significant cognitive impairment. Lower tolerance to network attack was associated with cognitive impairment in the breast cancer group. These findings provide further evidence of diffuse white matter pathology after breast cancer and extend the literature in this area with unique data demonstrating increased vulnerability of the post-breast cancer brain network to future neurodegenerative processes.

  16. The GENEPI accelerator operation feedback at the MASURCA reactor facility

    Science.gov (United States)

    Destouches, C.; Fruneau, M.; Belmont, J. L.; Do Pinhal, J.; Albrand, S.; Carreta, J. M.; Chaussonnet, P.; De Conto, J. M.; Fontenille, A.; Fougeras, P.; Garrigue, A.; Guisset, M.; Laurens, J. M.; Loiseaux, J. M.; Marchand, D.; Micoud, R.; Mellier, F.; Perbet, E.; Planet, M.; Ravel, J. C.; Richaud, J. P.

    2006-06-01

    The MUSE-4 experiment, dedicated to the Accelerator Driven System (ADS) development studies, was achieved in the MASURCA nuclear reactor facility from 2000 to 2004. An external neutron source was introduced in a lead buffer zone located at the centre of the reactor core in order to simulate the spallation source. This paper deals with the GENEPI accelerator operation feedback at the MASURCA reactor facility during the MUSE-4 experimental campaign. After a presentation of the MASURCA mock-up facility and of the experimental programme objectives, the different phases of the accelerator design and realization are detailed. Its installation in the MASURCA nuclear facility, achieved in June 2000, is described concerning the technical and administrative topics. Then, the accelerator operation feedback is given concerning maintenance, tritium target management, source monitoring, technical evolutions, etc. The accelerator partial dismantling, achieved in the first part of 2005, is also presented. In addition, the GENEPI contribution to the MUSE-4 programme is presented in terms of experimental results and experimental measurement method improvements. Also, GENEPI 2, an evolution of the GENEPI concept, is described. This accelerator, is coupled to the PEREN facility which is dedicated to the nuclear cross-section measurements. Last, this paper makes a synthesis of the GENEPI operation feedback at the MASURCA facility and proposes recommendations for future projects involving accelerators used in nuclear reactor environment.

  17. Lexicographic Shellability of Partial Involutions

    CERN Document Server

    Can, Mahir Bilen

    2012-01-01

    In this manuscript we study inclusion posets of Borel orbit closures on (symmetric) matrices. In particular, we show that the Bruhat poset of partial involutions is a lexicographiically shellable poset. Also, studying the embeddings of symmetric groups and involutions into rooks and partial involutions, respectively, we find new $EL$-labelings on permutations as well as on involutions.

  18. [Acrylic resin removable partial dentures

    NARCIS (Netherlands)

    Baat, C. de; Witter, D.J.; Creugers, N.H.J.

    2011-01-01

    An acrylic resin removable partial denture is distinguished from other types of removable partial dentures by an all-acrylic resin base which is, in principle, solely supported by the edentulous regions of the tooth arch and in the maxilla also by the hard palate. When compared to the other types of

  19. On Degenerate Partial Differential Equations

    OpenAIRE

    Chen, Gui-Qiang G.

    2010-01-01

    Some of recent developments, including recent results, ideas, techniques, and approaches, in the study of degenerate partial differential equations are surveyed and analyzed. Several examples of nonlinear degenerate, even mixed, partial differential equations, are presented, which arise naturally in some longstanding, fundamental problems in fluid mechanics and differential geometry. The solution to these fundamental problems greatly requires a deep understanding of nonlinear degenerate parti...

  20. Partial Epilepsy with Auditory Features

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-07-01

    Full Text Available The clinical characteristics of 53 sporadic (S cases of idiopathic partial epilepsy with auditory features (IPEAF were analyzed and compared to previously reported familial (F cases of autosomal dominant partial epilepsy with auditory features (ADPEAF in a study at the University of Bologna, Italy.