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Sample records for breast irradiation treatment

  1. Irradiation techniques for the breast cancer treatment

    International Nuclear Information System (INIS)

    The radiotherapy is a cancer treatment way based on the radiation employment. It acts on the tumor, destroying the wicked cells and impeding that this it grows and reproduce. With the radiotherapy the probability of cure of some types of cancer; among them the one of breast, it increases. The investigations in oncology have allowed to develop new technologies with which is possible, for example, to locate the tumors accurately and to adapt the irradiation fields to their form. This has allowed to improve the treatments since it can destroy the tumor applying an intense radiation dose without producing irreversible damages to other organs and healthy tissues of the body. In the underdeveloped countries or in development as Mexico, and almost all those of Latin America, it is not still possible to have several of these technologies in the main oncological centers of the country by their high cost. It is expected that their cost go lowering and that its going to develop technologies more cheap so that they can be applied in more general way to the population that suffers of this suffering. (Author)

  2. Conservation irradiation in the treatment of breast cancer

    International Nuclear Information System (INIS)

    Techniques of treatment and cosmetic results of 130 patients with breast cancer are presented. All patients received conservative treatment, with lumpectomy and radiotherapy at Centro de Oncologia Campinas. (M.A.C.)

  3. Long-term results of breast cancer irradiation treatment with low-dose-rate external irradiation

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to assess beam therapy with low-dose-rate (LDR) external irradiation in a group of patients with breast cancer. Methods and Materials: This trial compared, from 1986 to 1989, patients with advanced breast cancer treated either by conventional fractionation or low-dose-rate (LDR) external radiotherapy (dose-rate 15 mGy/min, 5 sessions of 9 Gy delivered on 5 consecutive days). Results: A total of 21 patients were included in the fractionated therapy arm. At follow-up 15 years after treatment, 7 local recurrences had occurred, 3 patients had died of cancer, 18 patients were alive, 10 were without evidence of disease, and 6 had evidence of disease. A total of 22 patients had been included in the LDR arm of the study. Of these, 11 had received a dose of 45 Gy; thereafter, in view of severe local reactions, the dose was reduced to 35 Gy. There was no local recurrence in patients who had received 45 Gy, although there were 2 local recurrences among the 11 patients after 35 Gy. The sequelae were severe in patients who received 45 Gy but were comparable to those observed in patients treated by fractionated radiotherapy who received 35 Gy. The higher efficacy of tumor control in patients treated by LDR irradiation as well as the lower tolerance of normal tissue are probably related to the lack of repopulation. Conclusion: Although the patient numbers in this study are limited, based on our study results we conclude that the data for LDR irradiation are encouraging and that further investigation is warranted

  4. Dosimetric validation of planning system Eclipse 10 in partial breast irradiation treatments with IMRT

    International Nuclear Information System (INIS)

    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)

  5. Mixed modality treatment planning of accelerated partial breast irradiation: to improve complex dosimetry cases

    International Nuclear Information System (INIS)

    Although 3D-conformal accelerated partial breast irradiation (APBI) is widely used, several questions still remain such as what are the optimal treatment planning modalities. Indeed, some patients may have an unfavorable anatomy and/or inadequate dosimetric constraints could be fulfilled ('complex cases'). In such cases, we wondered which treatment planning modality could be applied to achieve 3D-conformal APBI (2 mini-tangents and an 'en face' electron field or non-coplanar photon multiple fields; or a mixed technique combining non-coplanar photon multiple fields with an 'en face' electron beam). From October 2007 to March 2010, 55 patients with pT1N0 breast cancer were enrolled in a phase II APBI trial. Among them, 7 patients were excluded as they were considered as 'complex cases'. A dosimetric comparison was performed according to the 3 APBI modalities mentioned above and assessed: planning treatment volume (PTV) coverage, PTV/whole breast ratio, lung and heart distance within irradiated field and exposure of organs at risk (OAR). Adequate PTV coverage was obtained with the 3 different treatment planning. Regarding OAR exposure, the 'mixed technique' seemed to reduce the volume of non-target breast tissue in 4 cases compared to the other techniques (in only 1 case), with the mean V50% at 44.9% (range, 13.4 - 56.9%) for the mixed modality compared to 51.1% (range, 22.4 - 63.4%) and 51.8% (range, 23.1 - 59.5%) for the reference and non-coplanar techniques, respectively. The same trend was observed for heart exposure. The mixed technique showed a promising trend of reducing the volume of non-target breast tissue and heart exposure doses in APBI 'complex cases'

  6. Breast-Conserving Treatment With Partial or Whole Breast Irradiation for Low-Risk Invasive Breast Carcinoma-5-Year Results of a Randomized Trial

    International Nuclear Information System (INIS)

    Purpose: To report the 5-year results of a randomized study comparing the survival and cosmetic results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Methods and Materials: Between 1998 and 2004, 258 selected patients with T1 N0-1mi, Grade 1-2, nonlobular breast cancer without presence of extensive intraductal component and resected with negative margins were randomized after breast-conserving surgery to receive 50 Gy/25 fractions WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 x 5.2 Gy high-dose-rate (HDR) multicatheter brachytherapy (BT; n = 88) or 50 Gy/25 fractions electron beam (EB) irradiation (n = 40). Results: At a median follow-up of 66 months, the 5-year actuarial rate of local recurrence was 4.7% and 3.4% in the PBI and WBI arms, respectively (p = 0.50). There was no significant difference in the 5-year probability of overall survival (94.6% vs. 91.8%), cancer-specific survival (98.3% vs. 96.0%), and disease-free survival (88.3% vs. 90.3%). The rate of excellent to good cosmetic result was 77.6% in the PBI group (81.2% after HDR BT; 70.0% after EB) and 62.9% in the control group (52.2% after telecobalt; 65.6% after 6-9-MV photons; pWBI/PBI = 0.009). Conclusions: Partial breast irradiation using interstitial HDR implants or EB to deliver radiation to the tumor bed alone for a selected group of early-stage breast cancer patients produces 5-year results similar to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with carefully designed HDR multicatheter implants compared with the outcome after WBI

  7. Whole-breast irradiation: a subgroup analysis of criteria to stratify for prone position treatment

    International Nuclear Information System (INIS)

    To select among breast cancer patients and according to breast volume size those who may benefit from 3D conformal radiotherapy after conservative surgery applied with prone-position technique. Thirty-eight patients with early-stage breast cancer were grouped according to the target volume (TV) measured in the supine position: small (≤400 mL), medium (400–700 mL), and large (≥700 ml). An ad-hoc designed and built device was used for prone set-up to displace the contralateral breast away from the tangential field borders. All patients underwent treatment planning computed tomography in both the supine and prone positions. Dosimetric data to explore dose distribution and volume of normal tissue irradiated were calculated for each patient in both positions. Homogeneity index, hot spot areas, the maximum dose, and the lung constraints were significantly reduced in the prone position (p 5Gy did not vary consistently in the 2 positions (p = 0.06 and p = 0.7, respectively). The number of necessary monitor units was significantly higher in the supine position (312 vs. 232, p 5Gy, p < 0.0001). In the small TV group, a dose reduction in nontarget areas of 22% in the prone position was detected (p = 0.056); in the medium and high TV groups, the difference was of about −10% (p = NS). The decrease in hot spot areas in nontarget tissues was 73%, 47%, and 80% for small, medium, and large TVs in the prone position, respectively. Although prone breast radiotherapy is normally proposed in patients with breasts of large dimensions, this study gives evidence of dosimetric benefit in all patient subgroups irrespective of breast volume size.

  8. Impact of setup variability on incidental lung irradiation during tangential breast treatment

    International Nuclear Information System (INIS)

    Purpose: 1) To determine the variability in treatment setup during a 5 week course of tangential breast treatment. 2) To assess the relationship between the height of the lung shadow at the central axis (Central Lung Distance: CLD) on the tangential port film and the percent of total lung volume included within the tangential fields (to verify the previously reported result from Bornstein, et al, IJROBP 18:181, 90). 3) To determine the impact of the variabilities in treatment setup on the volume of lung that is incidentally included within the radiation fields. Methods: 1) 172 port films of tangential breast/chest wall fields were reviewed from 20 patients who received tangential beam treatment for breast cancer. All patients were immobilized in customized hemibody foam cradles during simulation and treatment. The CLD (height of the lung shadow at the central axis) seen on each of the port films was compared to the corresponding simulator film (correcting for differences in magnification) as an assessment of setup variability. Both inter and intrapatient differences were considered. 2) A three-dimensional dose calculation (reflecting lung density) was performed, and the percent of total lung volume within the field was compared to the CLD. 3) The three-dimensional dose calculation was repeated for selected patients with the location of the treatment beams modified to reflect typical setup variations, in order to assess the impact of this variability on the volume of lung irradiated. Results: 1) The CLD measured on the port films was within 3 mm of that prescribed on the simulator film in 43% ((74(172))) of the port films. The variation was 3-5 mm in 26 %, 5-10 mm in 25 % and > 10 mm in 6 %. The data are shown in Figure 1. 2) There was an excellent correlation found between the height of the lung shadow and the percent of total lung volume seen within the radiation field, (Figure 2), thus verifying the concept previously reported by Bornstein. 3) A 1 cm setup

  9. 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.

  10. Alternated Prone and Supine Whole-Breast Irradiation Using IMRT: Setup Precision, Respiratory Movement and Treatment Time

    International Nuclear Information System (INIS)

    Purpose: The objective of this study was to compare setup precision, respiration-related breast movement and treatment time between prone and supine positions for whole-breast irradiation. Methods and Materials: Ten patients with early-stage breast carcinoma after breast-conserving surgery were treated with prone and supine whole breast-irradiation in a daily alternating schedule. Setup precision was monitored using cone-beam computed tomography (CBCT) imaging. Respiration-related breast movement in the vertical direction was assessed by magnetic sensors. The time needed for patient setup and for the CBCT procedure, the beam time, and the length of the whole treatment slot were also recorded. Results: Random and systematic errors were not significantly different between positions in individual patients for each of the three axes (left-right, longitudinal, and vertical). Respiration-related movement was smaller in prone position, but about 80% of observations showed amplitudes <1 mm in both positions. Treatment slots were longer in prone position (21.2 ± 2.5 min) than in supine position (19.4 ± 0.8 min; p = 0.044). Conclusion: Comparison of setup precision between prone and supine position in the same patient showed no significant differences in random and systematic errors. Respiratory movement was smaller in prone position. The longer treatment slots in prone position can probably be attributed to the higher repositioning need.

  11. Conformal accelerated partial breast irradiation: State of the art

    International Nuclear Information System (INIS)

    Breast conserving treatment (breast conserving surgery followed by whole breast irradiation) has commonly been used in early breast cancer since many years. New radiation modalities have been recently developed in early breast cancers, particularly accelerated partial breast irradiation. Three-dimensional conformal accelerated partial breast irradiation is the most commonly used modality of radiotherapy. Other techniques are currently being developed, such as intensity-modulated radiotherapy, arc-therapy, and tomo-therapy. The present article reviews the indications, treatment modalities and side effects of accelerated partial breast irradiation. (authors)

  12. MO-A-BRD-06: In Vivo Cherenkov Video Imaging to Verify Whole Breast Irradiation Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, R; Glaser, A [Dartmouth College, Hanover, NH - New Hampshire (United States); Jarvis, L [Dartmouth-Hitchcock Medical Center, City Of Lebanon, New Hampshire (United States); Gladstone, D [Dartmouth-Hitchcock Medical Center, Hanover, City of Lebanon (Lebanon); Andreozzi, J; Hitchcock, W; Pogue, B [Dartmouth College, Hanover, NH (United States)

    2014-06-15

    Purpose: To show in vivo video imaging of Cherenkov emission (Cherenkoscopy) can be acquired in the clinical treatment room without affecting the normal process of external beam radiation therapy (EBRT). Applications of Cherenkoscopy, such as patient positioning, movement tracking, treatment monitoring and superficial dose estimation, were examined. Methods: In a phase 1 clinical trial, including 12 patients undergoing post-lumpectomy whole breast irradiation, Cherenkov emission was imaged with a time-gated ICCD camera synchronized to the radiation pulses, during 10 fractions of the treatment. Images from different treatment days were compared by calculating the 2-D correlations corresponding to the averaged image. An edge detection algorithm was utilized to highlight biological features, such as the blood vessels. Superficial dose deposited at the sampling depth were derived from the Eclipse treatment planning system (TPS) and compared with the Cherenkov images. Skin reactions were graded weekly according to the Common Toxicity Criteria and digital photographs were obtained for comparison. Results: Real time (fps = 4.8) imaging of Cherenkov emission was feasible and feasibility tests indicated that it could be improved to video rate (fps = 30) with system improvements. Dynamic field changes due to fast MLC motion were imaged in real time. The average 2-D correlation was about 0.99, suggesting the stability of this imaging technique and repeatability of patient positioning was outstanding. Edge enhanced images of blood vessels were observed, and could serve as unique biological markers for patient positioning and movement tracking (breathing). Small discrepancies exists between the Cherenkov images and the superficial dose predicted from the TPS but the former agreed better with actual skin reactions than did the latter. Conclusion: Real time Cherenkoscopy imaging during EBRT is a novel imaging tool that could be utilized for patient positioning, movement tracking

  13. MO-A-BRD-06: In Vivo Cherenkov Video Imaging to Verify Whole Breast Irradiation Treatment

    International Nuclear Information System (INIS)

    Purpose: To show in vivo video imaging of Cherenkov emission (Cherenkoscopy) can be acquired in the clinical treatment room without affecting the normal process of external beam radiation therapy (EBRT). Applications of Cherenkoscopy, such as patient positioning, movement tracking, treatment monitoring and superficial dose estimation, were examined. Methods: In a phase 1 clinical trial, including 12 patients undergoing post-lumpectomy whole breast irradiation, Cherenkov emission was imaged with a time-gated ICCD camera synchronized to the radiation pulses, during 10 fractions of the treatment. Images from different treatment days were compared by calculating the 2-D correlations corresponding to the averaged image. An edge detection algorithm was utilized to highlight biological features, such as the blood vessels. Superficial dose deposited at the sampling depth were derived from the Eclipse treatment planning system (TPS) and compared with the Cherenkov images. Skin reactions were graded weekly according to the Common Toxicity Criteria and digital photographs were obtained for comparison. Results: Real time (fps = 4.8) imaging of Cherenkov emission was feasible and feasibility tests indicated that it could be improved to video rate (fps = 30) with system improvements. Dynamic field changes due to fast MLC motion were imaged in real time. The average 2-D correlation was about 0.99, suggesting the stability of this imaging technique and repeatability of patient positioning was outstanding. Edge enhanced images of blood vessels were observed, and could serve as unique biological markers for patient positioning and movement tracking (breathing). Small discrepancies exists between the Cherenkov images and the superficial dose predicted from the TPS but the former agreed better with actual skin reactions than did the latter. Conclusion: Real time Cherenkoscopy imaging during EBRT is a novel imaging tool that could be utilized for patient positioning, movement tracking

  14. Intrafractional Target Motions and Uncertainties of Treatment Setup Reference Systems in Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Purpose: This study investigated the magnitude of intrafractional motion and level of accuracy of various setup strategies in accelerated partial breast irradiation (APBI) using three-dimensional conformal external beam radiotherapy. Methods and Materials: At lumpectomy, gold fiducial markers were strategically sutured to the surrounding walls of the cavity. Weekly fluoroscopy imaging was conducted at treatment to investigate the respiration-induced target motions. Daily pre- and post-RT kV imaging was performed, and images were matched to digitally reconstructed radiographs based on bony anatomy and fiducial markers, respectively, to determine the intrafractional motion magnitudes over the course of treatment. The positioning differences of the laser tattoo- and the bony anatomy-based setups compared with those of the marker-based setup (benchmark) were also determined. The study included 21 patients. Results: Although lung exhibited significant motion, the average marker motion amplitude on the fluoroscopic image was about 1 mm. Over a typical treatment time period, average intrafractional motion magnitude was 4.2 mm and 2.6 mm based on the marker and bony anatomy matching, respectively. The bony anatomy- and laser tattoo-based interfractional setup errors, with respect to the fiducial marker-based setup, were 7.1 and 9.0 mm, respectively. Conclusions: Respiration has limited effects on the target motion during APBI. Bony anatomy-based treatment setup improves the accuracy relative to that of the laser tattoo-based setup approach. Since fiducial markers are sutured directly to the surgical cavity, the marker-based approach can further improve the interfractional setup accuracy. On average, a seroma cavity exhibits intrafractional motion of more than 4 mm, a magnitude that is larger than that which is otherwise derived based on bony anatomy matching. A seroma-specific marker-based approach has the potential to improve treatment accuracy by taking the true inter

  15. Breast Cancer Treatment

    Science.gov (United States)

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...

  16. Breast Cancer: Treatment Options

    Science.gov (United States)

    ... Breast Cancer > Breast Cancer - Treatment Options Request Permissions Breast Cancer - Treatment Options Approved by the Cancer.Net Editorial ... recommendations for ovarian ablation . Hormonal therapy for metastatic breast cancer Hormonal therapies are also commonly used to treat ...

  17. Comparison of standard wedge technique and MLC segment technique for breast irradiation. Optimization using three dimensional treatment planning

    International Nuclear Information System (INIS)

    Postoperative radiotherapy has been delivered with wedged tangential fields, optimized isodose distribution without inhomogeniety corrections in a single central-axis. Three-dimensional radiation treatment planning systems (3D-RTPS) is now available and its utility for breast irradiation should be evaluated. We evaluated MLC segment technique whether it improves dose uniformity within target volume and reduces the dose delivered in normal tissue. Twenty-four consecutive patients with breast cancer undergoing lumpectomy and adjuvant breast radiotherapy were treated in our hospital from April to September 2000. Using 3D-RTPS, standard wedge technique and MLC segment technique were evaluated according to the following parameters; maximum absorbed dose in field, dose conformity in PTV (volume of PTV with dose outside 95-105% of the prescribed dose), absorbed dose in ipsilateral lung (volume with dose larger than 100% of the prescribed dose), and absorbed dose in contralateral breast (maximum dose and mean dose). Significant improvement in the doses PTV and critical structures were achieved using MLC segment technique. Compared with standard wedge technique, MLC segment technique decreased 6% of the maximum absorbed dose, improved 50% of dose homogeneity within the planning target volume, and decreased 50% of the maximum dose and 25% of mean dose to the contralateral breast. The ipsilateral lung volume receiving more than 100% of the prescribed dose was not significantly changed. MLC segment technique can significantly improve dose uniformity within PTV and decrease the maximum dose in the field and the dose of critical structures. It is suggested that customized 3D treatment planning for breast irradiation should be clinically applied to improve treatment outcome. (author)

  18. Analysis of Treatment Efficacy, Cosmesis, and Toxicity Using the MAMMOSITE Breast Brachytherapy Catheter to Deliver Accelerated Partial-Breast Irradiation: The William Beaumont Hospital Experience

    International Nuclear Information System (INIS)

    Purpose: To review our institution's experience of treating patients with the MammoSite (Cytyc Corp., Marlborough, MA) breast brachytherapy catheter to deliver accelerated partial-breast irradiation (APBI), for determining short-term treatment efficacy, cosmesis, and toxicity. Methods and Materials: From January 2000 to April 2006, 80 patients treated with breast-conserving therapy (BCT) received adjuvant radiation using the MammoSite (34 Gy in 3.4-Gy fractions prescribed to 1.0 cm from the balloon surface). Twenty-three patients (29%) had Stage 0 breast cancer, 46 (57%) had Stage I breast cancer, and 11 (14%) had Stage II breast cancer. The median follow-up was 22.1 months. Results: Two ipsilateral breast-tumor recurrences (IBTRs) (2.5%) developed for a 3-year actuarial rate of 2.9% (no regional failures were observed). On molecular-based clonality assay evaluation, both recurrences were clonally related. Younger age at diagnosis was the only variable associated with IBTR (continuous variable, p = 0.044; categorical variable [<55 years vs. ≥55 years], p = 0.012). The percentages of patients with good/excellent cosmetic results at 12 and 36 months were 96.9% and 88.2%, respectively (p = NS). Patients with applicator-to-skin spacing <7 mm and those who received adjuvant systemic chemotherapy exhibited lower rates of good/excellent cosmetic results, though the association was not statistically significant. The overall incidence of symptomatic seromas and any seromas was 10% and 45%, respectively. The overall incidence of fat necrosis and infections was 8.8% and 11.3%, respectively. Conclusions: Early-stage breast-cancer patients treated with adjuvant APBI using the MammoSite catheter exhibited a 3-year treatment efficacy, cosmesis, and toxicity similar to those observed with other forms of interstitial APBI at this length of follow-up

  19. Research on the dose of the tissues located outside the treatment field when breast cancer was irradiated by linear accelerator

    International Nuclear Information System (INIS)

    The purpose of study was to determine the dose of the tissues which located outside the treatment field, when breast cancer was irradiated by 9 MeV electron-beam and 6 MV-X ray after operation. A search for decreasing the dose of the tissues outside the treatment field was made. Clinically relevant treatment fields were simulated on a tissue-equivalent material phantom and subsequently irradiated with 9 MeV electron-beam and 6 MV-X ray. TLD were used to measure absorbed doses. The prescribed dose of breast cancer region was 50.0 Gy, region-lymph-nodes were 60.0 Gy, each exposure dose was 2.0 Gy. In breast cancer region, if only with 9 MeV electron-beam, the dose of the tissues located outside the treatment field were from 29.0 cGy to 295.5 cGy, when shielded with Pb lump, the doses of the tissues outside the treatment field may descended 9.4%-53.6%; if only with 6 MV-X ray, the doses of aforementioned tissues were from 32.0 cGy to 206.7 cGy, when shielded with Pb lump, the doses of the tissues outside the treatment field descended 19.7%-56.6%. In region-lymph-nodes, with 6 MV-X ray, the doses of aforementioned tissues were from 22.5 cGy to 1650.9 cGy, when shielded with Pb lump, the doses of the tissues outside the treatment field descended 19.7-65.6%. If mix-irradiation (9 MeV electron-beam vs. 6 MV-X ray 2:3) was used, the doses outside field would be lower than only used 9 MeV electron-beam or 6 MV-X ray were used

  20. Possibility of conservative local treatment after combined chemotherapy and preoperative irradiation for locally advanced noninflammatory breast cancer

    International Nuclear Information System (INIS)

    Purpose: The aims of this prospective study were to evaluate the outcome and the possibility of breast conservation therapy for patients with locally advanced noninflammatory breast cancer after primary chemotherapy followed by external preoperative irradiation. Methods and Materials: Between April 1982 and June 1990, 97 patients with locally advanced nonmetastatic and noninflammatory breast cancer were treated. The median follow-up was 93 months from the beginning of treatment. The induction treatment consisted of four courses of chemotherapy (doxorubicin, vincristine, cyclophosphamide, 5-fluorouracil) followed by preoperative irradiation (45 Gy to the breast and nodal areas). A fifth course of chemotherapy was given after radiation therapy. Three different loco-regional approaches were proposed, depending on the tumoral response. In 37 patients (38%) with residual tumor larger than 3 cm in diameter or located behind the nipple or with bifocal tumors, mastectomy and axillary dissection were performed. Sixty other patients (62%) benefited from conservative treatment: 33 patients (34%) achieved complete remission and no surgery was done but additional radiation boost was given to the initial tumor bed; 27 patients (28%) who had a residual mass less than or equal to 3 cm in diameter were treated by wide excision and axillary dissection followed by a boost to the excision site. After completion of local therapy, all patients received a sixth course of chemotherapy. A maintenance adjuvant chemotherapy regimen without anthracycline was prescribed (12 monthly cycles). Results: The 5-year actuarial loco-regional relapse rate was 16% after radiotherapy alone, 16% following wide excision and radiotherapy, and 5.4% following mastectomy. The 5-year loco-regional relapse rate was significantly higher after conservative local treatment (wide excision and radiotherapy, and radiotherapy alone) than after mastectomy (p = 0.04). After conservative local treatment, the 5-year breast

  1. Inactivation of Cytomegalovirus in Breast Milk Using Ultraviolet-C Irradiation: Opportunities for a New Treatment Option in Breast Milk Banking.

    Science.gov (United States)

    Lloyd, Megan L; Hod, Nurul; Jayaraman, Jothsna; Marchant, Elizabeth A; Christen, Lukas; Chiang, Peter; Hartmann, Peter; Shellam, Geoffrey R; Simmer, Karen

    2016-01-01

    Pasteurized donor human milk is provided by milk banks to very preterm babies where their maternal supply is insufficient or unavailable. Donor milk is currently processed by Holder pasteurization, producing a microbiologically safe product but significantly reducing immunoprotective components. Ultraviolet-C (UV-C) irradiation at 254 nm is being investigated as an alternative treatment method and has been shown to preserve components such as lactoferrin, lysozyme and secretory IgA considerably better than Holder pasteurization. We describe the inactivation of cytomegalovirus, a virus commonly excreted into breast milk, using UV-C irradiation. Full replication was ablated by various treatment doses. However, evidence of viral immediate early proteins within the cells was never completely eliminated indicating that some viral gene transcription was still occurring. In conclusion, UV-C may be a safe alternative to pasteurisation for the treatment of human donor milk that preserves the bioactivity. However, our data suggests that CMV inactivation will have to be carefully evaluated for each device designed to treat breast milk using UV-C irradiation. PMID:27537346

  2. Instrumental evaluation of colour changes in broiler breast and thigh muscles after irradiation treatment

    International Nuclear Information System (INIS)

    Colour changes in Biceps femoris, Rectus femoris and Pectoralis major broiler chicken muscles were determined with a reflectance colorimeter after irradiation with gamma 60Co rays. The muscles were irradiated with doses of 2, 3, 5, 7 and 10 kGy. The colour parameters L*, a* and b* were measured after 2, 5, 7 and 9 days of refrigerated storage of muscles at 1 deg C using a MINOLTA CR-200b reflectance colorimeter. The saturation of colour C* was also calculated and the significance of redness and yellowness effect on saturation was estimated by a linear regression analysis. Only in the Biceps femoris muscle were all the examined colour parameters found to be dependent both on storage time and irradiation treatment, however, the relationship between the dose and the measured effect demonstrated no linear characteristics. It was noted that the difference between the irradiated and control Biceps femoris muscles resulted from different trends of L*, b* and C* changes during storage

  3. Twelve years' experience with irradiation as the primary treatment for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nobler, M.P. (Mount Sinai School of Medicine, New York, NY); Venet, L.

    1981-01-01

    Ninety patients received comprehensive, high-dose, supervoltage teletherapy as the primary treatment for carcinoma of the breast, following a biopsy or a segmental resection. The tumor doses delivered to the breast ranged between 5600 and 7000 rad in six to nine weeks; the draining lymph nodes received tumor doses of 5000 to 7000 rad in six to eight weeks. In five cases, Iridium-192 implants were employed to boost the radiation dose to the breast, and in seven instances a toilette mastectomy was performed for residual cancer. Satisfactory local control and cosmetic results were achieved in 86 patients. The patients were followed for 2 1/2 to 12 1/2 years. The local control rates were: Stage I, 100%, Stage II, 95%; Stage III, 100%; Stave IV (M-0), 89%; Stave IV (M-1), 100%. The overall disease-free survival figures were: Stage I, 85%; Stage II, 48%; Stage III, 50%; and Stage IV (M-0), 29%. We feel that this approach to the initial management of breast cancer is a practical, useful, and successful substitute for mastectomy when medical or surgical contraindications exist, or when the patient refuses a mastectomy.

  4. Five-Year Analysis of Treatment Efficacy and Cosmesis by the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial in Patients Treated With Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Purpose: To present 5-year data on treatment efficacy, cosmetic results, and toxicities for patients enrolled on the American Society of Breast Surgeons MammoSite breast brachytherapy registry trial. Methods and Materials: A total of 1440 patients (1449 cases) with early-stage breast cancer receiving breast-conserving therapy were treated with the MammoSite device to deliver accelerated partial-breast irradiation (APBI) (34 Gy in 3.4-Gy fractions). Of 1449 cases, 1255 (87%) had invasive breast cancer (IBC) (median size, 10 mm) and 194 (13%) had ductal carcinoma in situ (DCIS) (median size, 8 mm). Median follow-up was 54 months. Results: Thirty-seven cases (2.6%) developed an ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial rate of 3.80% (3.86% for IBC and 3.39% for DCIS). Negative estrogen receptor status (p = 0.0011) was the only clinical, pathologic, or treatment-related variable associated with IBTR for patients with IBC and young age (<50 years; p = 0.0096) and positive margin status (p = 0.0126) in those with DCIS. The percentage of breasts with good/excellent cosmetic results at 60 months (n = 371) was 90.6%. Symptomatic breast seromas were reported in 13.0% of cases, and 2.3% developed fat necrosis. A subset analysis of the first 400 consecutive cases enrolled was performed (352 with IBC, 48 DCIS). With a median follow-up of 60.5 months, the 5-year actuarial rate of IBTR was 3.04%. Conclusion: Treatment efficacy, cosmesis, and toxicity 5 years after treatment with APBI using the MammoSite device are good and similar to those reported with other forms of APBI with similar follow-up.

  5. Treatment of early stage breast cancer by limited surgery and radical irradiation

    International Nuclear Information System (INIS)

    Eighty-five female patients with early stage breast cancer, i.e., Stage I and II were treated by limited surgery followed by radical radiation therapy at Massachusetts General Hospital between January, 1956 and December, 1974. Patients included those who were medically inoperable or who refused mastectomy. The 5-year survival rate was 83% and 76% for Stage I and II, respectively. The corresponding disease free survival (absolute) was 67% and 42%. Although the number of patients so treated is small, there was no significant difference in survival from the results of the radical mastectomy series at the same institution. No major complications were encountered. Seventeen of eighty-five patients developed minor problems; mostly fibrosis and minimal arm lymphedema stemmming from older orthovoltage equipment and treatment techniques. With the current availability of megavoltage equipment, improvements in techniques and dosimetry, complications should decrease. Combined limited surgery and radical radiation therapy should be considered in those patients where a radical mastectomy is not feasible because of psychological or medical problems. Since this procedure results in a cosmetically acceptable breast, radical radiation in early stage breast cancer seems a reasonable alternative to radical mastectomy

  6. Treatment of early stage breast cancer by limited surgery and radical irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Chu, A.M.; Cope, O.; Russo, R.; Wang, C.C.; Schulz, M.D.; Wang, C.; Rodkey, G.

    1980-01-01

    Eighty-five female patients with early stage breast cancer, i.e., Stage I and II were treated by limited surgery followed by radical radiation therapy at Massachusetts General Hospital between January, 1956 and December, 1974. Patients included those who were medically inoperable or who refused mastectomy. The 5-year survival rate was 83% and 76% for Stage I and II, respectively. The corresponding disease free survival (absolute) was 67% and 42%. Although the number of patients so treated is small, there was no significant difference in survival from the results of the radical mastectomy series at the same institution. No major complications were encountered. Seventeen of eighty-five patients developed minor problems; mostly fibrosis and minimal arm lymphedema stemmming from older orthovoltage equipment and treatment techniques. With the current availability of megavoltage equipment, improvements in techniques and dosimetry, complications should decrease. Combined limited surgery and radical radiation therapy should be considered in those patients where a radical mastectomy is not feasible because of psychological or medical problems. Since this procedure results in a cosmetically acceptable breast, radical radiation in early stage breast cancer seems a reasonable alternative to radical mastectomy.

  7. Calcium distribution in ribs of wistar rats after photon irradiation treatment for breast cancer using micro-XRF

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, L.P.; Almeida, A.P.; Braz, D. [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Barroso, R.C.; Almeida, C.E. de; Salata, C.; Andrade, C.B.V.; Silva, C.M. [Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ (Brazil)

    2012-07-01

    Full text: Therapeutic doses of radiation have been shown to have deleterious consequences on bone health. Among the treatment strategies used for breast cancer treatment, the most used are radiotherapy and chemotherapy. Radiotherapy may be given to destroy the cancer cells using high-dose x-rays. Protocols vary considerably, but generally whole body irradiation totals from 10 to 15 Gy, whereas local therapy totals from 40 to 70 Gy. In clinical practice, the quantitative evaluation of bone tissue relies on measurements of bone mineral density values, which are closely associated with the risk of osteoporotic fracture. Improved survivorship rates of cancer patients receiving radiotherapy increase the importance of understanding the mechanisms and long-term effects of radiation-induced bone loss. In this work, we investigated the variation on calcium distribution in ribs of female Wistar rats (Rattus norvegicus) submitted to photon irradiation with a single dose of 20 Gy. The determination of the calcium distribution was performed using synchrotron radiation micro fluorescence (SR-{mu}XRF) at the X-ray Fluorescence beamline at Brazilian Synchrotron Light Laboratory (LNLS). Animals were irradiated using the linear accelerator Varian (CLINAC 2100) at the University Centre for Cancer Control of the State University of Rio de Janeiro (CUCC/UERJ). The total dose delivered was 20 Gy. The animals were about three months old and weighting about 200g. They were distributed into two groups (seven per group): control (did not receive any treatment) and irradiated (submitted to irradiation procedure) groups. Results showed that calcium content decreased within the dorsal ribs of rats submitted to radiotherapy in comparison to the control group. (author)

  8. Morbidity related to axillary irradiation in the treatment of breast cancer

    International Nuclear Information System (INIS)

    Some of the most debilitating morbidity after surgery and radiotherapy for breast cancer is related to treatment of the axilla. This includes persistent arm lymphoedema, impaired shoulder mobility and brachial plexopathy. Considerable research efforts have been carried out on the radiation pathogenesis and the clinical radiobiology of these clinical endpoints, which has enabled their severity and incidence to be minimized. It is clear that the radiation dose-response relationships for these late endpoints are very steep. In other words, even small changes in the exact dose fractionation and physical dose distribution can cause major changes in toxicity. In particular, in many treatment schedules dose fractions larger than 2 Gy have been used without a sufficient reduction in total dose to avoid increased late effects. This is important, as much of the available literature reports side effects after suboptimal dose-fractionation schedules of side effects guaranteed and the locoregional lymphanot representative of what can be achieved using modern radiotherapy. An interesting parallelism to the problems encountered in reviewing historical experience is found in the British breast litigation, the current status of which is presented in this article. Furthermore, morbidity after radiotherapy is strongly influenced by concomitant surgery and/or chemotherapy, and this should be allowed for when designing the overall treatment. Apart from other therapeutic modalities, it has been suggested that other exogenous factors have an influence on the risk of radiotherapy-related morbidity. However, patients' age and, in the case of lymphoedema, also obesity are the only factors that have been established with some certainty. Routine adjustment of radiotherapy dose in these cases is not recommended. Two current developments may strengthen the role of radiotherapy in the treatment of breast cancer. Sentinel node biopsy may allow nodal staging without major surgical excision of

  9. Accelerated partial breast irradiation: the case for current use

    International Nuclear Information System (INIS)

    The treatment of early stage breast cancer is evolving from traditional breast conservation techniques, employing conventionally fractionated whole breast irradiation, to techniques in which partial breast irradiation is used in an accelerated fractionation scheme. A growing body of evidence exists, including favorable findings. Additional studies are under way that may ultimately prove equivalence. The logic behind this approach is reviewed, and the currently available data are presented to support the current use of carefully applied partial breast irradiation techniques in appropriately selected and informed patients

  10. Combined breast conserving surgery, chemotherapy, and irradiation in breast cancer treatment. Role of the interval between surgery and onset of radiotherapy

    International Nuclear Information System (INIS)

    Background: The timing of breast conserving surgery, chemotherapy, and radiotherapy in breast cancer treatment has become the subject of increasing interest over the last years. Results: Five years after start of treatment overall survival, disease-free survival, and local recurrence rates were 86% (95%-confidence limits, 76 to 93%), 73% (61 to 83%), and 8% (3 to 16%), respectively (totally 72 patients). For disease-free survival, the only significant prognostic factor was the number of involved lymph nodes: 0 to 3=86%, ≥4=40% (p20 weeks) had no significant influence on disease-free survival or local tumor control. In contrast, there was a trend of increased regional and distant failure with shortening of the interval due to the delivery of less than 6 cycles chemotherapy before the onset of radiotherapy. Conclusions: In our experience, there was no negative impact of a delay of radiotherapy in order to deliver full course chemotherapy before initiation of radiotherapy. However, the low statistical power of this analysis due to the small number of patients must be considered. It appears possible that a less intense chemotherapy before starting radiation treatment correlates with enhanced distant failure and subsequently decreased disease-free survival rates. Therefore, for patients at increased risk for distant metastasis, we prefer to give 6 cycles polychemotherapy before irradiation. (orig./VHE)

  11. Partial breast irradiation for locally recurrent breast cancer within a second breast conserving treatment: Alternative to mastectomy? Results from a prospective trial

    International Nuclear Information System (INIS)

    Purpose: To assess the outcome of multi-catheter pulse dose rate (PDR) brachytherapy of re-irradiation for local ipsilateral breast tumour recurrence (IBTR) in regard to local control, survival, morbidity and quality of life (QoL). Patients and methods: Between 1999 and 2006, 39 patients were included with histologically confirmed IBTR, Karnofsky index ⩾80% and refusal of mastectomy. Exclusion criteria were multicentric invasive growth pattern, unclear surgical margins, distant metastasis and a postoperative breast not suitable for interstitial brachytherapy. Primary endpoint was local tumour control. Morbidity, cosmetic outcome and QoL were assessed in 24/39 patients. Results: The five year actuarial local control rate was 93% after a mean follow up of 57 (±30) months with two second local relapses. Overall survival and disease free survival, both at 5 years, were 87% and 77%, respectively. Late side effects Grade 1–2 were observed in 20/24 patients after a mean follow-up of 30 (±18) months. Late side effects ⩾Grade 3 occurred in 4/24 patients. Cosmetic outcome was excellent to fair in 76% of women. Overall QoL was comparable to a healthy control group. Mean scores of scales and items of QLQ-BR23 were comparable to primary breast conserving therapy. Conclusions: Accelerated PDR-brachytherapy following breast conserving surgery (BCS) for local IBTR results in local tumour control comparable to mastectomy. Morbidity is moderate; the cosmetic outcome is good and hardly any impairment on QoL is observed.

  12. Treatment Optimization Using Computed Tomography-Delineated Targets Should be Used for Supraclavicular Irradiation for Breast Cancer

    International Nuclear Information System (INIS)

    Background: The purpose of this study was to determine whether the use of optimized CT treatment planning offered better coverage of axillary level III (LIII)/supraclavicular (SC) targets than the empirically derived dose prescription that are commonly used. Materials/Methods: Thirty-two consecutive breast cancer patients who underwent CT treatment planning of a SC field were evaluated. Each patient was categorized according to body mass index (BMI) classes: normal, overweight, or obese. The SC and LIII nodal beds were contoured, and four treatment plans for each patient were generated. Three of the plans used empiric dose prescriptions, and these were compared with a CT-optimized plan. Each plan was evaluated by two criteria: whether 98% of target volume receive >90% of prescribed dose and whether < 5% of the irradiated volume received 105% of prescribed dose. Results: The mean depth of SC and LIII were 3.2 cm (range, 1.4-6.7 cm) and 3.1 (range, 1.7-5.8 cm). The depth of these targets varied according across BMI classes (p = 0.01). Among the four sets of plans, the CT-optimized plans were the most successful at achieving both of the dosimetry objectives for every BMI class (normal BMI, p = .003; overweight BMI, p < .0001; obese BMI, p < .001). Conclusions: Across all BMI classes, routine radiation prescriptions did not optimally cover intended targets for every patient. Optimized CT-based treatment planning generated the most successful plans; therefore, we recommend the use of routine CT simulation and treatment planning of SC fields in breast cancer

  13. Effects of combined electron-beam irradiation and sous-vide treatments on microbiological and other qualities of chicken breast meat

    International Nuclear Information System (INIS)

    The microbiological safety, refrigeration shelf-life, and nutritional quality of chicken breast meat were investigated following combined electron-beam irradiation and cooking under vacuum (sous-vide). Chicken breast meat inoculated with 106 CFU/g of Listeria monocytogenes was irradiated with an electron beam at doses up to 3.1 kGy under vacuum in barrier bags, cooked in a boiling water bath for 3 min 45 s (previously determined to achieve an internal temperature of 71.1oC), and stored at 8oC for up to 5 weeks. Listeria was undetectable in samples treated with combined sous-vide and irradiation at 3.1 kGy, but the organism survived the sous-vide treatment without irradiation and multiplied during storage. A similar study, conducted with uninoculated chicken breast meat, revealed that the product which received both irradiation (3 kGy) and sous-vide treatment had a shelf-life of at least 8 weeks at 8oC, whereas the unirradiated samples treated sous-vide spoiled in 16 days. Listeria was undetectable in combination treated samples, but some of the unirradiated sous-vide samples tested after long storage showed high levels of Listeria. Some loss of thiamine occurred with the combined treatments. (author)

  14. Irradiation techniques for the breast cancer treatment; Tecnicas de irradiacion para el tratamiento de cancer de mama

    Energy Technology Data Exchange (ETDEWEB)

    Varon T, C.F.; Rojas C, E.L. [ININ, 52750 La Marquesa, Estado de Mexico (Mexico)]. e-mail: cbaron4@yahoo.es

    2007-07-01

    The radiotherapy is a cancer treatment way based on the radiation employment. It acts on the tumor, destroying the wicked cells and impeding that this it grows and reproduce. With the radiotherapy the probability of cure of some types of cancer; among them the one of breast, it increases. The investigations in oncology have allowed to develop new technologies with which is possible, for example, to locate the tumors accurately and to adapt the irradiation fields to their form. This has allowed to improve the treatments since it can destroy the tumor applying an intense radiation dose without producing irreversible damages to other organs and healthy tissues of the body. In the underdeveloped countries or in development as Mexico, and almost all those of Latin America, it is not still possible to have several of these technologies in the main oncological centers of the country by their high cost. It is expected that their cost go lowering and that its going to develop technologies more cheap so that they can be applied in more general way to the population that suffers of this suffering. (Author)

  15. Irradiation with external beam and interstitial radioactive implant as primary treatment for early carcinoma of the breast

    International Nuclear Information System (INIS)

    The locoregional control of 60 to 61 patients supports the results published by other centers and compares favorably with results of any surgical series. The cosmetic results are excellent with only three of 61 patients having severe fibrosis of the breast develop. No rib fractures, skin ulcerations, symptomatic radiation pneumonitis, edema of the arm or limitation of arm movement have been observed as complications. Ten of the 28 patients who have had axillary dissection had transient edema of the breast develop. Results of numerous studies suggest that primary radiotherapy without mastectomy is appropriate treatment for early carcinoma of the breast. The accessibility of the breast makes it relatively easy to deliver curative doses of radiation with minimal damage to surrounding normal tissues. The cumulative radiotherapy experience has demonstrated the gratifying results of not only maintaining a rather normal breast but also avoiding the negative physical and psychologic repercussions of the mastectomy. Radiation therapy is an alternative to Halsted's radical mastectomy

  16. Accelerated partial breast irradiation:advances and controversies

    Institute of Scientific and Technical Information of China (English)

    Mani Akhtari; Bin S Teh

    2016-01-01

    The management of localized breast cancer has changed dramatically over the past three to four decades. Breast-conserving therapy, which involved lumpectomy followed by adjuvant irradiation, is now widely considered the standard of care in women with early-stage breast cancer. Accelerated partial breast irradiation (APBI), which involves focal irradiation of the lumpectomy cavity over a short period of time, has developed over the past two decades as an alternative to whole breast irradiation (WBI). Multiple APBI modalities have been developed including brachytherapy, external beam irradiation, and intraoperative irradiation. These new techniques have provided early-stage breast can-cer patients with shorter treatment duration and more focused irradiation, delivering very high biological doses to the region at a high risk of failures over a much shorter treatment course as compared with conventional radiotherapy. However, the advantages of APBI over conventional radiotherapy are controversial, including a higher risk of compli-cations reported in retrospective literature and shorter follow-up duration in the intraoperative APBI trials. Neverthe-less, APBI presents a valuable alternative to WBI for a selected population of women with early-stage breast cancer.

  17. A Japanese prospective multi-institutional feasibility study on accelerated partial breast irradiation using interstitial brachytherapy: treatment planning and quality assurance

    International Nuclear Information System (INIS)

    In Japan, breast-conserving surgery with closed cavity has generally been performed for breast cancer patients, and accelerated partial breast irradiation (APBI) is considered difficult because Asian females generally have smaller breast sizes than Western females. Therefore, common identification of target and treatment plan method in APBI is required. A prospective multicenter study was conducted in Japan to determine institutional compliance with APBI using high-dose-rate interstitial brachytherapy (ISBT) designed for Japanese female patients. For this study, 46 patients were recruited at eight institutions from January 2009 to December 2011. The reproducibility of the ISBT–APBI plan was evaluated using three criteria: (1) minimum clinical target volume dose with a clip dose ≥ 6 Gy/fraction, (2) irradiated volume constraint of 40-150 cm3, and (3) uniformity of dose distribution, expressed as the dose non-uniformity ratio (DNR, V150/V100) < 0.35. The ISBT–APBI plan for each patient was considered reproducible when all three criteria were met. When the number of non-reproducible patients was ≤ 4 at study completion, APBI at this institution was considered statistically reproducible. Half of the patients (52 %) had a small bra size (A/B cup). The mean values of the dose-constrained parameters were as follows: Vref, 117 cm3 (range, 40-282), DNR, 0.30 (range, 0.22-0.51), and clip dose, 784 cGy (range, 469-3146). A total of 43/46 treatment plans were judged to be compliant and ISBT–APBI was concluded to be reproducible. This study showed that multi-institutional ISBT–APBI treatment plan was reproducible for small breast patient with closed cavity

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

    International Nuclear Information System (INIS)

    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. A CBCT image correction method was developed. First, rigid image registration was proceeded for CTs and CBCTs; second, these images were separated into four parts; then, ratio images for each of the four parts of planning CTs/CBCTs were calculated and filtered to reduce the high spatial frequency; finally, the enhanced CBCT images were generated combing the four parts. An anthropomorphic thorax rando phantom was used to evaluate the feasibility and accuracy of the CBCT correction method. The CBCT images of consecutive 10 patients receiving APBI were corrected using the above method and dosimetric variations were evaluated. Each set of CBCT is composed of three images: one acquired after skin-marker setup, one after online setup correction and one after treatment delivery. The phantom study showed the improved accuracy of dose calculation with corrected CBCT. The Dose Volume Histogram (DVH) difference between the planning CT and corrected CBCT is less than the difference between the planning CT and original CBCT. The maximum dose difference between the corrected CBCT and planning CT is 0.8% in PTV-EVAL V100, which is 3.8% between original CBCT and planning. In the patient study, 67.4% of fractions benefit from CBCT setup corrections in PTV-EVAL D95, while in 47.4% of the fractions, reduced dose coverage was found on the post-treatment CBCT. Overall, the CBCT based initial setup correction guaranteed target dose coverage in 9 patients. A generic CBCT image correction algorithm was created and proved to be easily implemented in clinic. Compared to the original CBCT, the corrected CBCT has more accuracy in dose calculation

  19. 3D-conformal Accelerated Partial Breast Irradiation treatment planning: the value of surgical clips in the delineation of the lumpectomy cavity

    International Nuclear Information System (INIS)

    Accurate localisation of the lumpectomy cavity (LC) volume is one of the most critical points in 3D-conformal Partial breast irradiation (3D-APBI) treatment planning because the irradiated volume is restricted to a small breast volume. Here, we studied the role of the placement of surgical clips at the 4 cardinal points of the lumpectomy cavity in target delineation. Forty CT-based 3D-APBI plans were retrieved on which a total of 4 radiation oncologists, two trainee and two experienced physicians, outlined the lumpectomy cavity. The inter-observer variability of LC contouring was assessed when the CTV was defined as the delineation that encompassed both surgical clips and remodelled breast tissue. The conformity index of tumour bed delineation was significantly improved by the placement of surgical clips within the LC (median at 0.65). Furthermore, a better conformity index of LC was observed according to the experience of the physicians (median CI = 0.55 for trainee physicians vs 0.65 for experienced physicians). The placement of surgical clips improved the accuracy of lumpectomy cavity delineation in 3D-APBI. However, a learning curve is needed to improve the conformity index of the lumpectomy cavity

  20. Accelerated partial breast irradiation with interstitial brachytherapy as second conservative treatment for ipsilateral breast tumour recurrence: Multicentric study of the GEC-ESTRO Breast Cancer Working Group

    International Nuclear Information System (INIS)

    Purpose: To analyse the clinical outcome after salvage lumpectomy and multi-catheter brachytherapy (MCB) for ipsilateral breast tumour recurrence (IBTR). Material and methods: Between 09/00 and 09/10, 217 patients presenting an IBTR underwent lumpectomy and MCB (low, pulsed, or high-dose rate). Survival rates without second local recurrence (2nd LR), distant metastasis (DM), and overall survival (OS) were analysed as well as late effects and cosmetic results. Univariate and multivariate analyses (MVA) based on IBTR data were performed to find prognostic factors for 2nd LR, DM, and OS. Results: Median follow-up after the IBTR was 3.9 years [range: 1.1–10.3]. Five and 10-year actuarial 2nd LR rates were 5.6% [range: 1.5–9.5] and 7.2% [range: 2.1–12.1], respectively. Five and 10-year actuarial DM rates were 9.6% [range: 5.7–15.2] and 19.1% [range: 7.8–28.3], respectively. Five and 10-year actuarial OS rates were 88.7% [range: 83.1–94.8] and 76.4% [range: 66.9–87.3], respectively. In MVA, histological grade was prognostic factor for 2nd LR (p = 0.008) and OS (p = 0.02); while tumour size was prognostic factor for DM (p = 0.03). G3-4 complication rate was 11%. Excellent/good cosmetic result was achieved in 85%. Conclusion: This study suggests that in case of IBTR, lumpectomy plus MCB is feasible and effective in preventing 2nd LR with an OS rate at least equivalent to those achieved with salvage mastectomy

  1. Life After Breast Cancer Treatment

    Science.gov (United States)

    FACTS FOR LIFE Life After Breast Cancer Treatment Once breast cancer treatment ends, you may face a new set of issues and concerns. ... fear. If fear starts to disrupt your daily life, talk to your doctor. Getting the support and ...

  2. Irradiation method in the breast conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Ohkawa, Tomohiko [Tokyo Women' s Medical Coll. (Japan); Akiyama, Futoshi; Ito, Yoshiyuki (and others)

    1998-12-01

    This is the guideline on the irradiation in the breast conserving surgery thought to be applicable now in Japan (May, 1998). The breast conserving surgery should be carried out to patients who sufficiently understood the informed consent. This guideline describes and recommends the application, the surgical method, the irradiation method, the adjuvant therapy, follow-up and the elevation. When the breast irradiation is carried out, it is important to sufficiently understand the breast conserving surgery and to make the radiation therapy planning under the consideration of the pathohistological examination for the postoperative evaluation. And it is also necessary to establish the quality control system for the guarantee of the quality assuarance. (K.H.)

  3. Irradiation method in the breast conserving surgery

    International Nuclear Information System (INIS)

    This is the guideline on the irradiation in the breast conserving surgery thought to be applicable now in Japan (May, 1998). The breast conserving surgery should be carried out to patients who sufficiently understood the informed consent. This guideline describes and recommends the application, the surgical method, the irradiation method, the adjuvant therapy, follow-up and the elevation. When the breast irradiation is carried out, it is important to sufficiently understand the breast conserving surgery and to make the radiation therapy planning under the consideration of the pathohistological examination for the postoperative evaluation. And it is also necessary to establish the quality control system for the guarantee of the quality assuarance. (K.H.)

  4. Design and implementation of a rotational radiotherapy technique for breast cancer treatment and their comparison with 3-D-Crt irradiation technique

    International Nuclear Information System (INIS)

    Breast cancer is one of oncological diseases worldwide, as well in Mexico, which causes even more deaths than cervical cancer; this condition is the second death cause in women aged 30-54 years and threatens all socio-economic groups. The treatment is highly dependent on the stage which is detected and based on protocols that include a combination of surgery, chemotherapy and radiotherapy. This paper studies the main irradiation technique for patients with mastectomy, breast full cycle (irradiation of the chest well and supraclavicular nodes) in their mode Three Dimensional - Conformal Radiation Therapy (3-D-Crt), and compared with the Volumetric Modulated Arc Therapy (VMAT) technique proposed in this paper. In both techniques the prescription was 50 Gy divided into 25 fractions. The techniques were applied in three female patients (being an initial study) with disease of the left side, the target volume and organs at risk were delineated by the medical treating radiation oncologist, the planning system used was Eclipse version 10; for quantitative comparison of both plans indexes of homogeneity were used, con formality, the target volume coverage and normal tissue, sub factors and overdosing, the conformation number and coverage quality. They were evaluated and compared the media, maximum and minimum dose of the organs at risk, based on the fact that the coverage of the target volume, dose gradient and dose at risk organs are acceptable (prescription dose greater that 90% coverage, gradient less that 20% and organs at risk in accordance with the Quantec limitations for both versions). (Author)

  5. Breast cancer in elderly women: a retrospective analysis of combined treatment with tamoxifen and once-weekly irradiation

    International Nuclear Information System (INIS)

    Purpose: To evaluate retrospectively the efficacy of combined modality treatment (hormone therapy and hypofractionated radiotherapy) in a population of very elderly women with breast cancer. Methods and Materials: Records on 70 patients of median age 81 years, treated between January 1988 and February 1994, whose median follow-up is now 36 months, have been evaluated. Information obtained included clinical stage at diagnosis, histology, tumor grading, hormone receptor levels, details of treatment, type of failure, survival data, and status at last follow-up examination. Treatment consisted of Tamoxifen 20 mg daily and a hypofractionated course of high dose-per-fraction once-weekly radiotherapy. In the majority of cases this consisted of seven exposures of 6.5 Gy (five to the involved breast, and two to the tumor bed) given over 6 weeks, on a 60Co unit. Nodes were treated when clinically involved, to a dose of 27.5-30 Gy in five to six fractions. Results: At median follow-up of 36 months, the overall survival rate is 87% [confidence interval (CI) 78-95%], the disease specific survival rate is 88% (CI 80-96%), and 72% (CI 60-84%) of patients are free of disease. The local control rate at 36 months is 86% (CI 76-95%). When analyzed by T stage, 81% of T1 patients, 96% of T2 patients, 60% of T3 patients and, paradoxically 100% of T4 patients were in local control at 36 months, although at that point there were just four such patients available for consideration in the T4 group. Initial response to hormone therapy does not appear to be a predictive indicator for ultimate loco-regional control. There is a trend towards greater probability of loco-regional failure if total dose delivered to the breast is less than 35 Gy. Conclusions: Women of elderly age are often denied combined modality therapy, because of coexistant disease or fears held by the responsible physicians that elderly patients are unable to tolerate surgery or protracted courses of radiotherapy. Consequently

  6. Determination of exit skin dose for 192Ir intracavitary accelerated partial breast irradiation with thermoluminescent dosimeters

    OpenAIRE

    Raffi, Julie A.; Stephen D. Davis; Hammer, Cliff G.; Micka, John A.; Kunugi, Keith A.; Musgrove, Jana E.; Winston, John W.; Ricci-Ott, Terresa J.; DeWerd, Larry A.

    2010-01-01

    Purpose: Intracavitary accelerated partial breast irradiation (APBI) has become a popular treatment for early stage breast cancer in recent years due to its shortened course of treatment and simplified treatment planning compared to traditional external beam breast conservation therapy. However, the exit dose to the skin is a major concern and can be a limiting factor for these treatments. Most treatment planning systems (TPSs) currently used for high dose-rate (HDR) 192Ir brachytherapy overe...

  7. Breast cancer: Postoperative irradiation and management of locally advanced disease

    International Nuclear Information System (INIS)

    Purpose/Objective: This course will review current indications for postoperative irradiation, present a videotape demonstration of a simulation technique for comprehensive chest wall/nodal irradiation, and discuss multimodality approaches to the difficult problem of locally advanced breast cancer. As part of an expanding role for the radiation oncologist in the treatment of all stages of breast cancer, recent data has inspired a reevaluation of chest wall and nodal irradiation following mastectomy. A decade ago, adjuvant irradiation was considered by many oncologists to be of no survival advantage or perhaps even harmful. Studies leading to this conclusion will be reviewed with special attention to the inadequacies and flawed constructs which biased these studies against adjuvant chest wall/nodal irradiation. The Fischer hypothesis or 'new paradigm' will be challenged. Can improvement in local control result in improved survival? If the goal of treatment is simply to reduce local-regional recurrence, a three-field technique covering the chest wall and supraclavicular nodes may suffice. But if the goal is an improvement in survival based on the treatment of all locoregional sites which may not be sterilized by chemotherapy and mastectomy, a more complex set of fields is required. Based on this premise, we designed a 5-field technique of comprehensive chest wall and nodal irradiation. Simulation of these fields will be demonstrated on videotape. Treatment strategies for both non-inflammatory and inflammatory non-metastatic breast cancer will be presented. Current recommendations include various combinations of chemohormonotherapy, radiation therapy, and mastectomy, but controversies abound regarding the proper sequencing of these modalities, whether breast conservation therapy can be offered to patients who have a dramatic response to systemic therapy, and whether or not any one of these treatment modalities can be dropped under specific clinical scenarios

  8. Breast cancer: Postoperative irradiation and management of locally advanced disease

    International Nuclear Information System (INIS)

    Purpose/Objective: This course will review current indications for postoperative irradiation, present a videotape demonstration of a simulation technique for comprehensive chest wall/nodal irradiation, and discuss multimodality approaches to the difficult problem of locally advanced breast cancer. As part of an expanding role for the radiation oncologist in the treatment of all stages of breast cancer, recent data has inspired a reevaluation of chest wall and nodal irradiation following mastectomy. A decade ago, adjuvant irradiation was considered by many oncologists to be of no survival advantage or perhaps even harmful. Studies leading to this conclusion will be reviewed with special attention to the inadequacies and flawed constructs which biased these studies against adjuvant chest wall/nodal irradiation. The Fischer hypothesis or 'new paradigm' will be challenged. Can improvement in local control result in improved survival? If the goal of treatment is simply to reduce local-regional recurrence, a three-field technique covering the chest wall and supraclavicular nodes may suffice. But if the goal is an improvement in survival based on the treatment of all locoregional sites which may not be sterilized by chemotherapy and mastectomy, a more complex set of fields is required. Based on this premise, we designed a 5-field technique of comprehensive chest wall and nodal irradiation. Simulation of these fields will be demonstrated on videotape. Treatment strategies for both non-inflammatory and inflammatory non-metastatic breast cancer will be presented. Current recommendations include various combinations of chemohormonotherapy, radiation therapy, and mastectomy, but Controversies abound regarding the proper sequencing of these modalities, whether breast conservation therapy can be offered to patients who have a dramatic response to systemic therapy, and whether or not any one of these treatment modalities can be dropped under specific clinical scenarios

  9. Tangential breast irradiation - rationale and methods for improving dosimetry

    International Nuclear Information System (INIS)

    In recent years there have been great advances and innovations in all technical aspects of radiotherapy, including three dimensional (3D) computer planning, patient immobilization, radiation delivery and treatment verification. Despite this progress, the technique of tangential breast irradiation has changed little over this period and has not exploited these advances. There is increasing evidence that dose inhomogeneity within the breast is greater than at other anatomical sites, especially in women with large breasts. This paper is a review of the factors contributing to poor dosimetry in the breast, the clinical consequences of an inhomogeneous dose distribution, and how breast dosimetry could be improved by considering each of the stages from planning to accurate treatment delivery. It also highlights the particular problem of women with large breasts who may be more likely to have a poorer outcome after a fractionated course of radiotherapy than women with small/medium-sized breasts, and supports the clinical impression that such women are also more likely to have greater inhomogenicity when 3D treatment plans are examined. Preliminary data from our current computed tomography (CT) planning study are presented to support these observations. (author)

  10. Skin toxicity during hypo fractionated breast irradiation in patient with early breast cancer

    International Nuclear Information System (INIS)

    Radiotherapy is an important component in the treatment of breast cancer. (1) Many women with an early stage of breast cancer are candidates for a breast conservation therapy, which combines both conservative surgery and radiotherapy. (2) According to the data from some series, an estimated 90% of the patients treated with radiotherapy for breast cancer will develop a degree of radiation-induced dermatitis. (3) The severity of the skin reactions during and following the breast irradiation is influenced by both treatment-related and patient-related factors. The treatment - related factors include the fraction size (the dose delivered with each treatment), the total dose delivered, the volume of tissue treated, the type of radiation (4) and the addition of chemotherapy. (5) The patient-related factors include breast size, smoking, axillary lymphocele drainage before treatment, age, and infection of the surgical wound. (6) A hypo fractionation radiotherapy is alternative for a standard fractionation radiotherapy for women with early stage of breast cancer after conservative surgery. The aim of the study was to analyse the acute skin reactions during a hypo fractionated radiotherapy in patients with early breast cancer at our institution. Materials and methods: Twenty patients with early stage of breast cancer (Stadium I and II) and conservative surgery (quadrantectomy of breast with ipsilateral axillary dissection) were analysed. The patients were treated with 6MV x rays on LINAC, using tangential fields with 2.65Gy per fraction and the total dose prescribed to target volume was 42,4 Gy. These patients were observed for acute skin toxicity during the second week and at the end of the treatment. We evaluated dryness, epilation, pigmentation, changes and eritema, dry desquamation (clinically characterized by scaling and pruritus) and moist desquamation (characterized by serious oozing and exposure of the dermis). By using the radiation therapy oncology group’s (RTOG

  11. 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)

  12. Partial-Breast Irradiation Versus Whole-Breast Irradiation for Early-Stage Breast Cancer: A Cost-Effectiveness Analysis

    International Nuclear Information System (INIS)

    Purpose: Accelerated partial-breast irradiation (PBI) is a new treatment paradigm for patients with early-stage breast cancer. Although PBI may lead to greater local recurrence rates, it may be cost-effective because of better tolerability and lower cost. We aim to determine the incremental cost-effectiveness of PBI compared with whole-breast radiation therapy (WBRT) for estrogen receptor-positive postmenopausal women treated for early-stage breast cancer. Methods and Materials: We developed a Markov model to describe health states in the 15 years after radiotherapy for early-stage breast cancer. External beam (EB) and MammoSite (MS) PBI were considered and assumed to be equally effective, but carried different costs. Patients received tamoxifen, but not chemotherapy. Utilities, recurrence risks, and costs were adapted from the literature; the baseline utility for no disease after radiotherapy was set at 0.92. Probabilistic sensitivity analyses were performed to model uncertainty in the PBI hazard ratio, recurrence pattern, and patient utilities. Costs (in 2004 US dollars) and quality-adjusted life-years were discounted at 3%/y. Results: The incremental cost-effectiveness ratio for WBRT compared with EB-PBI was $630,000/quality-adjusted life-year; WBRT strongly dominated MS-PBI. One-way sensitivity analysis found that results were sensitive to PBI hazard ratio, recurrence pattern, baseline recurrence risk, and no evidence of disease PBI utility values. Probabilistic sensitivity showed that EB-PBI was the most cost-effective technique over a wide range of assumptions and societal willingness-to-pay values. Conclusions: EB-PBI was the most cost-effective strategy for postmenopausal women with early-stage breast cancer. Unless the quality of life after MS-PBI proves to be superior, it is unlikely to be cost-effective.

  13. Multidisciplinary treatment for advanced and recurrent breast cancer including brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsukiyama, Iwao; Ohno, Tatsuya (Tochigi Cancer Center, Utsunomiya (Japan). Hospital); Takizawa, Yoshikazu; Ikeda, Hiroshi; Egawa, Sunao; Ogino, Takashi

    1994-06-01

    Between 1986 and 1992, 10 patients (12 lesions) of advanced breast cancer were treated with multidisciplinary treatment including brachytherapy. The lesions treated included 5 primary breast tumors, 3 metastatic lesions in the contra lateral breast, 2 recurrences after external beam irradiation, 1 metastasis to the axillary lymph node and 1 metastasis to the upper arm skin. The interstitial irradiation techniques used were [sup 192]Ir low dose-rate irradiation for 5 lesions and high dose-rate for 7 lesions (including 3 with mould irradiation). External hyperthermia as performed for 6 lesions and interstitial hyperthermia were performed for 4 lesions. The local response was CR for 3 lesions, PRa for 8 lesions, PRb for 1 lesion with the local response rate being 100%. Excellent local control could be achieved by combination external and interstitial irradiation, indicating that radiotherapy is definitely useful for the treatment of advanced breast cancer. (author).

  14. Partial Breast Irradiation Versus Whole Breast Radiotherapy for Early-Stage Breast Cancer: A Decision Analysis

    International Nuclear Information System (INIS)

    Purpose: To compare the quality-adjusted life expectancy between women treated with partial breast irradiation (PBI) vs. whole breast radiotherapy (WBRT) for estrogen receptor-positive early-stage breast cancer. Methods and Materials: We developed a Markov model to describe health states in the 15 years after radiotherapy for estrogen receptor-positive early-stage breast cancer. Breast cancer recurrences were separated into local recurrences and elsewhere failures. Ipsilateral breast tumor recurrence (IBTR) risk was extracted from the Oxford overview, and rates and utilities were adapted from the literature. We studied two cohorts of women (aged 40 and 55 years), both of whom received adjuvant tamoxifen. Results: Assuming a no evidence of disease (NED)-PBI utility of 0.93, quality-adusted life expectancy after PBI (and WBRT) was 12.61 (12.57) and 12.10 (12.06) years for 40-year-old and 55-year-old women, respectively. The NED-PBI utility thresholds for preferring PBI over WBRT were 0.923 and 0.921 for 40-year-old and 55-year-old women, respectively, both slightly greater than the NED-WBRT utility. Outcomes were sensitive to the utility of NED-PBI, the PBI hazard ratio for local recurrence, the baseline IBTR risk, and the percentage of IBTRs that were local. Overall the degree of superiority of PBI over WBRT was greater for 55-year-old women than for 40-year-old women. Conclusions: For most utility values of the NED-PBI health state, PBI was the preferred treatment modality. This result was highly sensitive to patient preferences and was also dependent on patient age, PBI efficacy, IBTR risk, and the fraction of IBTRs that were local

  15. Stereotactic breast irradiation with kilovoltage x-ray beams

    Science.gov (United States)

    Garnica-Garza, H. M.

    2016-01-01

    The purpose of this work is to determine, using Monte Carlo simulation and a realistic patient model, the characteristics of the resultant absorbed dose distributions when breast tumors are irradiated using small-field stereotactic body radiation therapy (SBRT) with kilovoltage x-ray beams instead of the standard megavoltage energies currently in use. The Rensselaer Polytechnic Institute (RPI) female phantom was used to model a pair of small-field SBRT breast treatments: in one treatment the tumor at depth and another one with the tumor located close to the breast surface. Each treatment consisted of 300 circular beams aimed at the tumor from a plurality of positions. The PENELOPE Monte Carlo code was used to determine the absorbed dose distribution for each beam and subsequently an optimization algorithm determined each beam weight according to a set of prescription goals. Both kilo- and megavoltage beam treatments were modeled, the latter to be used as a reference. Cumulative dose-volume histograms for eleven structures were used to compare the kilovoltage and reference treatments. Integral dose values are also reported. Absorbed dose distributions for the target volumes as well as the organs at risk were within the parameters reported in a clinical trial for both treatments. While for the ipsilateral healthy breast tissue the megavoltage treatment does offer an advantage in terms of less volume irradiated to intermediate doses, for the contralateral structures, breast and lung, the low penetration ability of the kilovoltage treatment results in a lower maximum dose. Skin dose is higher for the kilovoltage treatment but still well within the tolerance limits reported in the clinical trial.

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

    International Nuclear Information System (INIS)

    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

  17. Subclinical Cardiac Dysfunction Detected by Strain Imaging During Breast Irradiation With Persistent Changes 6 Weeks After Treatment

    International Nuclear Information System (INIS)

    Purpose: To evaluate 2-dimensional strain imaging (SI) for the detection of subclinical myocardial dysfunction during and after radiation therapy (RT). Methods and Materials: Forty women with left-sided breast cancer, undergoing only adjuvant RT to the left chest, were prospectively recruited. Standard echocardiography and SI were performed at baseline, during RT, and 6 weeks after RT. Strain (S) and strain rate (Sr) parameters were measured in the longitudinal, circumferential, and radial planes. Correlation of change in global longitudinal strain (GLS % and Δ change) and the volume of heart receiving 30 Gy (V30) and mean heart dose (MHD) were examined. Results: Left ventricular ejection fraction was unchanged; however, longitudinal systolic S and Sr and radial S were significantly reduced during RT and remained reduced at 6 weeks after treatment [longitudinal S (%) −20.44 ± 2.66 baseline vs −18.60 ± 2.70* during RT vs −18.34 ± 2.86* at 6 weeks after RT; longitudinal Sr (s−1) −1.19 ± 0.21 vs −1.06 ± 0.18* vs −1.06 ± 0.16*; radial S (%) 56.66 ± 18.57 vs 46.93 ± 14.56* vs 49.22 ± 15.81*; *P<.05 vs baseline]. Diastolic Sr were only reduced 6 weeks after RT [longitudinal E Sr (s−1) 1.47 ± 0.32 vs 1.29 ± 0.27*; longitudinal A Sr (s−1) 1.19 ± 0.31 vs 1.03 ± 0.24*; *P<.05 vs baseline], whereas circumferential strain was preserved throughout. A modest correlation between S and Sr and V30 and MHD was observed (GLS Δ change and V30 ρ = 0.314, P=.05; GLS % change and V30 ρ = 0.288, P=.076; GLS Δ change and MHD ρ = 0.348, P=.03; GLS % change and MHD ρ = 0.346, P=.031). Conclusions: Subclinical myocardial dysfunction was detected by 2-dimensional SI during RT, with changes persisting 6 weeks after treatment, though long-term effects remain unknown. Additionally, a modest correlation between strain reduction and radiation dose was observed

  18. Subclinical Cardiac Dysfunction Detected by Strain Imaging During Breast Irradiation With Persistent Changes 6 Weeks After Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Lo, Queenie [University of New South Wales, Sydney, NSW (Australia); Liverpool Hospital, Sydney, NSW (Australia); Hee, Leia; Batumalai, Vikneswary [University of New South Wales, Sydney, NSW (Australia); Liverpool Hospital, Sydney, NSW (Australia); Ingham Institute of Applied Medical Research, Liverpool, NSW (Australia); Allman, Christine [Liverpool Hospital, Sydney, NSW (Australia); MacDonald, Peter [University of New South Wales, Sydney, NSW (Australia); St. Vincent' s Hospital, Sydney, NSW (Australia); Delaney, Geoff P. [University of New South Wales, Sydney, NSW (Australia); Liverpool Hospital, Sydney, NSW (Australia); Ingham Institute of Applied Medical Research, Liverpool, NSW (Australia); Lonergan, Denise [Liverpool Hospital, Sydney, NSW (Australia); Ingham Institute of Applied Medical Research, Liverpool, NSW (Australia); Thomas, Liza, E-mail: l.thomas@unsw.edu.au [University of New South Wales, Sydney, NSW (Australia); Liverpool Hospital, Sydney, NSW (Australia)

    2015-06-01

    Purpose: To evaluate 2-dimensional strain imaging (SI) for the detection of subclinical myocardial dysfunction during and after radiation therapy (RT). Methods and Materials: Forty women with left-sided breast cancer, undergoing only adjuvant RT to the left chest, were prospectively recruited. Standard echocardiography and SI were performed at baseline, during RT, and 6 weeks after RT. Strain (S) and strain rate (Sr) parameters were measured in the longitudinal, circumferential, and radial planes. Correlation of change in global longitudinal strain (GLS % and Δ change) and the volume of heart receiving 30 Gy (V30) and mean heart dose (MHD) were examined. Results: Left ventricular ejection fraction was unchanged; however, longitudinal systolic S and Sr and radial S were significantly reduced during RT and remained reduced at 6 weeks after treatment [longitudinal S (%) −20.44 ± 2.66 baseline vs −18.60 ± 2.70* during RT vs −18.34 ± 2.86* at 6 weeks after RT; longitudinal Sr (s{sup −1}) −1.19 ± 0.21 vs −1.06 ± 0.18* vs −1.06 ± 0.16*; radial S (%) 56.66 ± 18.57 vs 46.93 ± 14.56* vs 49.22 ± 15.81*; *P<.05 vs baseline]. Diastolic Sr were only reduced 6 weeks after RT [longitudinal E Sr (s{sup −1}) 1.47 ± 0.32 vs 1.29 ± 0.27*; longitudinal A Sr (s{sup −1}) 1.19 ± 0.31 vs 1.03 ± 0.24*; *P<.05 vs baseline], whereas circumferential strain was preserved throughout. A modest correlation between S and Sr and V30 and MHD was observed (GLS Δ change and V30 ρ = 0.314, P=.05; GLS % change and V30 ρ = 0.288, P=.076; GLS Δ change and MHD ρ = 0.348, P=.03; GLS % change and MHD ρ = 0.346, P=.031). Conclusions: Subclinical myocardial dysfunction was detected by 2-dimensional SI during RT, with changes persisting 6 weeks after treatment, though long-term effects remain unknown. Additionally, a modest correlation between strain reduction and radiation dose was observed.

  19. Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag; Wilkinson, John Ben; Baschnagel, Andrew [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ghilezan, Mihai [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Riutta, Justin; Dekhne, Nayana; Balaraman, Savitha [Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Mitchell, Christina; Wallace, Michelle [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank, E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States)

    2012-07-15

    Purpose: To determine the rates of breast cancer-related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.

  20. Factors Associated With the Development of Breast Cancer–Related Lymphedema After Whole-Breast Irradiation

    International Nuclear Information System (INIS)

    Purpose: To determine the rates of breast cancer–related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.

  1. Bilateral breast cancer treated with breast-conserving surgery and definitive irradiation

    International Nuclear Information System (INIS)

    Objective: To assess whether patients with early stage bilateral breast cancer can be treated with definitive irradiation following breast-conserving surgery with acceptable survival, local control, complication rates, and cosmetic outcomes. Material and Methods: We reviewed 55 cases of patients with synchronous or sequential bilateral breast cancer treated with definitive irradiation following breast-conserving surgery at our institution from 1977 to 1992. Analysis of cases was limited to women who were AJCC clinical Stage 0, I, and II. The records of these 55 patients with 110 treated breasts were reviewed for tumor size, histology, AJCC stage, pathologic axillary lymph nodes status, first and overall site(s) of failure, and adjuvant chemotherapy or hormonal therapy. Analysis regarding matching technique, cosmetic outcome, and complication rate was also performed. The 5- and 10-year overall survival (OS), no evidence of disease (NED) survival, relapse-free survival (RFS), and local control rates were evaluated. Twelve women (22%) presented with synchronous bilateral carcinoma, and 43 women (78%) had sequential bilateral carcinoma. Of the 12 patients with synchronous cancer, 5 received adjuvant chemotherapy, 2 received Tamoxifen, and 1 received both adjuvant therapies. Of the 43 patients with sequential cancer, 6 received chemotherapy, 1 received Tamoxifen, and 1 received both adjuvant therapies for the first cancer treatment; seven received chemotherapy and 6 received Tamoxifen for the second cancer treatment. Results: The median age at the time of treatment of the first cancer was 56 years (range 26-86 years). For the 12 patients with synchronous cancer, the median follow-up was 48 months (range 9-164). For the 43 patients with sequential cancer, the median follow-up was 112 months (range 52-188 months) after the first cancer, and 59 months (range 11-153 months) after the second. The median dose delivered was 64 Gy (range 42-72 Gy) using a combination of

  2. Generic phytosanitary irradiation treatments

    International Nuclear Information System (INIS)

    The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies. - Highlights: ► The history of phytosanitary irradiation (PI) treatments is given. ► Generic PI treatments in use today are discussed. ► Suggestions for future research are presented. ► A dose of 250 Gy for most insects may suffice.

  3. Early-stage bilateral breast cancer treated with breast-conserving surgery and definitive irradiation: the university of Pennsylvania experience

    International Nuclear Information System (INIS)

    Purpose: To determine whether patients with early-stage bilateral breast cancer can be treated with definitive irradiation following breast-conserving surgery with acceptable survival, local control, complications, and cosmesis. Methods and Materials: During the period 1977-1992, 55 women with Stage 0, I, or II concurrent (n = 12) or sequential (n = 43) bilateral breast cancer were treated with definitive irradiation following breast-conserving surgery. The records of these 55 patients with 110 treated breasts were reviewed for tumor size, histology, pathologic axillary lymph node status, first and overall site(s) of failure, and adjuvant chemotherapy or hormonal therapy. Curves for survival, local control, and regional control were determined. Cosmetic outcome, complication rates, and matching technique were analyzed. The median total radiation dose delivered was 64 Gy (range 42-72) using tangential whole-breast irradiation followed by an electron or iridium implant boost. The tangential fields were matched with no overlap in 40 patients (73%); there was overlap on skin of up to 4 cm in 14 patients (25%); and the matching technique was unknown in 1 patient (2%). The median follow-up for the 12 women with concurrent bilateral breast cancer was 4.0 years. The median follow-up for the other 43 women with sequential cancer was 9.3 and 4.9 years, respectively, after the first and second cancers. Results: For the overall group of 55 patients, the 5- and 10-year overall survival rates were 96% and 94%, respectively, after treatment of the first cancer, and 96% and 92%, respectively, after treatment of the second cancer. The 5- and 10-year actuarial relapse-free survival rates were 90% and 75%, respectively, after treatment of the first cancer, and 83% and 72%, respectively, after treatment of the second cancer. For the 110 treated breast cancers, the 5- and 10-year actuarial local failure rates were 5% and 15%, respectively. Complication rates were: 28% breast edema, 8

  4. Breast hypoplasia following irradiation of the female breast in infancy and early childhood

    International Nuclear Information System (INIS)

    The occurrence and the degree of breast hypoplasia were studied in 129 women irradiated with ionizing radiation in infancy or childhood for hemangioma located in the breast region. The patients were born between 1934 and 1943 and were treated at Radiumhemmet before 4 years of age. Dosimetry was based on treatment data. The mean absorbed dose to the breast anlage was 2.3 Gy. Breast asymmetry was estimated by a mailed questionnaire to all patients and by a clinical examination of 53 patients living in Stockholm Country. Breast hypoplasia on the treated side was reported by 57% of the patients and on the contralateral side by 8%. A breast hypoplasia exceeding 10% was found in 53% of the clinically examined patients on the treated side and in 9% on the contralateral side. The frequency and the severity of impaired breast development increased with the absorbed dose. The possibility of a threshold dose for the occurrence of breast hypoplasia could neither be established nor ruled out. (orig.)

  5. Treatment Option Overview (Breast Cancer)

    Science.gov (United States)

    ... trials is available from the NCI website . Locally Advanced or Inflammatory Breast Cancer Treatment of locally advanced ... NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an ...

  6. Accelerated Partial Breast Irradiation with Intensity-Modulated Radiotherapy Is Feasible for Chinese Breast Cancer Patients

    OpenAIRE

    He, Zhenyu; Wu, Sangang; Zhou, Juan; Li, Fengyan; Sun, Jiayan; Lin, Qin; Lin, Huanxin; Guan, Xunxing

    2014-01-01

    Purpose Several accelerated partial breast irradiation (APBI) techniques are being investigated in patients with early-stage breast cancer. The present study evaluated the feasibility, early toxicity, initial efficacy, and cosmetic outcomes of accelerated partial breast intensity-modulated radiotherapy (IMRT) for Chinese female patients with early-stage breast cancer after breast-conserving surgery. Methods A total of 38 patients met the inclusion criteria and an accelerated partial breast in...

  7. Generic phytosanitary irradiation treatments

    International Nuclear Information System (INIS)

    The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies. (author)

  8. Accelerated partial breast irradiation using robotic radiotherapy: a dosimetric comparison with tomotherapy and three-dimensional conformal radiotherapy

    OpenAIRE

    Rault, Erwann; Lacornerie, Thomas; Dang, Hong-Phuong; Crop, Frederik; Lartigau, Eric; Reynaert, Nick; Pasquier, David

    2016-01-01

    Background Accelerated partial breast irradiation (APBI) is a new breast treatment modality aiming to reduce treatment time using hypo fractionation. Compared to conventional whole breast irradiation that takes 5 to 6 weeks, APBI is reported to induce worse cosmetic outcomes both when using three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). These late normal tissue effects may be attributed to the dose volume effect because a large portion of the no...

  9. Partial breast irradiation with interstitial high dose-rate brachytherapy: acute and late toxicities and cosmetic results

    International Nuclear Information System (INIS)

    Accelerated partial breast irradiation aims at decreasing the overall treatment time and reducing toxicity. The study we report is for early stage breast cancer and is a multicentre clinical investigation of partial breast irradiation achieved by interstitial high dose-rate (HDR) brachytherapy with intraoperative placement of catheters. We have been able to conclude from the initial data that an interstitial perioperative brachytherapy implant is a feasible method of treatment with good tolerance and good cosmetic results. (author)

  10. Search for the lowest irradiation dose from literatures on radiation-induced breast cancer

    International Nuclear Information System (INIS)

    A survey of past case reports concerning radiation-induced breast cancer was carried out in order to find the lowest irradiation dose. The search of literature published since 1951 revealed 10 cases of radiation-induced breast cancer. Only 5 cases had precise descriptions of the irradiation dose. The lowest irradiation dose was estimated at 1470 rads in the case of external X-ray irradiation for tuberous angioma. All of cases of radiation-induced breast cancer had received radiation for the treatment of nonmalignant tumors, such as pulmonary tuberculosis, mastitis, and tuberous angioma. There also were three statistical studies. The first concerned atomic bomb survivors, the second, pulmoanry tuberculous patients subjected to frequent fluoroscopies, and the third, patients of acute post partum mastitis. These statistical studies had revealed a significant increase in the incidence of breast cancer in the irradiated group, but there was little information about the lowest irradiation dose. It was noticed that radiation-induced breast cancer was more numerous in the upper inner quadrant of the breast. Most histopathological findings of radiation-induced breast cancer involved duct cell carcinoma. The latent period was about 15 years. (Evans, J.)

  11. Interfractional Target Variations for Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Purpose: In this work, we quantify the interfractional variations in the shape of the clinical target volume (CTV) by analyzing the daily CT data acquired during CT-guided partial breast irradiation (PBI) and compare the effectiveness of various repositioning alignment strategies considered to account for the variations. Methods and Materials: The daily CT data for 13 breast cancer patients treated with PBI in either prone (10 patients) or supine (3 patients) with daily kV CT guidance using CT on Rails (CTVision, Siemens, Malvern, PA) were analyzed. For approximately 25 points on the surface of the CTV, deformation vectors were calculated by means of deformable image registration and verified by visual inspection. These were used to calculate the distances along surface normals (DSN), which directly related to the required margin expansions for each point. The DSN values were determined for seven alignment methods based on volumetric imaging and also two-dimensional projections (portal imaging). Results: The margin expansion necessary to cover 99% of all points for all days was 2.7 mm when utilizing the alignment method based on deformation field data (the best alignment method). The center-of-mass based alignment yielded slightly worse results (a margin of 4.0 mm), and shifts obtained by operator placement (7.9 mm), two-dimensional-based methods (7.0–10.1 mm), and skin marks (13.9 mm) required even larger margin expansions. Target shrinkage was evident for most days by the negative values of DSN. Even with the best alignment, the range of DSN values could be as high as 7 mm, resulting in a large amount of normal tissue irradiation, unless adaptive replanning is employed. Conclusion: The appropriate alignment method is important to minimize the margin requirement to cover the significant interfractional target deformations observed during PBI. The amount of normal tissue unnecessarily irradiated is still not insignificant, and can be minimized if adaptive

  12. Combined conservative surgery, chemotherapy and radiation therapy in treatment of the breast cancer patient: the influence of the interval between surgery and start of irradiation

    International Nuclear Information System (INIS)

    Purpose: To analyze our experience treating breast cancer patients with combined breast conserving surgery, chemotherapy and radiation therapy in the light of considerable discussion on the role of the interval between surgery and radiation therapy (S-RT). Materials and Methods: Between 1985 and 1992, 100 patients with invasive breast cancer underwent radiation treatment at our institution after conservative surgery with axillary dissection and some form of chemotherapy. Criteria for inclusion in this retrospective analysis were: Stage M0, no simultaneous malignancies, gross total resection of primary and involved lymph nodes, at least three cycles of postoperative polychemotherapy, complete radiation treatment, complete follow-up information. Seventy-four patients fulfilling these criteria form the basis of this report. For patients alive at last observation date, median follow-up time was five years (i.e., 59 months; range, 36-112 months). Age at diagnosis ranged between 20 and 69 years (median, 48 years). Fifty-four patients were pre- or perimenopausal (73%) and 20 were postmenopausal (27%). Tumors were staged using the AJCC-system. Distribution of T-Stage was: T1 (n=36), T2 (n=37), T3 (n=1). In 95% of patients, axillary lymph nodes were positive: 1-3 nodes (n=50), ≥ 4 nodes (n=20), and 0 nodes (n=3). Thus, 91% of patients were Stage II. In 65% of patients, final pathological margins were negative. Margins showed invasive and intraductal carcinoma in 5 and 11% of cases, respectively (margins unknown in 19%). Chemotherapy regimens and doses varied according to the referring physicians as well as during the study period. Seventy percent of patients received six cycles of chemotherapy (predominan CMF) before onset of irradiation. The median S-RT interval was 20.5 weeks (range, 8.4-31.9 weeks). Usually, the breast was treated to 50 Gy, 2 Gy per fraction, five fractions per week, using Cobalt-60 (n=66) or 5 MeV photons (n=8). Then the tumor bed was boosted with

  13. Repeat high-dose external beam irradiation for in-breast tumor recurrence after previous lumpectomy and whole breast irradiation

    International Nuclear Information System (INIS)

    Purpose: To determine whether excision of an in-breast tumor recurrence (IBTR) plus 5000 cGy in 25 fractions to the new operative area is both tolerated and effective as treatment for an IBTR after previous lumpectomy and whole breast irradiation. Methods and Materials: Thirty-nine women with an IBTR after lumpectomy and breast irradiation for invasive carcinoma (n 31) or ductal carcinoma in situ (n = 8) were treated with excision of the IBTR and radiotherapy (RT), 5000 cGy in 25 fractions, to the operative area using electrons of appropriate energy. The interval from completion of the first course of RT to diagnosis of the IBTR ranged from 16 to 291 months (median 63). Results: The repeat course of RT to the new operative area was well tolerated in all patients, and no late sequelae occurred other than skin pigmentation changes. Eight patients, including 2 with suspicious bone scans at the time of IBTR, developed distant metastases, and 7 died 21-71 months (median 48) after retreatment. One patient was alive with distant metastases at 27 months after retreatment. Four of the 8 patients who developed distant metastases also had a second IBTR, and 3 died with persistent disease in the breast. An additional 4 patients, for a total of 8, had a second IBTR. Three were alive and free of disease after mastectomy, and 1 was alive and free of disease after mastectomy and additional RT for chest wall recurrence. An additional patient developed recurrence in the axilla 9 months after reirradiation and was treated with surgery; she died free of disease at 63 months. One patient underwent mastectomy for suspected persistent disease 2 months after completion of repeat RT; no evidence of recurrent tumor was found in the removed breast. Thus, 30 women (76.9%) had an intact breast free of tumor at death or at last follow-up 1-180 months (median 51.5) after reirradiation. Using the Kaplan-Meier life table analysis, the estimated overall and disease-free 5-year survival rate for the

  14. Oncologic treatment of patients with breast cancer

    International Nuclear Information System (INIS)

    Full text: Objective: To perform a retrospective descriptive study on breast cancer in patients treated in our hospital to assess the biological profile and treatment heating in these patients. Material and methods: We collect information from medical records for the period 2006 to 2010 included. Basic statistical analyzes were performed with the sample obtained using the Epi data. Results: From a total of 720 patients, showed that 31% are under 50 and 69% are older than 50 years. The 95 % of the total, surgery was performed. The 94 % is to Infiltrating Ductal Carcinoma. I stages were 17%, 39% Stages II, III Stages Stages IV 29% and 15%. 79% had one or two positive hormone receptors. At 86 % Radiation was performed either in the breast or chest wall treatments regional nodal areas when directed. In the vast majority gave a dose of 50 Gy to the whole breast and nodal areas when corresponded with overprinting in the surgical bed of 16Gy. In cases of treatment of wall thoracic, was given a dose of 50 Gy. The number of relapses in irradiated territories was 5 patients. The average treatment time was 45 heating days for patients who underwent conservative surgery and 38 days for patients who underwent mastectomy. Conclusions: The parameters analyzed in this study are comparable to those work results in other centers. The local recurrence rate in patients treated with surgery and adjuvant radiotherapy is extremely low

  15. Analysis of whole Breast Radiotherapy Methods for Treatment of Early Stage Breast Cancer after Conserving Surgery

    International Nuclear Information System (INIS)

    Introduction. At present moment breast cancer in Latvia is at second place for whole population and at first place among women. In year 2004 there were 1012 new breast cancer cases discovered. There was growth in number of breast cancer patients from 58.6 per 100 000 inhabitants in 1995 to 80.4 per 100 000 inhabitants in 2004. This growth is primarily attributed to breast cancer screening program which is nowadays active in Latvia. Breast cancer is third death cause among cancers in Latvia, - in 1995 there where 27.4 deaths per 100 000 inhabitants and in 2004 - 36.2 deaths per 100 000 inhabitants. Due to screening program there is increasing number of patients with stage I and II breast cancer. In 2004 toe where 9884 women with breast cancer registered in Latvian Cancer Registry and among them 79 percent were presented as stage I or II. Breast conservative surgery with adjuvant radiotherapy as standard part of it plays great role in breast cancer treatment in our Center. In year 2004 there were 103 breast conservative surgeries performed in our Center. Radiotherapy is a standard part of treatment in modem breast saving operations for early stage breast cancer, At present, only whole breast postoperative irradiation is performed in Latvia. For selected group of patients this treatment can be substituted with other radiotherapy methods in order to reduce acute reactions and/or late toxicity, maintaining the same tumor control. Aim of this work is to show that during whole breast irradiation dose maximum and tissue volume which receives doses more than 105% from prescribed dose, is linked with size of treated volume (treated volume - tissue volume receiving > 95% from prescribed dose), which is strictly linked with breast volume. Because of this for large breast volumes there is higher complication probability performing whole breast irradiation, and it seems to be meaningful to use Intensity Modulated Radiotherapy or Accelerated Partial Breast Irradiation for

  16. Upper limb lymphedema after breast cancer treatment

    International Nuclear Information System (INIS)

    Purpose. - To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer. Patients and methods. - It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51 years (27-92 years). Tumour was T2 in 59% of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80% of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68 months (12-120). Results. - Lymphedema appeared in 23% of cases (51 patients), 14 months after surgery (mean period). Lymphedema affected the brachium in 17% of cases, the forearm in 12% of cases and all upper limb in 71% of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema. Conclusion. - Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10. (authors)

  17. Dosimetric comparison of three dimensional conformal radiation therapy versus intensity modulated radiation therapy in accelerated partial breast irradiation

    OpenAIRE

    Moorthy, S; H S Elhateer; SKD Majumdar; Mohammed, S; Patnaik, R; Narayanamurty

    2016-01-01

    Aim of Study: Breast conserving surgery (BCS) is the standard treatment for stage I and II breast cancer. Multiple studies have shown that recurrences after lumpectomy occur mainly in or near the tumor bed. Use of accelerated partial breast irradiation (APBI) allows for significant reduction in the overall treatment time that results in increasing patient compliance and decreasing healthcare costs. We conducted a treatment planning study to evaluate the role of intensity modulated radiation t...

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  19. Monte Carlo-derived TLD cross-calibration factors for treatment verification and measurement of skin dose in accelerated partial breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Garnica-Garza, H M [Centro de Investigacion y de Estudios Avanzados del Instituto Politecnico Nacional Unidad Monterrey, VIa del Conocimiento 201 Parque de Investigacion e Innovacion Tecnologica, Apodaca NL C.P. 66600 (Mexico)], E-mail: hgarnica@cinvestav.mx

    2009-03-21

    Monte Carlo simulation was employed to calculate the response of TLD-100 chips under irradiation conditions such as those found during accelerated partial breast irradiation with the MammoSite radiation therapy system. The absorbed dose versus radius in the last 0.5 cm of the treated volume was also calculated, employing a resolution of 20 {mu}m, and a function that fits the observed data was determined. Several clinically relevant irradiation conditions were simulated for different combinations of balloon size, balloon-to-surface distance and contents of the contrast solution used to fill the balloon. The thermoluminescent dosemeter (TLD) cross-calibration factors were derived assuming that the calibration of the dosemeters was carried out using a Cobalt 60 beam, and in such a way that they provide a set of parameters that reproduce the function that describes the behavior of the absorbed dose versus radius curve. Such factors may also prove to be useful for those standardized laboratories that provide postal dosimetry services.

  20. Monte Carlo-derived TLD cross-calibration factors for treatment verification and measurement of skin dose in accelerated partial breast irradiation

    International Nuclear Information System (INIS)

    Monte Carlo simulation was employed to calculate the response of TLD-100 chips under irradiation conditions such as those found during accelerated partial breast irradiation with the MammoSite radiation therapy system. The absorbed dose versus radius in the last 0.5 cm of the treated volume was also calculated, employing a resolution of 20 μm, and a function that fits the observed data was determined. Several clinically relevant irradiation conditions were simulated for different combinations of balloon size, balloon-to-surface distance and contents of the contrast solution used to fill the balloon. The thermoluminescent dosemeter (TLD) cross-calibration factors were derived assuming that the calibration of the dosemeters was carried out using a Cobalt 60 beam, and in such a way that they provide a set of parameters that reproduce the function that describes the behavior of the absorbed dose versus radius curve. Such factors may also prove to be useful for those standardized laboratories that provide postal dosimetry services.

  1. Phase II trial of proton beam accelerated partial breast irradiation in breast cancer

    International Nuclear Information System (INIS)

    Background and purpose: Here, we report the results of our phase II, prospective study of proton beam accelerated partial breast irradiation (PB-APBI) in patients with breast cancer after breast conserving surgery (BCS). Materials and methods: Thirty patients diagnosed with breast cancer were treated with PB-APBI using a single-field proton beam or two fields after BCS. The treatment dose was 30 cobalt gray equivalent (CGE) in six CGE fractions delivered once daily over five consecutive working days. Results: All patients completed PB-APBI. The median follow-up time was 59 months (range: 43–70 months). Of the 30 patients, none had ipsilateral breast recurrence or regional or distant metastasis, and all were alive at the last follow-up. Physician-evaluated toxicities were mild to moderate, except in one patient who had severe wet desquamation at 2 months that was not observed beyond 6 months. Qualitative physician cosmetic assessments of good or excellent were noted in 83% and 80% of the patients at the end of PB-APBI and at 2 months, respectively, and decreased to 69% at 3 years. A good or excellent cosmetic outcome was noted in all patients treated with a two-field proton beam at any follow-up time point except for one. For all patients, the mean percentage breast retraction assessment (pBRA) value increased significantly during the follow-up period (p = 0.02); however, it did not increase in patients treated with two-field PB-APBI (p = 0.3). Conclusions: PB-APBI consisting of 30 CGE in six CGE fractions once daily for five consecutive days can be delivered with excellent disease control and tolerable skin toxicity to properly selected patients with early-stage breast cancer. Multiple-field PB-APBI may achieve a high rate of good-to-excellent cosmetic outcomes. Additional clinical trials with larger patient groups are needed

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  3. Comparison of accelerated partial breast irradiation via multicatheter interstitial brachytherapy versus whole breast radiation

    International Nuclear Information System (INIS)

    Brachytherapy as adjuvant treatment for early-stage breast cancer has become widely available and offers patients an expedited treatment schedule. Given this, many women are electing to undergo brachytherapy in lieu of standard fractionation radiotherapy. We compare outcomes between patients treated with accelerated partial breast irradiation (APBI) via multicatheter interstitial brachytherapy versus patients who were also eligible for and offered APBI but who chose whole breast radiation (WBI). Patients treated from December 2002 through May 2007 were reviewed. Selection criteria included patients with pTis-T2N0 disease, ≤ 3 cm unifocal tumors, and negative margins who underwent breast conservation surgery. Local control (LC), cause-specific (CSS) and overall survival (OS) were analyzed. 202 patients were identified in the APBI cohort and 94 patients in the WBI cohort. Median follow-up for both groups exceeded 60 months. LC was 97.0% for the APBI cohort and 96.2% for the WBI cohort at 5 years (ns). Classification by 2010 ASTRO APBI consensus statement categories did not predict worse outcomes. APBI via multicatheter interstitial brachytherapy provides similar local failure rates compared to WBI at 5 years for properly selected patients. Excellent results were seen despite the high fraction of younger patients (< 60 years old) and patients with DCIS

  4. Comparison of accelerated partial breast irradiation via multicatheter interstitial brachytherapy versus whole breast radiation

    Directory of Open Access Journals (Sweden)

    Ferraro Daniel J

    2012-03-01

    Full Text Available Abstract Background Brachytherapy as adjuvant treatment for early-stage breast cancer has become widely available and offers patients an expedited treatment schedule. Given this, many women are electing to undergo brachytherapy in lieu of standard fractionation radiotherapy. We compare outcomes between patients treated with accelerated partial breast irradiation (APBI via multicatheter interstitial brachytherapy versus patients who were also eligible for and offered APBI but who chose whole breast radiation (WBI. Methods Patients treated from December 2002 through May 2007 were reviewed. Selection criteria included patients with pTis-T2N0 disease, ≤ 3 cm unifocal tumors, and negative margins who underwent breast conservation surgery. Local control (LC, cause-specific (CSS and overall survival (OS were analyzed. Results 202 patients were identified in the APBI cohort and 94 patients in the WBI cohort. Median follow-up for both groups exceeded 60 months. LC was 97.0% for the APBI cohort and 96.2% for the WBI cohort at 5 years (ns. Classification by 2010 ASTRO APBI consensus statement categories did not predict worse outcomes. Conclusion APBI via multicatheter interstitial brachytherapy provides similar local failure rates compared to WBI at 5 years for properly selected patients. Excellent results were seen despite the high fraction of younger patients (

  5. Dosimetric comparison of 3DCRT versus IMRT in whole breast irradiation of early stage breast cancer

    Directory of Open Access Journals (Sweden)

    Mudasir Ashraf

    2014-08-01

    Full Text Available Purpose: The counseling regarding the treatment option is an important objective in the management of early stages breast cancer. In this study, we attempt to compare and analyze the dosimetric aspects of 3DRT over IMRT in the whole breast radiotherapy.Methods and Materials:  Both right and left sided computed tomography simulations of 14 women with early stage breast cancer were used for our retrospective study to compare the 3DCRT and IMRT. The dose prescribed was 50 Gy in 25 fractions to the whole breast PTV. The PTV was defined by adding unequal margins to the directional safety margin status of each lumpectomy cavity (i.e., medial, lateral, superior, inferior and deep margins measured from the tumor front after the examination of the surgical specimen: 2, 1.5, and 1 cm for resection margins < 1 cm, 1-2 cm, and > 2cm, respectively. And than modified so that it was no longer closer than 3mm to the skin surface and was no deep than the lung –chest interface. The prescribed dose delivered in 5 fractions per week schedule. Treatment plans were compared for target minimum dose, maximum dose, mean dose, conformity index, heterogeneity index and doses to organs at risk were compared and analysed.Results: The target coverage was achieved with 90% prescription to the 95% of the PTV. Conformity to the PTV was significantly higher with 3DCRT technique than IMRT. 3DCRT technique seems better in sparing critical organs parameters like lung V20 and Mean, heart, V25, Maximum, both lungs V20, Mean and Dose to the Normal Healthy tissue.Conclusion: We conclude from our study that treatment technique selection for whole Breast irradiation is an important factor in sparing the adjacent normal structures and in determining the associated risk. 3DCRT produces better conformity and heterogeneity indices of the target volume, also reduces dose to OARs the 3DCRT reduces the risk of radiation induced heart diseases

  6. Radiation dose to contra lateral breast during treatment of breast malignancy by radiotherapy

    Directory of Open Access Journals (Sweden)

    Chougule Arun

    2007-01-01

    Full Text Available Aims: External beam radiotherapy is being used regularly to treat the breast malignancy postoperatively. The contribution of collimator leakage and scatter radiation dose to contralateral breast is of concern because of high radio sensitivity of breast tissue for carcinogenesis. This becomes more important when the treated cancer breast patient is younger than 45 years and therefore the contralateral breast must be treated as organ at risk. Quantification of contralateral dose during primary breast irradiation is helpful to estimate the risk of radiation induced secondary breast malignancy. Materials and Methods: In present study contralateral breast dose was measured in 30 cancer breast patients undergoing external beam therapy by Co-60 teletherapy machine. Postoperative radiotherapy was delivered by medial and lateral tangential fields on alternate days in addition to supraclavicle field daily with 200 cGy/F to a total dose of 5000 cGy in 25 fractions. CaSO4: Dy themoluminescence dosimeter discs were employed for these measurements. Three TLD discs were put on the surface of skin of contra lateral breast, one at the level of nipple and two at 3 cms away from nipple on both side along the midline for each field. At the end treatment of each filed, TLD discs were removed and measured for dose after 24h on Thelmador - 6000 TLD reader. Results: The dose at the contra lateral breast nipple was to be 152.5 to 254.75 cGy for total primary breast dose of 5000 cGy in 25 equal fractions which amounted to 3.05-6.05% of total dose to diseased breast. Further it was observed that the maximum contribution of contralateral breast dose was due to medical tangential half blocked field. Conclusion: CaSO4; Dy thermoluminescence dosimetry is quite easy, accurate and convenient method to measure the contra lateral breast dose.

  7. Breast cancers and leukaemias after irradiation. Cancers du sein et leucemies apres irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Vathaire, F. de (Centre de Lutte Contre le Cancer Gustave-Roussy, 94 - Villejuif (France))

    1994-01-01

    The influence of new data or recent re-analysis concerning the risks of breast cancer and leukaemia after irradiation is summarized in this article. The risk of breast cancer, particularly after irradiation during childhood, seems to be more important than estimated previously. Because the pattern of risk after irradiation seems to be multiplicative and since breast cancer is very frequent among western populations, these new findings may have important consequences in public health. Despite leukaemias have been known for a long time to be a radioinduced tumour, very little information is available about the effects of age at irradiation and dose rate. (author). 9 refs., 2 tabs.

  8. External Beam Accelerated Partial Breast Irradiation Yields Favorable Outcomes in Patients with Prior Breast Augmentation

    OpenAIRE

    RachelYi-FengLei; CharlesELeonard; JaneMKercher; TereseKaske

    2014-01-01

    Purpose: To report outcomes in breast cancer patients with prior breast augmentation treated with external beam accelerated partial breast irradiation (EB-APBI) utilizing intensity modulated radiotherapy (IMRT) or 3-dimensional conformal radiotherapy (3D-CRT), both with image-guided radiotherapy (IGRT).Methods and Materials: 16 stage 0/I breast cancer patients with previous elective bilateral augmentation were treated post-lumpectomy on institutional EB-APBI trials (01185132 and 01185145 on c...

  9. Time Course of Mild Arm Lymphedema After Breast Conservation Treatment for Early-Stage Breast Cancer

    International Nuclear Information System (INIS)

    Purpose: Arm lymphedema is a potential consequence of the treatment for breast carcinoma. The objective of this retrospective study was to characterize the progression of mild arm lymphedema after breast conservation treatment for breast cancer. Methods and Materials: The study cohort was drawn from 1,713 consecutive Stage I or II breast cancer patients who underwent breast conservation therapy, including axillary staging followed by radiation. Arm lymphedema was documented in 266 (16%) of 1,713 patients. One hundred nine patients, 6% of the overall group and 40% of the patients with arm lymphedema, presented with mild arm lymphedema, defined as a difference of 2 cm or less between the measured circumferences of the affected and unaffected arms. Results: Among the 109 patients with mild arm lymphedema at the time of arm lymphedema diagnosis, the rate of freedom from progression to more severe lymphedema was 79% at 1 year, 66% at 3 years, and 52% at 5 years. The patients who were morbidly obese, had positive axillary lymph nodes, or received supraclavicular irradiation at the time of breast cancer treatment were at higher risk of progression from mild arm lymphedema to more severe edema. Conclusions: Mild arm lymphedema, generally considered to be a minor complication after breast conservation treatment for breast cancer, was associated with a risk of progression to a more severe grade of arm lymphedema in a substantial fraction of patients.

  10. Primary breast lymphoma in the right breast during treatment for left breast cancer

    OpenAIRE

    Fukuzawa Kengo; Kinoshita Tadahiko; Iwashita Yukio; Nishimura Ataru; Nagata Shigeyuki; Tashiro Hideya; Wakasugi Kenzo

    2007-01-01

    Abstract Background Primary breast lymphoma is a rare condition, and distinguishing it from breast cancer is important because their treatments differ radically. Moreover, a recent report showed that mastectomy offered no benefit in the treatment of primary breast lymphoma. Case presentation A 59-year-old woman was treated with adjuvant chemotherapy and local radiation after surgery for left breast cancer. She presented with a rapidly growing mass in the right breast at 20 months after surger...

  11. Stereotactic Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Rationale, Feasibility, and Early Experience Using the CyberKnife Radiosurgery Delivery Platform

    OpenAIRE

    Obayomi-Davies, Olusola; Kole, Thomas P.; Oppong, Bridget; Rudra, Sonali; Makariou, Erini V.; Lloyd D Campbell; Hozaifa M Anjum; Sean P Collins; Unger, Keith; WILLEY, SHAWNA; Tousimis, Eleni; Collins, Brian T.

    2016-01-01

    Purpose The efficacy of accelerated partial breast irradiation (APBI) utilizing brachytherapy or conventional external beam radiation has been studied in early-stage breast cancer treated with breast-conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rati...

  12. Stereotactic Accelerated Partial Breast Irradiation (SAPBI) for Early Stage Breast Cancer: Rationale, Feasibility and Early Experience using the CyberKnife Radiosurgery Delivery Platform

    OpenAIRE

    Olusola eOBAYOMI-DAVIES; Kole, Thomas P.; Bridget eOppong; Sonali eRudra; Erini eMakariou; Lloyd D Campbell; Hozaifa M Anjum; Sean P Collins; Keith eUnger; Willey, Shawna C.; Eleni A Tousimis; Brian Timothy Collins

    2016-01-01

    Purpose: The efficacy of accelerated partial breast irradiation (APBI) utilizing brachytherapy or conventional external beam radiation has been studied in early stage breast cancer treated with breast conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rat...

  13. Breast Cancer After Treatment of Hodgkin's Lymphoma: General Review

    International Nuclear Information System (INIS)

    The improved survival rates among patients with Hodgkin's lymphoma over the past few decades have come with increased incidence of second malignancies. One of the major concerns among female survivors is the significantly elevated risk of breast cancer that appears with extended follow-up. In this review, we include the published literature regarding the risk of breast cancer after irradiation for Hodgkin's lymphoma. We also present the possible long-term surveillance strategies and the optimal time to start screening these women. This could potentially help in early detection of secondary breast cancers and consequently improve outcomes. Furthermore, because of prior radiotherapy, the management of the breast cancer among this unique population has been controversial. We discuss the characteristics of breast cancer that occurs after Hodgkin's lymphoma and also treatment options that could be implemented

  14. Cardiotoxicity of oncologic treatment of breast cancer

    International Nuclear Information System (INIS)

    Cardiac affectation by neoplastic diseases may be due to the heart invasion produced by itself tumor, compression of the heart and / or great vessels by noncardiac neoplasms, most commonly embolization and therapeutic purposes antitumor. Cancer treatment has experienced significant progress in recent decades by the great expansion of chemotherapeutic agents and the refinement of radiotherapy techniques; however, many of the most effective drugs antineoplastic and thoracic irradiation cause both acute and chronic cardiotoxicity. Thus, the long-term monitoring of patients receiving anthracycline drugs Crucial in the therapy of many neoplasms, demonstrates clinical heart failure in 4.5 to 7% of patients, increasing the incidence of defects in the cardiac function over time. Its pathogenesis is likely included in the formation of free radicals, alterations calcium transport, dysfunction or adrenergic amines glass release active. Dex razoxane is the only clinically used cardio protective marketed for selected group of patients with breast cancer, it is necessary development of new agents that protect the cardiotoxicity of this group of drugs and reduce morbidity and secondary mortality to them. In this work, the tracking shows 4 patients with breast cancer who had received treatment with anthracyclines and the cardiotoxic manifestation suffered, resulting in changes in their treatment, and in one of the patients was used cardio protective medication

  15. Screening for Breast Cancer: Staging and Treatment

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Screening For Breast Cancer Staging and Treatment Past Issues / Summer 2014 Table ... oncology nurse and a registered dietitian. Read More "Screening For Breast Cancer" Articles #BeBrave: A life-saving test / Breast Cancer ...

  16. Histamine modifies malignant biological behaviour in irradiated breast cancer cells

    International Nuclear Information System (INIS)

    MDA MB 231, a metastatic breast cancer cell line, expresses the four known types of histamine receptors (HAR), which differentially regulate cell proliferation. HA also exerts a radiosensitizing effect when is added to MDA MB 231 cells before irradiation in a way related to the elevation of H2O2 levels. However, ionizing radiation (IR) has also been demonstrated to affect malignant biological behaviour depending upon cell type and irradiation characteristics. The present study was conducted to investigate the action of HA and IR on two events involved in metastatic capacity such as the expression and activity of matrix metalloproteinases (MMPs) and cell motility. HA decreased MMP2 and MMP9 expression assessed by RT-PCR and cytochemistry as well enzymatic activity determined by zimography. This effect was mimicked by H2 agonists, while an opposite action was mainly observed when H4 agonists were employed. Cell motility, evaluated by wound healing assay, was also distinctly modulated through HAR. It was significantly augmented via H4R and to a lesser extent via H1R and H3R, though diminished through H2R. 2 Gy irradiated cells showed an enhanced MMP2 and MMP9 activity and cell motility compared to control cells. However, this effect was counteracted by HA. Results suggest that HA treatment could improve radiotherapy efficacy regarding the potential development of metastases. (authors)

  17. 早期乳腺癌部分乳腺加速放疗%Accelerated partial breast irradiation for early breast cancer

    Institute of Scientific and Technical Information of China (English)

    张秋宁; 王小虎

    2011-01-01

    随着乳腺癌术后复发模式的研究进展,部分乳腺照射方法 成为乳腺癌放疗的热点.组织间插植、球囊近距离治疗、术中放疗及三维适形放疗和调强放疗等部分乳腺加速放疗已进入临床研究.其局部控制率和安全性与全乳腺照射比较相当,同时具有治疗周期短、方便患者等优势.部分乳腺加速放疗在部分患者有望代替全乳腺放疗,成为早期乳腺癌保乳术后放疗的标准治疗之一.%With a view to patterns of local recurrence after breast conserving surgery, whole breast irradiation(WBI) after surgery is controversial and partial-breast irradiation(PBI) came up. Many clinical trials related with accelerated partial-breast irradiation using a variety of radiotherapeutic techniques such as interstitial brachytherapy (IBT), MammoSite Radiation Therapy System, intraoperative radiotherapy(IORT), threedimensional conformal radiotherapy(3-DCRT)and intensity modulated radiation therapy(IMRT) in selected patients have been carried out. Accelerated partial-breast irradiation that provides faster, more convenient treat-ment demonstrates local control rate and safety comparable to that of whole breast irradiation. Partial breast irradiation may be an alternative way to whole breast radiotherapy and will be one of the standard treatments in women with early breast cancer seeking breast conservation.

  18. Dosimetric analysis of intact breast irradiation in off-axis planes

    International Nuclear Information System (INIS)

    Purpose/Objective: The purpose of this investigation is to quantify dose inhomogeneity of intact breast irradiation in off-axis planes, and determine how dose inhomogeneity varies according to patient breast size and anatomical region of the breast. Methods and Materials: Eleven patients treated with intact breast radiation underwent a treatment-planning computer tomography (CT) scan with 1-cm slices through the entire breast. The area of breast tissue was defined on each CT slice. Treatment planning with lung correction factors was performed using a two-dimensional treatment-planning system that calculates off-axis dose distributions on a slice-by-slice basis. Each plan utilized tangential beams with matched non divergent posterior borders and with collimator rotation to match the chest wall slope. Dose inhomogeneity within the central plane was minimized during treatment planning by the use of a wedge on the lateral tangent field and by the differential weighting of fields. Dose was normalized at the breast and pectoralis major interface at mid separation in the central plane. Off-axis dose inhomogeneity was not considered in the optimization of the treatment plan. Dose distributions were plotted for each 1-cm slice, and the area of each isodose curve within the breast on each CT slice was calculated. The results of each slice were summed to give an approximation of dose-volume relationships. Results: For the entire population, an average of 10% of the breast volume (range 1-40%) received 110% or greater of the prescribed dose. Increasing dose inhomogeneity was positively correlated with increasing breast sizes (r 0.72, p = 0.01--Spearmen rank test). Analysis of dose as a function of location within the breast, revealed that the greatest dose inhomogeneity occurred in the lower anatomical quadrants of the breast (p 0.003--Kruskal-Wallis test). For the group, the mean breast volume that received a 110% or greater dose was: 30% at 6 cm below central axis, 14% at 4

  19. Effects of irradiation for cervical cancer on subsequent breast cancer

    International Nuclear Information System (INIS)

    Previous research suggests that cervical cancer patients have a lower risk of breast cancer than women in the general population. Possible explanations include opposing risk factors for cervical cancer and breast cancer, the effect of irradiation used to treat cervical cancer, or both. The purpose of this study was to explore the relationship between irradiation for cervical cancer and the subsequent development of breast cancer. There was no statistically significant relationship between radiation to the ovarian area and the risk of breast cancer in this study. However, the results were consistent with a 19% reduction in risk for women irradiated for cervical cancer when compared to nonirradiated women. In a dose-response analysis, there was a nonsignificant trend of decreased risk of breast cancer with increased radiation up to 1800 rad. There was no consistent pattern for higher doses. The trend, although nonsignificant, differed by age. Women <60 years of age at irradiation were generally at a lower risk of breast cancer than nonirradiated women. Women over 59 years were at an increased risk. There are some potentially important findings from this study which might influence medical care. These should be examined in the larger International Radiation Study

  20. Efficiency and prognosis of whole brain irradiation combined with precise radiotherapy on triple-negative breast cancer

    OpenAIRE

    Xinhong Wu; Bo Luo; Shaozhong Wei; Yan Luo; Yaojun Feng; Juan Xu; Wei Wei

    2013-01-01

    Aim: To investigate the treatment efficiency of whole brain irradiation combined with precise radiotherapy on triple-negative (TN) phenotype breast cancer patients with brain metastases and their survival times. Materials and Methods : A total of 112 metastatic breast cancer patients treated with whole brain irradiation and intensity modulated radiotherapy (IMRT) or 3D conformal radiotherapy (3DCRT) were analyzed. Thirty-seven patients were of TN phenotype. Objective response rates were co...

  1. Accelerated partial breast irradiation trials: Diversity in rationale and design

    International Nuclear Information System (INIS)

    Seven randomised trials are currently testing accelerated partial breast irradiation against whole breast radiotherapy after breast conservation surgery. The trials are varied in the techniques used to deliver partial breast radiotherapy, reflecting the range of opportunities offered by advanced brachytherapy and teletherapy modalities. Dose schedules also vary between trials, but the most important point of difference between them reflects alternative concepts of clinical and planning target volumes. These are based mainly on the spatial pattern of relapse in retrospective and prospective studies, which report the majority of first local relapses close to the primary tumour site, and on the assumption that radiotherapy does not prevent the development of new primary tumours developing elsewhere in the breast. However, the pattern of ipsilateral breast tumour relapse is not accurately defined in the clinical literature and does not correspond closely to pathological findings. In addition, published data are consistent with a significant reduction in the rate of other quadrant relapse after whole breast radiotherapy. Regardless of the biological model of local tumour relapse and responsiveness to radiation, the ongoing trials will generate level I evidence for or against accelerated partial breast irradiation, provided patients are followed up long enough before the first reporting of results.

  2. In vivo dosimetry for tangential breast irradiation

    International Nuclear Information System (INIS)

    Entrance dose measurements (920) have been performed on both tangential treatment fields for 105 breast cancer patients. About half of the (52) were treated on a modern unit (Mevatron, Siemens), supplied with an automatic verification system, the other half (53) were treated on an old therapy unit (cobalt-60). A team of three radiographers worked on the modern unit, while only one radiographer was responsible for treatment set-up on the old unit. A small systematic error (+14%) has been detected on the old unit; a small discrepancy existed in the region of the maximum dose between the measured and the published percentage depth-dose values, the latter being used for dose calculation. A striking difference has been observed for the rate of large deviations (of 5% and more from the mean dose): 2.3% (10/430) for the modern unit vs. 15 (75/490) for the old one. This shows clearly that the precision in dose delivery is strongly dependent on the characteristics and staffing of the therapy unit, the modern unit being supplied with a check-and-confirm system and with beam accessory devices in fixed position in the beam and a team of radiographers responsible for the set-up. (author). 12 refs.; 1 tab

  3. Breast-conserving therapy with partial or whole breast irradiation: Ten-year results of the Budapest randomized trial

    International Nuclear Information System (INIS)

    Background and purpose: To report the long-term results of a single-institution randomized study comparing the results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Patients and methods: Between 1998 and 2004, 258 selected women with pT1 pN0-1mi M0, grade 1–2, non-lobular breast cancer without the presence of extensive intraductal component and resected with negative margins were randomized after BCS to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 × 5.2 Gy high-dose-rate (HDR) multi-catheter brachytherapy (BT; n = 88) or 50 Gy electron beam (EB) irradiation (n = 40). Primary endpoint was local recurrence (LR) as a first event. Secondary endpoints were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and cosmetic results. Results: After a median follow up of 10.2 years, the ten-year actuarial rate of LR was 5.9% and 5.1% in PBI and WBI arms, respectively (p = 0.77). There was no significant difference in the ten-year probability of OS (80% vs 82%), CSS (94% vs 92%), and DFS (85% vs 84%), either. The rate of excellent-good cosmetic result was 81% in the PBI, and 63% in the control group (p < 0.01). Conclusions: Partial breast irradiation delivered by interstitial HDR BT or EB for a selected group of early-stage breast cancer patients produces similar ten-year results to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with HDR BT implants compared with the outcome after WBI

  4. Hypoplasty of the breast due to x-ray irradiation

    International Nuclear Information System (INIS)

    We treated five women with hypoplasty of the breast induced by radiation. Only one of these women underwent mammaplasty with the use of a latissimus dorsi muscle flap and prosthesis. Hypoplasty of the breast is considered a result of imprudent utilization of x-ray irradiation of young patients with benign skin diseases. To prevent underdevelopment and hypoplasty, attention must be directed to the risk involved in radiation therapy for benign diseases

  5. Treatment of Breast Cancer Brain Metastases

    OpenAIRE

    Freedman, Rachel A; Anders, Carey K.

    2011-01-01

    Approximately 10% to 15% of women with metastatic breast cancer will develop brain metastases. Treatment options for these women remain limited, particularly at the time of central nervous system (CNS) relapse following completion of initial CNS-directed therapy. Historically, prior studies have broadly examined systemic treatments for breast cancer brain metastases with mixed, but overall disappointing, results. More recently, studies have increasingly selected patients based on breast cance...

  6. External beam accelerated partial breast irradiation (EB-APBI yields favorable outcomes in patients with prior breast augmentation

    Directory of Open Access Journals (Sweden)

    Rachel Yi-Feng Lei

    2014-06-01

    Full Text Available Purpose: To report outcomes in breast cancer patients with prior breast augmentation treated with external beam accelerated partial breast irradiation (EB-APBI utilizing intensity modulated radiotherapy (IMRT or 3-dimensional conformal radiotherapy (3D-CRT, both with image-guided radiotherapy (IGRT.Methods and Materials: 16 stage 0/I breast cancer patients with previous elective bilateral augmentation were treated post-lumpectomy on institutional EB-APBI trials (01185132 and 01185145 on clinicaltrials.gov. Patients received 38.5 Gy in 10 fractions over 5 consecutive days. Breast/chest wall pain and cosmesis were rated by patient; cosmesis was additionally evaluated by physician per RTOG criteria.Results: The median follow-up from APBI completion was 18.0 months (range, 1.2-58.6. Little to no change in cosmesis or pain from baseline was reported. Cosmetic outcomes at last follow-up were judged by patients as excellent/good in 93.8% (15/16, and by physicians as excellent/good in 100% (16/16. Eight patients (50.0% reported no breast/chest wall pain, and the remaining 8 patients (50.0% reported mild pain. All patients remain disease free at last follow-up. The median ipsilateral breast, planning target volume (PTV, and implant volumes were 614 cc, 57 cc, and 333 cc. The median ratios of PTV/ipsilateral breast volume (implant excluded and PTV/total volume (implant included were 9% and 6%. Conclusions: These 16 breast cancer cases with prior bilateral breast augmentation treated with external beam APBI demonstrate favorable clinical outcomes. Further exploration of external beam APBI as a treatment option for this patient po

  7. Lymphedema of the arm and breast in irradiated breast cancer patients: risks in an era of dramatically changing axillary surgery.

    Science.gov (United States)

    Goffman, Thomas E; Laronga, Christine; Wilson, Lori; Elkins, David

    2004-01-01

    The purpose of this study was to assess risk for lymphedema of the breast and arm in radiotherapy patients in an era of less extensive axillary surgery. Breast cancer patients treated for cure were reviewed, with a minimum follow-up of 1.5 years from the end of treatment. Clinical, surgical, and radiation-related variables were tested for statistical association with arm and breast lymphedema using regression analyses, t-tests, and chi-squared analyses. Between January 1998 and June 2001, 240 women received radiation for localized breast cancer in our center. The incidence of lymphedema of the ipsilateral breast, arm, and combined (breast and arm) was 9.6%, 7.6%, and 1.8%, respectively, with a median follow-up of 27 months. For breast edema, t-test and multivariate analysis showed body mass index (BMI) to be significant (p = 0.043, p = 0.0038), as was chi-squared and multivariate testing for site of tumor in the breast (p = 0.0043, p = 0.0035). For arm edema, t-test and multivariate analyses showed the number of nodes removed to be significant (p = 0.0040, p = 0.0458); the size of the tumor was also significant by multivariate analyses (p = 0.0027). Tumor size appeared significant because a number of very large cancers failed locally and caused cancer-related obstructive lymphedema. In our center, even modern, limited level 1-2 axillary dissection and tangential irradiation carries the risk of arm lymphedema that would argue in favor of sentinel node biopsy. For breast edema, disruption of draining lymphatics by surgery and radiation with boost to the upper outer quadrant increased risk, especially for the obese. Fortunately both breast and arm edema benefited from manual lymphatic drainage. PMID:15327493

  8. Pregnancy associated breast cancer and pregnancy after breast cancer treatment

    OpenAIRE

    Doğer, Emek; Çalışkan, Eray; Mallmann, Peter

    2011-01-01

    Breast cancer is one of the most common cancers diagnosed during pregnancy and its frequency is increasing as more women postpone their pregnancies to their thirties and forties. Breast cancer diagnosis during pregnancy and lactation is difficult and complex both for the patient and doctors. Delay in diagnosis is frequent and treatment modalities are difficult to accept for the pregnant women. The common treatment approach is surgery after diagnosis, chemotherapy after the first trimester and...

  9. Angiosarcoma of the skin overlying an irradiated breast; Brief communication

    Energy Technology Data Exchange (ETDEWEB)

    Badwe, R.A.; Hanby, A.M.; Fentiman, I.S.; Chaudary, M.A. (Guy' s Hospital, London (United Kingdom))

    1991-09-01

    A case of angiosarcoma of the breast which developed 6 1/2 years after treatment for carcinoma of the same breast is reported. As a result of radiotherapy the breast manifested signs of chronic lymphedema prior to development of angiosarcoma. Although the aetiology in this case is uncertain, there was a past history of childhood naevus regressing spontaneously. Angiosarcoma is a well known complication following radiotherapy and lymphedema , and is likely to be seen more frequently as conservation treatment is used more commonly for patients with early breast cancer. (author). 15 refs.; 2 figs.

  10. Shielding of the contralateral breast during tangential irradiation.

    Science.gov (United States)

    Goffman, Thomas E; Miller, Michael; Laronga, Christine; Oliver, Shelly; Wong, Ping

    2004-08-01

    The purpose of this study was to investigate both optimal and practical contralateral breast shielding during tangential irradiation in young patients. A shaped sheet of variable thickness of lead was tested on a phantom with rubber breasts, and an optimized shield was created. Testing on 18 consecutive patients 50 years or younger showed shielding consistently reduced contralateral breast dose to at least half, with small additional reduction after removal of the medial wedge. For younger patients in whom radiation exposure is of considerable concern, a simple shield of 2 mm lead thickness proved practical and effective. PMID:15289741

  11. Sewage water treatment by irradiation

    International Nuclear Information System (INIS)

    Irradiation of the outlet wastewater from Adra Plant shows that radiation sensitivity for the total count of the microorganism, fungi, and pathogenic microorganism were 0.328, 0.327, 0.305 kGy respectively at 3.4 kGy/h. No Ascaris Lumbricoides eggs were found. These results show that radiation technology in wastewater treatment at Adra Plant for reuse in irrigation safely from microbial point of view can be applied. (author)

  12. Breast Conserving Treatment for Breast Cancer: Dosimetric Comparison of Sequential versus Simultaneous Integrated Photon Boost

    Directory of Open Access Journals (Sweden)

    Hilde Van Parijs

    2014-01-01

    Full Text Available Background. Breast conserving surgery followed by whole breast irradiation is widely accepted as standard of care for early breast cancer. Addition of a boost dose to the initial tumor area further reduces local recurrences. We investigated the dosimetric benefits of a simultaneously integrated boost (SIB compared to a sequential boost to hypofractionate the boost volume, while maintaining normofractionation on the breast. Methods. For 10 patients 4 treatment plans were deployed, 1 with a sequential photon boost, and 3 with different SIB techniques: on a conventional linear accelerator, helical TomoTherapy, and static TomoDirect. Dosimetric comparison was performed. Results. PTV-coverage was good in all techniques. Conformity was better with all SIB techniques compared to sequential boost (P = 0.0001. There was less dose spilling to the ipsilateral breast outside the PTVboost (P = 0.04. The dose to the organs at risk (OAR was not influenced by SIB compared to sequential boost. Helical TomoTherapy showed a higher mean dose to the contralateral breast, but less than 5 Gy for each patient. Conclusions. SIB showed less dose spilling within the breast and equal dose to OAR compared to sequential boost. Both helical TomoTherapy and the conventional technique delivered acceptable dosimetry. SIB seems a safe alternative and can be implemented in clinical routine.

  13. Breast-conservation treatment of breast cancer in elderly women

    International Nuclear Information System (INIS)

    In the recent 3 years, 8 elderly women with breast cancer of various stages were treated with breast-conservation treatment (BCT) combined with endocrine therapy and/or systemic chemotherapy mainly based on patients' obvious desire. Until now, one out of these 8 patients had died of heart failure with no evidence of breast cancer progression, and the other 7 patients are alive with no evidence of disease. As for side effects of the therapy, no severe sequelae have been experienced so far. Cosmetic results of the therapy were considerably sufficient. (author)

  14. Studies On Quality Criteria For Irradiated Breaded Chicken Breast Fillets

    International Nuclear Information System (INIS)

    Quality criteria of irradiated breaded chicken breast fillets were studied. Fresh boneless and skinless breaded chicken breast meats samples were divided into four separate batches and packed in plastic bags and sealed by an impulse sealer. Samples in plastic bags were exposed to different doses of gamma irradiation (2.5, 5 and 7 kGy) at ambient temperature. Just after irradiation, the samples were stored at 4 ±10C. All samples were evaluated for microbiological, chemical and sensorial properties after irradiation and throughout the storage periods. During storage, the total bacterial count was significantly increased (P<0.05) in all samples with higher rates of increase in non-irradiated samples. In all irradiated samples, Staphylococcus aureus did not detected up to 6 days then detected after 22 days in samples treated with 2.5 kGy as well as 31 days in samples treated with 5 kGy. On the other hand, Staphylococcus aureus was detected after 45 days in samples treated with 7 kGy. Salmonella sp., Listeria monocytogenes and Campylobacter jejuni could not detected in untreated and treated samples. The protein content showed significant decrease immediately after irradiation and during the refrigerated storage. The TVN values for non-irradiated samples were significantly higher (P<0.05) than irradiated samples. The present data showed significant decrease (P<0.05) in protein solubility percentages of irradiated samples at day 0 and 6 of refrigerated storage. The observed decrease was related to the increase of radiation dose. At the end of storage period (62 days), 2.5 kGy samples were significantly higher in TBA values than other irradiated samples. On the other hand, irradiation was significantly reduced (P<0.05) the amount of major mono unsaturated and poly unsaturated fatty acids. Sensory attributes of breaded chicken breast fillets did not affected by irradiation. It could be concluded that irradiation dose of 5 kGy can be used in chicken samples stored in

  15. Breast cancer and irradiation: a review

    International Nuclear Information System (INIS)

    Breast cancer, the most frequent in females, can be induced by many physical and chemical agents. The contribution on ionizing radiation has been clearly demonstrated both by animal experiments on rats and epidemiologic surveys on populations of women submitted to medical exposure or on Japanese atomic bomb survivors. The mean risk per dose unit (rad) is estimated at about 6 per year and per 106 females. It can vary widely with the age at the time of exposure and other internal (mainly hormonal) or external (diet for instance) factors. For radiation protection purposes, breast is a high risk tissue, which explains the high risk factor adopted by ICRP for this tissue

  16. [Treatment of elderly patients with breast cancer

    DEFF Research Database (Denmark)

    Paaschburg, B.; Pedersen, A.; Tuxen, M.K.;

    2008-01-01

    The latest investigations have been searched in order to present new guidelines for the treatment of elderly patients with primary breast cancer. It is concluded that breast-conserving surgery should be offered as well as the sentinel node technique. Axillary lymph node dissection is not necessary...

  17. Pathophysiology of irradiated skin and breast

    International Nuclear Information System (INIS)

    The evolution, time course, and dose response of gross and histologic changes associated with the acute and late changes of the skin are noted and a composite pathophysiologic operational model given. This model focuses the selection of the observations to be 'scored' to assess the tolerance and cosmetic response of the skin and breast to different dose and combined therapy studies

  18. Comparison of different treatment plannings for whole breast irradiation with tumor bed boost after breast-conservative surgery%乳腺癌保乳术后全乳加瘤床补量照射不同治疗计划的比较

    Institute of Scientific and Technical Information of China (English)

    李建彬; 卢洁; 范廷勇; 刘娟; 白瞳; 孙涛; 邢军; 王永胜; 邵倩

    2008-01-01

    目的 探讨乳腺癌保乳术后全乳加瘤床照射不同治疗计划靶区剂量适形度、靶区剂量分布均匀性及肺脏、心脏和对侧乳腺受照剂量体积的差异.方法 选择术腔各边界放置银夹且无腋窝淋巴结转移的12例左侧乳腺癌保乳术后患者,每例患者分别制定常规放疗(CRT)、无挡肺子野调强放疗(IMRT-F)、挡肺子野调强(IMRT-F-L)和瘤床同步整合补量调强放疗(SIB-IMRT)计划.比较不同治疗计划全乳靶区和瘤床靶区的剂量适形度和剂量分布均匀性,对比不同治疗计划肺脏、心脏和对侧乳腺受照剂量体积.结果 各计划中V处方剂量-PTV1/VPTV1、VPTV1-处方剂量/VPTV2、V处方剂量-PTV2/VPTV2/VPTV2、VPTV2-处方剂量/VPTV2组间差异均有统计学意义;CRT计划中患侧肺V20显著高于不同方式的IMRT计划,但不同方式的IMRT计划之间V20差异无统计学意义;CRT计划中心脏受照剂量显著高于IMRT和SIBIMRT计划.CRT计划中对侧乳腺最大照射剂量Dmax和平均剂量Dmean明显高于不同实现方式的IMRT计划,但不同实现方式的IMRT计划中Dmax和Dmean差异无统计学意义.结论 IMRT-F、IMRT-F-L、SIBIMRT计划均显著优于CRT计划,而不同方式IMRT计划间除个别参数外差异无统计学意义.%Objective To explore the difference of conformity and homogeneity of dose distribution in the whole breast and tumor bed targets and dose-volume parameters of the irradiated heart,lung and contralateral breast between the different treatment plannings for whole breast irradiation with tumor bed boost after breast-conservative surgery.Methods Twelve left-side breast cancer patients received breast-conservative surgery with negative axillary lymph node and with silver slips set in the cavity were selected.The different plannings including conventional radiotherapy(CRT),forward intensity-modulated radiotherapy with no lung block segments(IMRT-F),forward intensity-modulated radiotherapy with

  19. Microbiological and sensory evaluation of the shelf-life of irradiated chicken breast meat

    International Nuclear Information System (INIS)

    Kraft paper boxes containing 10 expanded polystyrene trays with 200g skinless deboned chicken breast each were irradiated with 60Co source of a Nordion JS7500 irradiator. The trays were previously wrapped with polyethylene film. The samples were exposed to 1.5; 3.0 and 7.0 kGy doses in the static mode at 0º and 180º in relation to the irradiation beam. Set of 18 alanine+paraffin dosimeters per treatment were distributed inside the boxes for evaluation of irradiation dose homogeneity. A separeted dose calibration curve was obtained by irradiating in the range of 1 to 10kGy. After the irradiation, the chicken breasts were stored at 5±1ºC for 39 days and were analysed microbiologically in total psychrotrophic aerobic bacteria, total mesophilic aerobic bacteria, molds and yeasts, Pseudomonas spp, Enterobacteriaceae, lactic bacteria counts and E.coli during the storage period. The results revealed a linear behaviour of the alanine+paraffin dosimeters in the range of 1 to 10kGy irradiation. In regard to the microbiological aspect, compared to the shelf-life of 5 days for the controls, there were a increasing of 1.75; 4.40 e 7.0 times shelf-life for chicken breasts irradiated with 1.5; 3.0 and 7.0kGy, respectively. There was an increasing change of the smell of burnt as the irradiation doses increased. Thus, 3kGy dose was considered as the ideal dose to assure a longer shelf-life to the product, without perceptible changes in the aspect

  20. 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

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

    International Nuclear Information System (INIS)

    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

  2. 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.

  3. Accelerated partial breast irradiation using multicatheter brachytherapy for select early-stage breast cancer: local control and toxicity

    International Nuclear Information System (INIS)

    To investigate the efficacy and safety of accelerated partial breast irradiation (APBI) via high-dose-rate (HDR) multicatheter interstitial brachytherapy for early-stage breast cancer. Between 2002 and 2006, 48 prospectively selected patients with early-stage breast cancer received APBI using multicatheter brachytherapy following breast-conserving surgery. Their median age was 52 years (range 36-78). A median of 34 Gy (range 30-34) in 10 fractions given twice daily within 5 days was delivered to the tumor bed plus a 1-2 cm margin. Most (92%) patients received adjuvant systemic treatments. The median follow-up was 53 months (range 36-95). Actuarial local control rate was estimated from surgery using Kaplan-Meier method. Local recurrence occurred in two patients. Both were true recurrence/marginal miss and developed in patients with close (< 0.2 cm) surgical margin after 33 and 40 months. The 5-year actuarial local recurrence rate was 4.6%. No regional or distant relapse and death has occurred to date. Late Grade 1 or 2 late skin and subcutaneous toxicity was seen in 11 (22.9%) and 26 (54.2%) patients, respectively. The volumes receiving 100% and 150% of the prescribed dose were significantly higher in the patients with late subcutaneous toxicity (p = 0.018 and 0.034, respectively). Cosmesis was excellent to good in 89.6%. APBI using HDR multicatheter brachytherapy yielded local control, toxicity, and cosmesis comparable to those of conventional whole breast irradiation for select early-stage breast cancer. Patients with close resection margins may be ineligible for APBI

  4. Phase II investigation: partial breast irradiation with high-dose brachytherapy using intratissue multicatheter implant

    International Nuclear Information System (INIS)

    Local control, side-effects, and cosmetic results were analyzed in patients with early-stage breast cancer after organpreserving surgery and adjuvant partial accelerated irradiation of the breast using high dose rate brachytherapy and intratissue multicatheter implant. The patients over 50 with solitary tumors < 3 cm invasive ductal carcinoma, differentiation grade I-III, resection R0, N0 (axillary dissection or investigation of signal lymph node) were included in the study. The irradiation was performed twice a day with a 6-hour interval at a single dose of 4 Gy. Total focal dose of 32 Gy was delivered with 8 fractions. With a mean observation period of 31 months (13-46), a local relapse was diagnosed in one patient (1.7 %). Cosmetic results were assessed as good and excellent. Immediate complications of the treatment were minimal. The method can be indicated in a selected group of patients and cannot be a standard of treatment at present.

  5. A Phase 2 Trial of Once-Weekly Hypofractionated Breast Irradiation: First Report of Acute Toxicity, Feasibility, and Patient Satisfaction

    International Nuclear Information System (INIS)

    Purpose: To report on early results of a single-institution phase 2 trial of a 5-fraction, once-weekly radiation therapy regimen for patients undergoing breast-conserving surgery (BCS). Methods and Materials: Patients who underwent BCS for American Joint Committee on Cancer stage 0, I, or II breast cancer with negative surgical margins were eligible to receive whole breast radiation therapy to a dose of 30 Gy in 5 weekly fractions of 6 Gy with or without an additional boost. Elective nodal irradiation was not permitted. There were no restrictions on breast size or the use of cytotoxic chemotherapy for otherwise eligible patients. Patients were assessed at baseline, treatment completion, and at first posttreatment follow-up to assess acute toxicity (Common Terminology Criteria for Adverse Events, version 3.0) and quality of life (European Organization for Research and Treatment of Cancer QLQ-BR23). Results: Between January and September 2011, 42 eligible patients underwent weekly hypofractionated breast irradiation immediately following BCS (69.0%) or at the conclusion of cytotoxic chemotherapy (31.0%). The rates of grade ≥2 radiation-induced dermatitis, pain, fatigue, and breast edema were 19.0%, 11.9%, 9.5%, and 2.4%, respectively. Only 1 grade 3 toxicity—pain requiring a course of narcotic analgesics—was observed. One patient developed a superficial cellulitis (grade 2), which resolved with the use of oral antibiotics. Patient-reported moderate-to-major breast symptoms (pain, swelling, and skin problems), all decreased from baseline through 1 month, whereas breast sensitivity remained stable over the study period. Conclusions: The tolerance of weekly hypofractionated breast irradiation compares well with recent reports of daily hypofractionated whole-breast irradiation schedules. The regimen appears feasible and cost-effective. Additional follow-up with continued accrual is needed to assess late toxicity, cosmesis, and disease-specific outcomes

  6. A Phase 2 Trial of Once-Weekly Hypofractionated Breast Irradiation: First Report of Acute Toxicity, Feasibility, and Patient Satisfaction

    Energy Technology Data Exchange (ETDEWEB)

    Dragun, Anthony E., E-mail: aedrag01@louisville.edu [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Quillo, Amy R. [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Riley, Elizabeth C. [Department of Medical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Roberts, Teresa L.; Hunter, Allison M. [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Rai, Shesh N. [Department of Biostatistics and Epidemiology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Callender, Glenda G. [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Jain, Dharamvir [Department of Medical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); McMasters, Kelly M. [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Spanos, William J. [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)

    2013-03-01

    Purpose: To report on early results of a single-institution phase 2 trial of a 5-fraction, once-weekly radiation therapy regimen for patients undergoing breast-conserving surgery (BCS). Methods and Materials: Patients who underwent BCS for American Joint Committee on Cancer stage 0, I, or II breast cancer with negative surgical margins were eligible to receive whole breast radiation therapy to a dose of 30 Gy in 5 weekly fractions of 6 Gy with or without an additional boost. Elective nodal irradiation was not permitted. There were no restrictions on breast size or the use of cytotoxic chemotherapy for otherwise eligible patients. Patients were assessed at baseline, treatment completion, and at first posttreatment follow-up to assess acute toxicity (Common Terminology Criteria for Adverse Events, version 3.0) and quality of life (European Organization for Research and Treatment of Cancer QLQ-BR23). Results: Between January and September 2011, 42 eligible patients underwent weekly hypofractionated breast irradiation immediately following BCS (69.0%) or at the conclusion of cytotoxic chemotherapy (31.0%). The rates of grade ≥2 radiation-induced dermatitis, pain, fatigue, and breast edema were 19.0%, 11.9%, 9.5%, and 2.4%, respectively. Only 1 grade 3 toxicity—pain requiring a course of narcotic analgesics—was observed. One patient developed a superficial cellulitis (grade 2), which resolved with the use of oral antibiotics. Patient-reported moderate-to-major breast symptoms (pain, swelling, and skin problems), all decreased from baseline through 1 month, whereas breast sensitivity remained stable over the study period. Conclusions: The tolerance of weekly hypofractionated breast irradiation compares well with recent reports of daily hypofractionated whole-breast irradiation schedules. The regimen appears feasible and cost-effective. Additional follow-up with continued accrual is needed to assess late toxicity, cosmesis, and disease-specific outcomes.

  7. Neoadjuvant treatment for breast cancer

    Directory of Open Access Journals (Sweden)

    V. F. Semiglazov

    2014-01-01

    Full Text Available linical trials have shown that the status of the women achieving complete pathomorphological repression (CPR of a tumor is characterized by significantly improved survival as compared to that of those who have not to an equal degree. The achievement of CPR as an intermediate marker for improved survival is chiefly observed in women with aggressive subtypes of breast cancer (BC: triple-negative and HER-2-positive. In patients with the latter subtype, addition of trastuzumab to neoadjuvant chemotherapy doubles the rate of CPR and correlates with higher survival rates. The performed clinical trials have established that neoadjuvant endocrine therapy is the most suitable treatment for patients with steroid hormone receptor overexpression. Whether it may be used in combination with targeted (anti-HER-2 therapy for estrogen and HER-2 coexpression is being investigated. Neoadjuvant therapy for suitable BC stages can accelerate the assessment of novel medications through identification of predictive biological markers for response (CPR in particular. Although standard neoadjuvant therapy gives an obvious benefit to patients with CPR, other patients with the so-called residual disease are at high recurrence risk.

  8. Computer model challenges breast cancer treatment strategy.

    Science.gov (United States)

    Retsky, M W; Swartzendruber, D E; Bame, P D; Wardwell, R H

    1994-01-01

    The breast cancer treatment failure rate remains unacceptably high. The current breast cancer treatment paradigm, based primarily on Gompertzian kinetics and animal models, advocates short-course, intensive chemotherapy subsequent to tumor debulking, citing drug resistance and host toxicity as the primary reasons for treatment failure. To better understand treatment failure, we have studied breast cancer from the perspective of computer modeling. Our results demonstrate breast cancers grow in an irregular fashion; this differs from the Gompertzian mode of animal models and thus challenges the validity of the current paradigm. Clinical and laboratory data support the concept of irregular growth rather than the common claim that human tumors grow in a Gompertzian fashion. Treatment failure mechanisms for breast cancer appear to differ from those for animal models, and thus treatments optimize on animal models may not be optimal for breast cancer. A failure mechanism consistent with our results involves temporarily dormant tumor cells in anatomical or pharmacological sanctuary, which eventually result in aggressive metastatic disease. PMID:7994590

  9. Influence of irradiation on therapy-associated psychological distress in breast carcinoma patients

    International Nuclear Information System (INIS)

    Purpose: To confirm our assumptions regarding factors that apparently cause psychological distress related to adjuvant radiotherapy in breast cancer patients and to evaluate variables that can predict therapy-associated distress. Methods and Materials: Between January 1997 and April 1998, 111 women (33-84 years) with early-stage breast cancer were irradiated (56 Gy) after breast-conserving surgery. Patients were given self-assessment questionnaires on the first and last day of radiotherapy. Statistical analysis was performed using the structural equation model LISREL, variance analysis, and regression analysis. Results: The internal subject-related factors (coping, radiation-related anxiety, physical distress, psychological distress) reciprocally influenced each other, whereas external radiotherapy-specific factors (environmental influence, confidence in the medical staff) were causally related to coping, anxiety, and distress. Fifty-three percent of the women felt distressed because cancer affected the breast; 48% were initially afraid of radiotherapy. For 36%, anxiety was not reduced during treatment. Highly distressed women were identified by the following parameters: ≤58 years; initial anxiety; they were affected by having breast cancer, were negatively affected by environmental factors, and did not find distraction helpful. Conclusion: Despite considerable individual variability in breast cancer patients, it seems possible to identify women who run a high risk of therapy-associated distress. In these patients, psychosocial support is necessary to reduce treatment-related anxiety and to stabilize confidence in the medical staff

  10. Inversely planned intensity modulated radiotheraphy for irradiation of a woman with breast cancer and funnel chest

    International Nuclear Information System (INIS)

    Background: A 44-year old woman with breast cancer was transferred to our institution for irradiation. Due to a pronounced funnel chest no satisfying dose distribution was obtained by conventional techniques. Thus an intensity-modulated radiotherapy (IMRT) based on inverse optimisation was carried out. IMRT was compared to conventional techniques regarding dose distribution and feasibility. Patient and Methods: Tumor site was in the right middle lower quadrant. Target volume included the right breast and the parasternal lymph nodes. Target dose was 50.4 Gy. Based on inverse optimisation irradiation was carried out in 'step-and-short'-technique with twelve intensity modulated beams with six intensity steps. Additionally, treatment plans were calculated using conventional techniques (technique A with two tangential wedged 6-MV photon beams, technique B with additional oblique 15-MeV electron portal). We analysed conformality and homogeneity of target volume and dose distribution within normal tissue. Results: Dose conformality was substantially improved by IMRT. Dose homogeneity was slightly decreased compared to technique A. Lung volume irradiated with a dose higher than 20 Gy was reduced from 56.8% with technique A and 40.1% with technique B, respectively to 22.1% with IMRT. Treatment was tolerated well by the patient without relevant side effects. Mean treatment time was 19.5 min. Conclusion: The inversely planned IMRT using multiple beam directions is suitable for breast irradiation following breast conserving surgery. In the present case of a woman with funnel chest lung dose was substantially reduced without reduction of target dose. In which way the complex treatment technique leads to a clinically detectable advantage is examined at present, in the context of a study. (orig.)

  11. Early breast cancer: diagnosis, treatment and survivorship.

    LENUS (Irish Health Repository)

    Meade, Elizabeth

    2013-01-11

    Breast cancer is the most common female cancer and globally remains a major public health concern. The diagnosis and treatment of breast cancer continues to develop. Diagnosis is now more precise, surgery is less mutilating and women now have the option of breast conserving therapy with better cosmesis, and without sacrificing survival. Radiotherapy is more targeted and the selection of patients for adjuvant chemotherapy is based not only on prognostic and predictive factors, but also on newer molecular profiling that will ensure that chemotherapy is given to the patients who need and respond to it. These developments all provide a more tailored approach to the treatment of breast cancer. Management now involves a multidisciplinary team approach in order to provide the highest standard of care for patients throughout their cancer journey from diagnosis through treatment and into follow-up care.

  12. Radiotherapy effect in conservation treatment for breast cancer

    International Nuclear Information System (INIS)

    Radiotherapy (RT) in conservative treatment for breast cancer (CT-BC) has been proven to be determinant for the local control of the disease. Radiation therapy was described by several authors as the most important factor affecting the cosmetic results of this treatment. Technical progress in RT, use of filters and wedges and an increased knowledge of the influence of fraction size total dose and irradiated volume on breast tissues contributed to avoid major radiotherapeutic side effects in the CT-BC. Cosmetic outcome from 2 groups of patients (pts) with breast cancer in stage T 1-2(T> = 2,5 cm) N 0-1 M o0 of the prospective trial Milan III were compared. Both groups pts (n=89) were treated with quadrantectomyand axillary dissection. 49 pts received complementary RT with a dose of 50 Gy over 5 weeks with a daily fraction of 2 Gy and a further boost of 10 Gy (10 MeV electrons) on the scar. Remaining 40 pts did not receive RT. Cosmetic results were subjectively and objectively (asymmetry index) evaluated. No significant cosmetic differences were observed between the 2 study groups. A good or excellent symmetry was observed in 59% of irradiated pts and 64% of non irradiated pts. Negative results were observed in 4% and 2% respectively. Subjective ovulation showed similar results, with a good or excellent symmetry in 57% of irradiated pts and 72.5% of non irradiated pts. Poor results were observed in 16.3% and 27.5% respectively. Telangiectasia were observed in 4% of irradiated pts, while hypertrophied scars were only noted in non irradiated pts (15%). No acute side effects of RT, as erythema or ulceration of breast skin, were recorded. In our experience, the standard dose of 50 Gy administered by two opposite tangential fields plus a 10 Gy boost did not affect the cosmetic results of CT.BC, whereas it provided a better local control of disease. The possibility to avoid RT in selected group of pts should be justified by the discomfort of this treatment for the pt, cost

  13. Accelerated Partial Breast Irradiation Consensus Statement From the American Society for Radiation Oncology (ASTRO)

    International Nuclear Information System (INIS)

    Purpose: To present guidance for patients and physicians regarding the use of accelerated partial-breast irradiation (APBI), based on current published evidence complemented by expert opinion. Methods and Materials: A systematic search of the National Library of Medicine's PubMed database yielded 645 candidate original research articles potentially applicable to APBI. Of these, 4 randomized trials and 38 prospective single-arm studies were identified. A Task Force composed of all authors synthesized the published evidence and, through a series of meetings, reached consensus regarding the recommendations contained herein. Results: The Task Force proposed three patient groups: (1) a 'suitable' group, for whom APBI outside of a clinical trial is acceptable, (2) a 'cautionary' group, for whom caution and concern should be applied when considering APBI outside of a clinical trial, and (3) an 'unsuitable' group, for whom APBI outside of a clinical trial is not generally considered warranted. Patients who choose treatment with APBI should be informed that whole-breast irradiation (WBI) is an established treatment with a much longer track record that has documented long-term effectiveness and safety. Conclusion: Accelerated partial-breast irradiation is a new technology that may ultimately demonstrate long-term effectiveness and safety comparable to that of WBI for selected patients with early breast cancer. This consensus statement is intended to provide guidance regarding the use of APBI outside of a clinical trial and to serve as a framework to promote additional clinical investigations into the optimal role of APBI in the treatment of breast cancer.

  14. 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.

  15. New developments in irradiation treatments

    International Nuclear Information System (INIS)

    Various processes using ionizing radiations are used in industry and allow the commercialization of many products made of polymers, the properties of which were modified by irradiation. Those modifications are made to remove a drawback of a polymer or to bring the improvement of one or several new properties. By grafting it is mainly possible to modify the chemical properties of the basic polymer; the grafting allows to make fabrics having bacteriostatic properties, polyethylene having adhesive properties on metals, perm-selective membranes, biocompatible polymers and so on. The polymerizing cross linking, which is a combination of polymerization and cross linking is mainly used for surface treatments, for the curing of varnishes, paints, inks, at high speeds, on various substrates, as wood, paper, metals. The radiation induced cross-linking of polymers, which can be obtained by chemical initiation as well, is generaly more easily controlled and the economy of the process is often better

  16. Exercise after breast cancer treatment: current perspectives

    Directory of Open Access Journals (Sweden)

    Dieli-Conwright CM

    2015-10-01

    Full Text Available Christina M Dieli-Conwright, Breanna Z Orozco Division of Biokinesiology and Physical Therapy, Women's Health and Exercise Laboratory, University of Southern California, Los Angeles, CA, USA Abstract: Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength, negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass, increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer. Keywords: breast cancer, exercise, physical well-being

  17. Effects of recombinant epidermal growth factor receptor antisense adenovirus combined with irradiation on breast cancer cells

    International Nuclear Information System (INIS)

    Objective: To investigate the effects of a recombinant antisense adenovirus for epidermal growth factor receptor (EGFR) combined with irradiation on breast cancer cells. Methods: Human EGFR cDNA fragment was subcloned in the opposite orientation to the cytomegaloviral promoter and inserted into a E1/E3-deleted type 5 adenoviral vector to obtain AdE5 construct which expresses EGFR antisense RNA. Combined with γ-ray irradiation, its effects on clonogenicity and cell cycle phase distribution were studied in a human breast cancer line MDA-MB-23. Results: EGFR protein expression was dramatically inhibited in MDA-MB-231 cells after AdE5 infection. The post-irradiation clonogenicity was reduced by AdE5 in a viral and irradiation dose-dependent manner. Further cytometric analysis showed that AdE5 infection at a MOI of 300 pfu/cell induced a cell cycle progression from radio-resistant G0 + G1 phases to radiosensitive G2 + M phases, resulting in a synergistic effect after combination of these two treatments. Conclusions: The transduction of EGFR antisense RNA by adenoviral vector is effective for antisense strategy targeting EGFR, and increases the cell-killing effect of ionizing radiation on breast cancer cells.(authors)

  18. Cooperative study in breast cancer treatment

    International Nuclear Information System (INIS)

    The results of surgical treatment of early breast cancers are discussed. Radical mastectomy for stage 1 tumor and a modified mastectomy after Patey - for stage 2 were shown to be feasible. A cooperative randomized study on therapy of localized stage 2b and 3b breast tumors made the case for application of polychemotherapy and radio-therapy as a components of combined and multimodulity therapy

  19. Diabetes, diabetes treatment and breast cancer prognosis

    OpenAIRE

    Luo, Juhua; Virnig, Beth; Hendryx, Michael; Wen, Sijin; Chelebowski, Rowan; Chen, Chu; Rohan, Tomas; Tinker, Lesley; Wactawski-Wende, Jean; Lessin, Lawrence; Margolis, Karen

    2014-01-01

    The objectives of this study are to assess the impact of pre-existing diabetes and diabetes treatment on breast cancer prognosis. 8,108 women with centrally confirmed invasive breast cancer in the Women’s Health Initiative diagnosed between 1998 and 2013 were followed through the date of death or September 20, 2013. Information on diabetes and diabetes therapy were obtained via self-report and face-to-face review of current medication containers, respectively. Cox proportional hazard regressi...

  20. Incidence of cardiac deaths after irradiation for breast cancer

    International Nuclear Information System (INIS)

    The authors ascertained the cause of death of 1489 women who underwent mastectomy for breast cancer from 1959 through 1972. Postmastectomy irradiation, using parasternal portals which treated some heart, was given to 916 of these patients. The usual dose of raction was 45 Gray (4500 rad) in three weeks, a dose previously considered safe. Analysis by lifetable and Cox proportional hazard methods showed an excess of cardiac deaths in the irradiated women (logrank P = .02) even after controlling for age, hospital, calendar year, number of axillary lymph nodes involved, abnormal electrocardiogram, and prior history of heart disease. The excess deaths only occurred more than ten years after irradiation and only in women under age 70 at the time of mastectomy. Limiting analysis to patients age 40 and 69 years at the time of mastectomy, the authors observed that the hazard ratio for cardiac death was 2.24 (90% confidence interval 1.40 to 3.61) for right sided irradiation and 1.95 (90% confidence interval 1.87 to 4.66) for left sided irradiation. They conclude that irradiation of the heart, in doses previously considered safe, predisposes to cardiac death more than ten years later

  1. Exercise after breast cancer treatment: current perspectives.

    Science.gov (United States)

    Dieli-Conwright, Christina M; Orozco, Breanna Z

    2015-01-01

    Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength), negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass), increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer. PMID:26543382

  2. Objective assessment of dermatitis following post-operative radiotherapy in patients with breast cancer treated with breast-conserving treatment

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Ken; Takenaka, Tadashi; Tanaka, Eiichi; Kuriyama, Keiko; Yoshida, Mineo [National Hospital Organization Osaka National Hospital (Japan). Dept. of Radiology; Yamazaki, Hideya; Nishimura, Tsunehiko [Kyoto Prefectural Univ. of Medicine (Japan). Dept. of Radiology; Kotsuma, Tadayuki [Osaka Univ. Graduate School of Medicine (Japan). Dept. of Radiation Oncology; Fujita, Yuka [Osaka Univ. Graduate School of Medicine (Japan). Dept. of Diagnostic and Interventional Radiology; Masuda, Norikazu [National Hospital Organization Osaka National Hospital (Japan). Dept. of Surgery

    2010-11-15

    To evaluate radiation dermatitis objectively in patients with breast cancer who had undergone post-operative radiotherapy after breast-conserving surgery. Skin color (L{sup *}, a{sup *}, and b{sup *} values) and moisture analyses were performed for both breasts (before, after, 1 month, 6 months, and 1 year after radiotherapy) to examine irradiated and non-irradiated skin divided into four quadrants in 118 patients. These patients underwent breast conservative surgery followed by 50 Gy/25 fractions (median) of radiotherapy with or without boost irradiation (10 Gy/5 fractions). L{sup *}, a{sup *}, and moisture values were changed by irradiation and maximized at completion or 1 month after radiotherapy. One year after radiotherapy, the skin color had returned to the range observed prior to radiotherapy. However, moisture did not return to previous values even 1 year after treatment. The lateral upper side (quadrant C) showed greater changes than other quadrants in the L{sup *} value (darker) at the end of radiotherapy. The Common Toxicity Criteria version 3 scores were found to correlate well with a{sup *} and L{sup *} values at the completion and 1 month after radiotherapy. Boost radiotherapy intensified reddish and darker color changes at the completion of radiotherapy, while chemotherapy did not intensify the skin reaction caused by radiotherapy. Moisture impairment as a result of irradiation lasts longer than color alterations. Objective assessments are useful for analyzing radiation dermatitis. (orig.)

  3. Mammographically detected ductal carcinoma in situ of the breast treated with breast-conserving surgery and definitive breast irradiation: long-term outcome and prognostic significance of patient age and margin status

    International Nuclear Information System (INIS)

    Purpose: This study was performed to determine the long-term outcome for women with mammographically detected ductal carcinoma in situ (DCIS; intraductal carcinoma) of the breast treated with breast-conserving surgery followed by definitive breast irradiation. Methods and Materials: An analysis was performed of 422 mammographically detected intraductal breast carcinomas in 418 women from 11 institutions in North America and Europe. All patients were treated with breast-conserving surgery followed by definitive breast irradiation. The median follow-up time was 9.4 years (mean, 9.4 years; range, 0.1-19.8 years). Results: The 15-year overall survival rate was 92%, and the 15-year cause-specific survival rate was 98%. The 15-year rate of freedom from distant metastases was 94%. There were 48 local failures in the treated breast, and the 15-year rate of any local failure was 16%. The median time to local failure was 5.0 years (mean, 5.7 years; range, 1.0-15.2 years). Patient age at the time of treatment and final pathology margin status from the primary tumor excision were both significantly associated with local failure. The 10-year rate of local failure was 31% for patient age ≤ 39 years, 13% for age 40-49 years, 8% for age 50-59 years, and 6% for age ≥ 60 years (p=0.0001). The 10-year rate of local failure was 24% when the margins of resection were positive, 9% when the margins of resection were negative, 7% when the margins of resection were close, and 12% when the margins of resection were unknown (p=0.030). Patient age ≤ 39 years and positive margins of resection were both independently associated with an increased risk of local failure (p=0.0006 and p=0.023, respectively) in the multivariable Cox regression model. Conclusions: The 15-year results from the present study demonstrated high rates of overall survival, cause-specific survival, and freedom from distant metastases following the treatment of mammographically detected ductal carcinoma in situ of the

  4. Treatment of early breast cancer with conservation of the breast

    International Nuclear Information System (INIS)

    This paper reviews the current status of conservative treatment for early breast cancer. Radiotherapy to the breast after local tumour excision is important to prevent local breast relapse, but it is not clear whether it has any influence on the risk of distant metastases. Several questions remain to be answered. While most investigators agree that the breast should receive a radiation dose of about 50 Gy in 5 weeks, there is no general agreement about the need for a tumour bed booster dose. Considering patients with tumour infiltration at the surgical resection line for whom it is not possible for cosmetic reasons to perform re-resection, it is not clear whether an acceptable local control rate can be achieved through application of a high booster dose in the tumour bed. More trials are needed to show whether certain patients with small invasive carcinomas should be treated with wide local excision without radiotherapy. The need for radiotherapy after local excision for small intraductal (ductal carcinoma in situ) cancers is being addressed in ongoing trials. (orig.)

  5. Change in volume of lumpectomy cavity during external-beam irradiation of the intact breast

    International Nuclear Information System (INIS)

    Purpose: Definition of the lumpectomy cavity is an important component of irradiation of the breast. We use computed tomography (CT)-based planning and contour the lumpectomy volume on the planning CT. We obtained a second CT in the 4th or 5th week of treatment for boost planning and compared the volume change with the first planning-CT scan. Methods and Materials: This retrospective study reviewed the planning-CT data for 20 patients. In the first CT, images were obtained from the mandible to 2 cm below the breast in 3-mm slices. In the second CT, for the boost, images were obtained from the top to the bottom of the clinically defined breast, in 3-mm slices. Lumpectomy cavities were contoured on both CT scans and volumes compared. Results: Sixteen of the 20 patients (80%) had more than a 20% decrease from the first to the second volume, with a corresponding 95% confidence interval. The mean decrease was 16.13 cc, with a standard deviation of 14.05. The Spearman correlation coefficient of 0.18 did not show a significant correlation between the initial volume and the percent change. Conclusions: During external breast irradiation, many patients will have significant volume reduction in the lumpectomy cavity. Because CT-based definition of the lumpectomy cavity can influence the planning of a boost technique, further study appears warranted

  6. Effect of irradiation dose and irradiation temperature on the thiamin content of raw and cooked chicken breast meat

    International Nuclear Information System (INIS)

    The usefulness of ionising radiation for the elimination of pathogenic bacteria in poultry meat has been well documented as have the effects of this processing treatment on the nutritional status of the food, in particular, the vitamins. Unfortunately, much of the earlier research carried out on the effect of irradiation on vitamins was carried out in solution or in model systems at doses much greater than those used commercially thereby resulting in considerable destruction of these compounds. Thus, those opposed to the process of food irradiation labelled the treated food as nutritionally poor. However, in reality, due to the complexity of food systems the effects of irradiation on vitamins are generally not as marked and many processes, for example cooking, cause the same degree of change to the vitamins. Thiamin (vitamin B1) is the most radiation sensitive of the water-soluble vitamins and is therefore a good indicator of the effect of irradiation treatment. In this study the effects of irradiation at either 4°C or −20°C followed by cooking on the thiamin content of chicken breast meat was determined. Results showed that whilst both irradiation and cooking resulted in a decrease in thiamin concentration, the losses incurred were unlikely to be of nutritional significance and could be further minimised by irradiating the chicken meat at a low temperature. Thiamin analyses were carried out using high-performance liquid chromatography since this technique is faster and more selective than the chemical or microbiological methods more commonly employed. Total thiamin, both free and combined form, was determined following acid and enzyme hydrolysis. © 1998 Society of Chemical Industry

  7. Treatment of locally advanced/locally recurrent breast cancer and inflammatory breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Masao [Tenri Hospital, Nara (Japan)

    2000-10-01

    This paper summarizes the treatment of locally advanced breast cancer, inflammatory breast cancer, and locally recurrent breast cancer. A multidisciplinary approach considering subclinical distant metastases is needed to treat these types of breast cancer. Subclinical distant metastasis is observed in about 80% of case of locally advanced cancer, and treatment of subclinical distant metastases, e.g., by endocrinotherapy and chemotherapy, is therefore essential to improving the prognosis. The standard therapy for unresectable locally advanced breast cancer consists of induction chemotherapy with anthracyclines and local treatment with mastectomy or irradiation. Previous reports have stated that induction chemotherapy was effective in 60-80% of the primary lesions or lymph node metastasis, and the CR rates were in the 10-20% range. Combination therapy with induction chemotherapy clearly improved the outcome over local treatment alone. The usual irradiation dose is 50 to 60 Gy/5 to 7 weeks to the whole breast or the thoracic wall. Boost irradiation at a dose of 10 to 25 Gy is performed in unresectable cases. The boost irradiation dose to the lymph node area is usually 45 to 50 Gy/5 to 6 weeks in cases without gross lesions and 10 to 15 Gy in cases with gross lesions. Combination therapy consisting of conservative pectoral mastectomy and postoperative adjuvant chemo- endocrino-therapy (i.e., adjuvant therapy) has become the standard regimen for treating resectable locally advanced breast cancer, because it significantly improves the recurrence rate and survival rate compared to local treatment alone. Some clinical have studies indicated that neoadjuvant therapy (i.e., induction chemotherapy + surgery/radiation therapy) is comparable or superior to adjuvant therapy in terms of improving the prognosis. However, the efficacy and most appropriate method of breast-conserving therapy after induction chemotherapy are still unclear. More clinical trials are needed. It has been

  8. Three-dimensional conformal partial breast external-beam irradiation after conservative surgery of the breast

    International Nuclear Information System (INIS)

    Objective: To explore the methods, dosimetric features and short-term effects of partial breast irradiation carried out by three-dimensional external-beam irradiation (3DCPBI) assisted by active breathing control (ABC). Methods: Computed tomography (CT) simulation assisted by active breathing control (ABC) was carried out for each patient and intended to get CT images in condition of 75% deepest inspiration named moderate deep inspiration breath hold (mDIBH). The extent labeled by the silver slips located in the cavity was delineated as gross target volume (GTV), GTV plus the margin of 15 mm was defined as planning target volume (PTV). 6 MV X-ray was selected as the radiation source and noncoplanar radiation with four three-dimensional conformal fields was used, the described dose was 34 Gy/10f/5d. The volume of GTV, PTV, the affected whole breast, and the percentage of PTV accounted for the affected whole breast, the percentages of PTV included by 100%, 95% and 90% isodose curve, the percentage of volume of the affected breast irradiated by 34.0, 27.2, 20.4, 13.6 and 6.8 Gy , and Dmean, D5, V20 of the lungs and heart were calculated respectively. Acute radiation skin response was recorded and the cosmetic effect of the breast after radiotherapy were appraised, with the local tumor control and survival rate followed. Results: The mean of volume ratio of PTV and affected whole breast was 14.88%; the mean of the volume covered by 90% isodose curve accounted for 92.54% of the PTV; the volume irradiated by 34 Gy (100% of described dose) accounted for 17.23% (mean) of the whole breast and 6.8 Gy (20% of described dose) for 46.11%, in other words, the volume covered by 20% of described dose was less than 50% of the whole breast. The Dmean, D5, V20 for the affected lateral lung were 1.97, 9.25 Gy and 1.58%, it was 0.20, 0.87 Gy, and 0% for the unaffected lateral lung. The Dmean, D5, V20 for the heart was 0.65 Gy, 2.82 Gy, and 0.85%. Zero grade of acute radiation skin

  9. Low-power laser irradiation did not stimulate breast cancer cells following ionizing radiation

    Science.gov (United States)

    Silva, C. R.; Camargo, C. F. M.; Cabral, F. V.; Ribeiro, M. S.

    2016-03-01

    Cancer has become a public health problem worldwide. Radiotherapy may be a treatment to a number of types of cancer, frequently using gamma-radiation with sources such as 137Cs and 60Co, with varying doses, dose rates, and exposure times to obtain a better as a stimulant for cell proliferation and tissue healing process. However, its effects on cancer cells are not yet well elucidated. The purpose of this work was to evaluate the effects of the LPL on breast cancer cultures after ionizing radiation. The breast cancer-MDA-MB-231 cells were gamma irradiated by a 60Co source, with dose of 2.5 Gy. After 24h, cells were submitted to LPL irradiation using a red laser emitting at λ= 660 nm, with output power of 40 mW and exposure time of 30 s and 60 s. The plates were uniformly irradiated, with energy of 1.2 J and 2.4 J, respectively. Cell viability was analyzed using the exclusion method with trypan blue. Our results show that breast cancer cells submitted to LPL after ionizing radiation remained 95 % viable. No statistically significant differences were observed between laser and control untreated cells, (P > 0.05). These findings suggest that LPL did not influenced cancer cells viability.

  10. Locoregional Treatment for Breast Carcinoma After Hodgkin's Lymphoma: The Breast Conservation Option

    International Nuclear Information System (INIS)

    Purpose: To report clinical and pathologic characteristics and outcome of breast cancer (BC) after irradiation for Hodgkin’s lymphoma (HL) in women treated at the Institut Curie, with a special focus on the breast-conserving option. Methods and Materials: Medical records of 72 women who developed either ductal carcinoma in situ or Stage I–III invasive carcinoma of the breast after HL between 1978 and 2009 were retrospectively reviewed. Results: Median age at HL diagnosis was 23 years (range, 14–53 years). Median total dose received by the mediastinum was 40 Gy, mostly by a mantle-field technique. Breast cancers occurred after a median interval of 21 years (range, 5–40 years). Ductal invasive carcinoma and ductal carcinoma in situ represented, respectively, 51 cases (71%) and 14 cases (19%). Invasive BCs consisted of 47 cT0–2 tumors (82%), 5 cN1–3 tumors (9%), and 20 Grade 3 tumors (35%). Locoregional treatment for BCs consisted of mastectomy with (3) or without (36) radiotherapy in 39 patients and lumpectomy with (30) or without (2) adjuvant radiotherapy in 32 patients. The isocentric lateral decubitus radiation technique was used in 17 patients after breast-conserving surgery (57%). With a median follow-up of 7 years, 5-year overall survival rate and locoregional control rate were, respectively, 74.5% (95% confidence interval [CI], 64–88%) and 82% (95% CI, 72–93%) for invasive carcinoma and 100% (95% CI, 100 –100%) and 92% (95% CI, 79–100%) for in situ carcinoma. In patients with invasive tumors, the 5-year distant disease-free survival rate was 79% (95% CI, 69–91%), and 13 patients died of progressive BC. Contralateral BC was diagnosed in 10 patients (14%). Conclusions: Breast-conserving treatment can be an option for BCs that occur after HL, despite prior thoracic irradiation. It should consist of lumpectomy and adjuvant breast radiotherapy with use of adequate techniques, such as the lateral decubitus isocentric position, to protect the

  11. Locoregional Treatment for Breast Carcinoma After Hodgkin's Lymphoma: The Breast Conservation Option

    Energy Technology Data Exchange (ETDEWEB)

    Haberer, Sophie, E-mail: sophie.haberer@wanadoo.fr [Department of Radiation Oncology, Institut Curie, Paris (France); Belin, Lisa [Department of Biostatistics, Institut Curie, Paris (France); Le Scodan, Romuald; Kirova, Youlia M. [Department of Radiation Oncology, Institut Curie, Paris (France); Savignoni, Alexia; Stevens, Denise [Department of Biostatistics, Institut Curie, Paris (France); Moisson, Patricia [Department of Radiation Oncology, Institut Curie, Paris (France); Decaudin, Didier; Pierga, Jean-Yves [Department of Medical Oncology, Institut Curie, Paris (France); Reyal, Fabien [Department of Surgery, Institut Curie, Paris (France); Campana, Francois; Fourquet, Alain; Bollet, Marc A. [Department of Radiation Oncology, Institut Curie, Paris (France)

    2012-02-01

    Purpose: To report clinical and pathologic characteristics and outcome of breast cancer (BC) after irradiation for Hodgkin's lymphoma (HL) in women treated at the Institut Curie, with a special focus on the breast-conserving option. Methods and Materials: Medical records of 72 women who developed either ductal carcinoma in situ or Stage I-III invasive carcinoma of the breast after HL between 1978 and 2009 were retrospectively reviewed. Results: Median age at HL diagnosis was 23 years (range, 14-53 years). Median total dose received by the mediastinum was 40 Gy, mostly by a mantle-field technique. Breast cancers occurred after a median interval of 21 years (range, 5-40 years). Ductal invasive carcinoma and ductal carcinoma in situ represented, respectively, 51 cases (71%) and 14 cases (19%). Invasive BCs consisted of 47 cT0-2 tumors (82%), 5 cN1-3 tumors (9%), and 20 Grade 3 tumors (35%). Locoregional treatment for BCs consisted of mastectomy with (3) or without (36) radiotherapy in 39 patients and lumpectomy with (30) or without (2) adjuvant radiotherapy in 32 patients. The isocentric lateral decubitus radiation technique was used in 17 patients after breast-conserving surgery (57%). With a median follow-up of 7 years, 5-year overall survival rate and locoregional control rate were, respectively, 74.5% (95% confidence interval [CI], 64-88%) and 82% (95% CI, 72-93%) for invasive carcinoma and 100% (95% CI, 100 -100%) and 92% (95% CI, 79-100%) for in situ carcinoma. In patients with invasive tumors, the 5-year distant disease-free survival rate was 79% (95% CI, 69-91%), and 13 patients died of progressive BC. Contralateral BC was diagnosed in 10 patients (14%). Conclusions: Breast-conserving treatment can be an option for BCs that occur after HL, despite prior thoracic irradiation. It should consist of lumpectomy and adjuvant breast radiotherapy with use of adequate techniques, such as the lateral decubitus isocentric position, to protect the underlying heart

  12. Asymmetric collimation in breast cancer irradiation

    International Nuclear Information System (INIS)

    Many methods have been devised to achieve an ideal match of the anterior supraclavicular field (SCV) caudal edge and the cephalad edges of the tangential fields. A non divergent SCV field edge is easily achieved using a half beam block. A number of methods are used to achieve a non divergent edge from the tangential beams including blocking, table angulation, collimator angulation in combination, and half beam blocking, collimator angulation. Using asymmetric collimation technique it is possible to achieve a perfect match-line at the junction of SCV and tangential fields. Via the longitudinal X-jaws, caudal edge of the SCV field and the cephalad margin of the tangential fields is defined. All three fields use one isocenter and thus a single set-up point by abutting beam-split fields at the match plane. The transverse Y jaws are used to beam-split the medial and lateral tangential fields at the chest wall level and define the lateral and medial edges of the SCV field. This technique eliminates lifting heavy half beam block, and the use of single isocenter is time-saving during set-up procedure. Computerized water phantom was utilized in dosimetric evaluations in this nonstandard technique. The match-line is clinically confirmed with verification film for each patient at first treatment. Our treatment planning system, Theraplan - Version 5B, is capable of asymmetric field planning. The 3-D treatment planning is performed at the central axis plane. Angle of tangential fields and source-skin distance at the set-up point is confirmed by 3D treatment planning

  13. Accelerated Partial Breast Irradiation for Pure Ductal Carcinoma in Situ

    International Nuclear Information System (INIS)

    Purpose: To report outcomes for ductal carcinoma in situ (DCIS) treated with breast-conserving therapy using accelerated partial breast irradiation (APBI). Methods and Materials: From March 2001 to February 2009, 53 patients with Stage 0 breast cancer were treated with breast conserving surgery and adjuvant APBI. Median age was 62 years. All patients underwent excision with margins negative by ≥1 mm before adjuvant radiotherapy (RT). A total of 39 MammoSite brachytherapy (MS) patients and 14 three-dimensional conformal external beam RT (3DCRT) patients were treated to the lumpectomy bed alone with 34 Gy and 38.5 Gy, respectively. Of the DCIS cases, 94% were mammographically detected. All patients with calcifications had either specimen radiography or postsurgical mammography confirmation of clearance. Median tumor size was 6 mm, and median margin distance was 5 mm. There were no statistically significant differences according to APBI method for race/ethnicity, tumor detection method, tumor grade, estrogen receptor (ER) status, or use of tamoxifen (p = NS). Recurrence and survival were calculated using the Kaplan-Meier method. Cosmesis was scored by the Harvard criteria. Results: With a median follow-up of 3.6 years (range, 0.4-6.3 years), the overall and cause-specific survival rates were 98% and 100%, respectively. Three-year actuarial ipsilateral breast tumor recurrence was 2%. One failure was observed at the resection bed 11 months post-RT. No other elsewhere breast failures, regional recurrences, or distant metastases were noted. Cosmesis was excellent or good in 92.4% of cases, with no statistically significant differences according to the APBI method (92.3% with MammoSite and 92.8% with 3DCRT; p = 0.649). Conclusions: APBI as part of breast-conserving therapy for pure DCIS was associated with excellent local control and survival rates, with the vast majority of patients having good to excellent cosmesis. This finding supports the recent analysis by the

  14. Time Interval From Breast-Conserving Surgery to Breast Irradiation in Early Stage Node-Negative Breast Cancer: 17-Year Follow-Up Results and Patterns of Recurrence

    International Nuclear Information System (INIS)

    Purpose: A retrospectivechart review was conducted to determine whether the time interval from breast-conserving surgery to breast irradiation (surgery-radiation therapy interval) in early stage node-negative breast cancer had any detrimental effects on recurrence rates. Methods and Materials: There were 566 patients with T1 to T3, N0 breast cancer treated with breast-conserving surgery and breast irradiation and without adjuvant systemic treatment between 1985 and 1992. The surgery-to-radiation therapy intervals used for analysis were 0 to 8 weeks (201 patients), >8 to 12 weeks (233 patients), >12 to 16 weeks (91 patients), and >16 weeks (41 patients). Kaplan-Meier estimates of time to local recurrence, disease-free survival, distant disease-free survival, cause-specific survival, and overall survival rates were calculated. Results: Median follow-up was 17.4 years. Patients in all 4 time intervals were similar in terms of characteristics and pathologic features. There were no statistically significant differences among the 4 time groups in local recurrence (P=.67) or disease-free survival (P=.82). The local recurrence rates at 5, 10, and 15 years were 4.9%, 11.5%, and 15.0%, respectively. The distant disease relapse rates at 5, 10, and 15 years were 10.6%, 15.4%, and 18.5%, respectively. The disease-free failure rates at 5, 10, and 15 years were 20%, 32.3%, and 39.8%, respectively. Cause-specific survival rates at 5, 10, and 15 years were 92%, 84.6%, and 79.8%, respectively. The overall survival rates at 5, 10, and 15 years were 89.3%, 79.2%, and 66.9%, respectively. Conclusions: Surgery-radiation therapy intervals up to 16 weeks from breast-conserving surgery are not associated with any increased risk of recurrence in early stage node-negative breast cancer. There is a steady local recurrence rate of 1% per year with adjuvant radiation alone

  15. Time Interval From Breast-Conserving Surgery to Breast Irradiation in Early Stage Node-Negative Breast Cancer: 17-Year Follow-Up Results and Patterns of Recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Vujovic, Olga, E-mail: olga.vujovic@lhsc.on.ca [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Yu, Edward [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Cherian, Anil [Station Health Centre, Royal Air Force Lossiemouth, Moray (United Kingdom); Dar, A. Rashid [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Stitt, Larry [Department of Biometry, London Regional Cancer Program, London, Ontario (Canada); Perera, Francisco [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada)

    2015-02-01

    Purpose: A retrospectivechart review was conducted to determine whether the time interval from breast-conserving surgery to breast irradiation (surgery-radiation therapy interval) in early stage node-negative breast cancer had any detrimental effects on recurrence rates. Methods and Materials: There were 566 patients with T1 to T3, N0 breast cancer treated with breast-conserving surgery and breast irradiation and without adjuvant systemic treatment between 1985 and 1992. The surgery-to-radiation therapy intervals used for analysis were 0 to 8 weeks (201 patients), >8 to 12 weeks (233 patients), >12 to 16 weeks (91 patients), and >16 weeks (41 patients). Kaplan-Meier estimates of time to local recurrence, disease-free survival, distant disease-free survival, cause-specific survival, and overall survival rates were calculated. Results: Median follow-up was 17.4 years. Patients in all 4 time intervals were similar in terms of characteristics and pathologic features. There were no statistically significant differences among the 4 time groups in local recurrence (P=.67) or disease-free survival (P=.82). The local recurrence rates at 5, 10, and 15 years were 4.9%, 11.5%, and 15.0%, respectively. The distant disease relapse rates at 5, 10, and 15 years were 10.6%, 15.4%, and 18.5%, respectively. The disease-free failure rates at 5, 10, and 15 years were 20%, 32.3%, and 39.8%, respectively. Cause-specific survival rates at 5, 10, and 15 years were 92%, 84.6%, and 79.8%, respectively. The overall survival rates at 5, 10, and 15 years were 89.3%, 79.2%, and 66.9%, respectively. Conclusions: Surgery-radiation therapy intervals up to 16 weeks from breast-conserving surgery are not associated with any increased risk of recurrence in early stage node-negative breast cancer. There is a steady local recurrence rate of 1% per year with adjuvant radiation alone.

  16. Accelerated Partial Breast Irradiation: 5-Year Results of the German-Austrian Multicenter Phase II Trial Using Interstitial Multicatheter Brachytherapy Alone After Breast-Conserving Surgery

    International Nuclear Information System (INIS)

    Purpose: To evaluate the impact of accelerated partial breast irradiation on local control, side effects, and cosmesis using multicatheter interstitial brachytherapy as the sole method for the adjuvant local treatment of patients with low-risk breast cancer. Methods and Materials: 274 patients with low-risk breast cancer were treated on protocol. Patients were eligible for the study if the tumor size was 35 years, hormone receptors were positive, and histologic grades were 1 or 2. Of the 274 patients, 175 (64%) received pulse-dose-rate brachytherapy (Dref = 50 Gy). and 99 (36%) received high-dose-rate brachytherapy (Dref = 32.0 Gy). Results: Median follow-up was 63 months (range, 9-103). Only 8 of 274 (2.9%) patients developed an ipsilateral in-breast tumor recurrence at the time of analysis. The 5-year actuarial local recurrence-free survival probability was 98%. The 5- year overall and disease-free survival probabilities of all patients were 97% and 96%, respectively. Contralateral in-breast malignancies were detected in 2 of 274 (0.7%) patients, and distant metastases occurred in 6 of 274 (2.2%). Late side effects ≥Grade 3 (i.e., breast tissue fibrosis and telangiectasia) occurred in 1 patient (0.4%, 95%CI:0.0-2.0%) and 6 patients (2.2%, 95%CI:0.8-4.7%), respectively. Cosmetic results were good to excellent in 245 of 274 patients (90%). Conclusions: The long-term results of this prospective Phase II trial confirm that the efficacy of accelerated partial breast irradiation using multicatheter brachytherapy is comparable with that of whole breast irradiation and that late side effects are negligible.

  17. Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone

    Energy Technology Data Exchange (ETDEWEB)

    Hoejris, I.; Andersen, J.; Overgaard, M.; Overgaard, J. [Aarhus Univ. Hospital (Denmark). Dept. of Oncology

    2000-07-01

    Late treatment-related morbidity after mastectomy and adjuvant systemic treatment with and without postoperative irradiation was assessed in 84 patients randomized in the Danish Breast Cancer Cooperative Group Trials 82b and c. A structured interview and physical examination, using a standardized assessment sheet, constructed on the basis of the late effects normal tissues (LENT) scoring system, was used. The median length of follow-up from mastectomy was 9 years (range 6-13 years). Lymphedema was measured in 14%, of the irradiated patients versus 3% of the non-irradiated patients (NS). Slightly decreased shoulder morbidity was measured in 45% of the irradiated women versus 15% of the non-irradiated patients, but moderate or more severe impairment was seen in only 5% of the irradiated patients and in none of the non-irradiated patients (p = 0.004). Seventeen percent of the irradiated patients and 2% of the non-irradiated patients found that impairment of shoulder movement caused symptoms (p = 0.001)

  18. Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone

    International Nuclear Information System (INIS)

    Late treatment-related morbidity after mastectomy and adjuvant systemic treatment with and without postoperative irradiation was assessed in 84 patients randomized in the Danish Breast Cancer Cooperative Group Trials 82b and c. A structured interview and physical examination, using a standardized assessment sheet, constructed on the basis of the late effects normal tissues (LENT) scoring system, was used. The median length of follow-up from mastectomy was 9 years (range 6-13 years). Lymphedema was measured in 14%, of the irradiated patients versus 3% of the non-irradiated patients (NS). Slightly decreased shoulder morbidity was measured in 45% of the irradiated women versus 15% of the non-irradiated patients, but moderate or more severe impairment was seen in only 5% of the irradiated patients and in none of the non-irradiated patients (p = 0.004). Seventeen percent of the irradiated patients and 2% of the non-irradiated patients found that impairment of shoulder movement caused symptoms (p = 0.001)

  19. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review

    International Nuclear Information System (INIS)

    Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy

  20. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Smyth, Lloyd M, E-mail: lloyd.smyth@epworth.org.au [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia); Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Knight, Kellie A [Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Aarons, Yolanda K; Wasiak, Jason [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia)

    2015-03-15

    Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy.

  1. Multi-modality fusion of CT, 3D ultrasound, and tracked strain images for breast irradiation planning

    Science.gov (United States)

    Foroughi, Pezhman; Csoma, Csaba; Rivaz, Hassan; Fichtinger, Gabor; Zellars, Richard; Hager, Gregory; Boctor, Emad

    2009-02-01

    Breast irradiation significantly reduces the risk of recurrence of cancer. There is growing evidence suggesting that irradiation of only the involved area of the breast, partial breast irradiation (PBI), is as effective as whole breast irradiation. Benefits of PBI include shortened treatment time, and perhaps fewer side effects as less tissue is treated. However, these benefits cannot be realized without precise and accurate localization of the lumpectomy cavity. Several studies have shown that accurate delineation of the cavity in CT scans is very challenging and the delineated volumes differ dramatically over time and among users. In this paper, we propose utilizing 3D ultrasound (3D-US) and tracked strain images as complementary modalities to reduce uncertainties associated with current CT planning workflow. We present the early version of an integrated system that fuses 3D-US and real-time strain images. For the first time, we employ tracking information to reduce the noise in calculation of strain image by choosing the properly compressed frames and to position the strain image within the ultrasound volume. Using this system, we provide the tools to retrieve additional information from 3D-US and strain image alongside the CT scan. We have preliminarily evaluated our proposed system in a step-by-step fashion using a breast phantom and clinical experiments.

  2. Early experiences of breast-conservation treatment without axillary dissection for breast cancer patients with clinically-negative axillary nodes

    International Nuclear Information System (INIS)

    Nineteen patients with breast cancer who had clinically negative axillary nodes were treated with breast-conservation treatment, consisting of lumpectomy, irradiation, endocrine therapy (tamoxifen), and adjuvant chemotherapy. They were all women, whose ages ranged from 35 to 84 years with a mean of 53.8 years. Preoperative UICC staging was I in 10 patients, IIA in 8, and IIB in one; and postoperative staging was I in 7 and IIA in 12. Among evaluable 13 patients, 5 (38.5%) had microscopically positive margin. Radiation therapy was started within two to three weeks after breast-conserving surgery. Patients received irradiation to the ipsilateral breast and chest wall, including the ipsilateral axillary region, using opposed tangential fields to a dose of 4400 cGy at 275 cGy per fraction. Boost irradiation using an electron beam was delivered with a dose of 1000 cGy in 2 fractions in the last week of radiotherapy in all patients. In addition, adjuvant chemotherapy (cyclophosphamide, pirarubicin or epirubicin, 5-fluorouracil) and endocrine therapy (tamoxifen) were given. With a mean follow up of 20.7 months, one patient aged 80 died of cardiac failure and pneumonia without evidence of breast cancer progression. The other 18 patients are alive without either local failure or distant metastases. Cosmetic evaluation showed each 9 patients to be 'excellent' or 'good'. No patients have serious adverse effects as of this writing. Although the follow-up period is short and the number of patients is limited, the preliminary results of breast-conservation treatment for axillary negative breast cancer seem to be sufficiently good. (N.K.)

  3. Outcomes After Breast Conservation Treatment With Radiation in Women With Prior Nonbreast Malignancy and Subsequent Invasive Breast Carcinoma

    International Nuclear Information System (INIS)

    Purpose: Little information has been reported regarding outcomes after treatment for patients with early-stage invasive breast cancer and a prior nonbreast malignancy. This report analyzes the outcomes in patients with Stage I and II breast cancer after breast conservation treatment (BCT) with a prior nonbreast malignancy. Methods and Materials: The study cohort comprised 66 women with invasive breast cancer and a prior nonbreast malignancy. All patients were treated with breast conservation surgery followed by definitive breast irradiation between 1978 and 2003. Median ages at diagnosis of invasive breast cancer and prior malignancy were 57 and 50 years, respectively. The median interval between the prior malignancy and breast cancer was 7.0 years. Median and mean follow-up times after BCT were 5.3 and 7.0 years. Results: The 5-year and 10-year overall survival rates were 94% (95% confidence interval [CI], 82-98%) and 78% (95% CI, 59-89%), respectively. There were 4 patients (6%) with local failure and 10 patients (15%) with distant metastases. The 10-year rate of local failure rate was 5% (95% CI, 2-16%) and freedom from distant metastases was 78% (95% CI, 61-88%). No obvious differences in survival or local control were noted compared with the reported results in the literature for patients with invasive breast cancer alone. Conclusions: Both overall survival and local control at 5 and 10 years were comparable to rates observed in early-stage breast cancer patients without a prior malignancy. Prior nonbreast malignancy is not a contraindication to BCT, if the primary cancer is effectively controlled

  4. Breast cancer treatment and ethnicity in British Columbia, Canada

    OpenAIRE

    Barroetavena Maria; Yavari Parvin; Hislop T Greg; Bajdik Chris D

    2010-01-01

    Abstract Background Racial and ethnic disparities in breast cancer incidence, stage at diagnosis, survival and mortality are well documented; but few studies have reported on disparities in breast cancer treatment. This paper compares the treatment received by breast cancer patients in British Columbia (BC) for three ethnic groups and three time periods. Values for breast cancer treatments received in the BC general population are provided for reference. Methods Information on patients, tumou...

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    International Nuclear Information System (INIS)

    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 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-term results are needed to assess

  7. Breast conservation treatment of early stage breast cancer: patterns of failure

    International Nuclear Information System (INIS)

    Purpose: This study retrospectively assesses the patterns of failure in conservatively treated early stage breast cancer patients by correlating various clinical, pathologic, and treatment-related factors with local, axillary, and distant relapse. Methods and Materials: Between 1973 and 1990, 796 patients (817 breasts) received breast conservation surgery followed by radiotherapy. Local recurrences were counted as events even if they occurred simultaneously or after the appearance of axillary or distant metastases. Results: The 10-year actuarial relative disease-free survival (DFS) rate for T1N0, T2N0, and T1-2N1 was 82%, 71%, and 54%, respectively. Stage N0 patients had a significant DFS advantage over N1 patients (p = 0.02). The 15-year actuarial local recurrence-free rate for T1 and T2 tumors was 82% and 87%, respectively (p = nonsignificant). Univariate analysis identified three significant risk factors for local relapse: (a) 48 breasts with tumors showing an extensive intraductal component had a crude local recurrence rate of 23% compared to 8% for 769 breasts without intraductal component (p 0.0016); (b) the actuarial 10-year local recurrence-free rate for patients under age 40 years was 64% compared to 88% for patients over 40 years (p < 0.0001); (c) the 10-year actuarial local recurrence-free rate for 416 postmenopausal women without adjuvant tamoxifen was 83% compared to 97% for 107 postmenopausal women with tamoxifen (p = 0.0479). Salvage therapy for operable local recurrent patients resulted in a 8-year actuarial DFS rate of 47%, significantly lower than that obtained with primary treatment. The incidence of axillary relapse as the first sign of recurrence was 2%, and could be correlated with the lack of axillary dissection (p < 0.0000005) and primary tumor size (p = 0.03). Radiotherapy to the axilla did not influence axillary relapse. Actuarial 5-year DFS rate after treatment of isolated axillary recurrence was 27%. Axillary failure was a marker for

  8. Irradiation in combined treatments and food safety

    International Nuclear Information System (INIS)

    Irradiation combined with other processes can contribute to insuring food safety to consumers and controlling severe losses during transportation and commercialisation. We have demonstrated that using in synergy with other treatments; a lower dose could be used to eliminate pathogenic bacteria and permit a better protection of the sensorial quality and to prolong the shelf life of foods. Results indicated that some bacteria are more sensitive to irradiation under modified atmosphere (MAP) and the presence of active compound can increase the bacterial radiosensitivity by more than 4 times under air and by more than 10 times under MAP. Mild heat treatment or addition of natural antimicrobial compounds before irradiation treatment has also permitted an increase of Bacillus cereus radiosensitization. An increase of the bacterial radiosensitization of 1.5 and 1.56 was respectively observed. The effectiveness of the use of edible coating containing natural antimicrobial compounds, modified atmosphere packaging (MAP) or mild treatment before irradiation treatment was demonstrated in order to inactivate Listeria monocytogenes, Salmonella typhimurium, Escherichia coli and Bacillus cereus growth or B. cereus spore germination, to increase the bacterial sensitivity to irradiation, to reduce the water loss and to extend the shelf life of the food when stored at 4 deg C. Also, the use of edible coating previously crosslinked by irradiation have permitted a better control of the active compounds release. Studies of combined treatments were used in ready to eat vegetables, fruits and meat products. (author)

  9. Stereotactic Accelerated Partial Breast Irradiation (SAPBI for Early Stage Breast Cancer: Rationale, Feasibility and Early Experience using the CyberKnife Radiosurgery Delivery Platform

    Directory of Open Access Journals (Sweden)

    Olusola eOBAYOMI-DAVIES

    2016-05-01

    Full Text Available Purpose: The efficacy of accelerated partial breast irradiation (APBI utilizing brachytherapy or conventional external beam radiation has been studied in early stage breast cancer treated with breast conserving surgery. Data regarding stereotactic treatment approaches are emerging. The CyberKnife linear accelerator enables excellent dose conformality to target structures while adjusting for target and patient motion. We report our institutional experience on the technical feasibility and rationale for SAPBI delivery using the CyberKnife radiosurgery system.Methods: Ten patients completed CyberKnife SAPBI in 2013 at Georgetown University Hospital. Four gold fiducials were implanted around the lumpectomy cavity prior to treatment under ultrasound guidance. The synchrony system tracked intrafraction motion of the fiducials. The clinical target volume (CTV was defined on contrast enhanced CT scans using surgical clips and post-operative changes. A 5 mm expansion was added to create the planning treatment volume (PTV. A total dose of 30 Gy was delivered to the PTV in 5 consecutive fractions. Target and critical structure doses were assessed as per the National Surgical Adjuvant Breast and Bowel Project B-39 study.Results: At least 3 fiducials were tracked in 100% of cases. The Mean treated PTV was 70 cm3 and the mean prescription isodose line was 80%. Mean dose to target volumes and constraints are as follows: 100% of the PTV received the prescription dose (PTV30. The volume of the ipsilateral breast receiving 30 Gy (V30 and above 15 Gy (V>15 was 14% and 31% respectively. The ipsilateral lung volume receiving 9 Gy (V9 was 3% and the contralateral lung volume receiving 1.5 Gy (V1.5 was 8%. For left sided breast cancers, the volume of heart receiving 1.5 Gy (V1.5 was 31%. Maximum skin dose was 36 Gy. At a median follow up of 1.3 years, all patients have experienced excellent/good breast cosmesis outcomes, and no breast events have been recorded

  10. Leiomyosarcoma arising in irradiated region after breast-conserving surgery: a case report

    OpenAIRE

    Hayashi, Satoshi; KITADA, MASAHIRO; Matsuda, Yoshinari; Ishibashi, Kei; Takahashi, Nana

    2015-01-01

    Background Radiation therapy (RT) is considered a risk factor for the development of sarcoma in patients with breast cancer. However, there are few reports regarding post-irradiation sarcoma (PIS). Case presentation The patient was a 59-year-old woman who presented with a chief complaint of induration in the lower outer quadrant of the left breast. She underwent breast-conserving surgery (BCS) for breast cancer located in the left upper inner region and received endocrine therapy following RT...

  11. Irradiation as a quarantine treatment of fruit

    International Nuclear Information System (INIS)

    Disinfestation treatment of fresh is often necessary to permit transport of fresh produce to markets otherwise unavailable due to plant quarantine regulations. For many years, chemical fumigation treatments were successfully applied for this purpose. However, concern over the human health risks associated with their continued use has seen the removal of such chemicals from the international fresh fruit trade. Injury to many fruits by such alternative physical treatments as cold storage has led to renewed interest in irradiation as a commoditytreatment. Low dose irradiation of eggs and larvae will stop the emergence of adult fruit flies and therefore, by breaking the life-cycle of these insects, overcome quarantine barriers. Since most fruit will tolerate these low irradiation doses, such a treatment is technically not only a feasible alternative to chemical fumigation but a viable quarantine treatment in it own right

  12. Treatment results in males with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pakisch, B. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria); Stoeger, H. [Dept. of Clinical Oncology, Karl Franzens Univ. of Graz (Austria); Poschauko, H. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria); Samonigg, H. [Dept. of Clinical Oncology, Karl Franzens Univ. of Graz (Austria); Bauernhofer, T. [Dept. of Clinical Oncology, Karl Franzens Univ. of Graz (Austria); Pojer, E. [Dept. of Clinical Oncology, Karl Franzens Univ. of Graz (Austria); Leitner, H. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria); Stuecklschweiger, G. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria); Peichl, K.H. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria); Quehenberger, F. [Dept. of Statistics and Documentation, Karl Franzens Univ. of Graz (Austria); Hackl, A. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria)

    1995-08-01

    Because cancer of the male breast is rare knowledge about its biology and behavior is essentially due to a compilation of pooled experiences. Hence, a continued report of cases appears to be important. Therefore a retrospective review of patients suffering from male breast cancer was carried out. Twenty-four evaluable cases were analyzed. Eight patients (1 patient with bilateral Stage I carcinoma was included) were in Stage I, 7 in Stage II, 2 in Stage IIIa, 4 in Stage IIIb, and 3 in Stage IV. Of 23 patients who were treated with mastectomy, 22 had modified radical mastectomy and postoperative irradiation to the chest wall as well as to the peripheral lymphatic areas in most cases. One patient underwent radical mastectomy. Another patient had an excision biopsy only, followed by irradiation. One of 24 patients received tamoxifen; another received cyclophosphamide, methotrexate, 5-fluorouracil, prednisone (CMF) regimen in an adjuvant setting. Local recurrence developed in one of 23 (4%) patients treated with mastectomy and radiation therapy to the chest wall and peripheral lymphatics. Four (17%) patients developed distant metastases. The 5-year overall survival (Kaplan-Maier) was 90% for the entire group, 100% for patients in Stage I-III disease, and 60% in Stage IV disease (P = < 0.005). As observed in former reports the stage of disease at initial presentation seems to be a parameter that significantly contributes to survival in male breast cancer patients. To what extent improved local control by adequate local therapy, such as surgery and postoperative radiotherapy, may improve overall survival remains to be discussed. (orig.)

  13. Treatment results in males with breast cancer

    International Nuclear Information System (INIS)

    Because cancer of the male breast is rare knowledge about its biology and behavior is essentially due to a compilation of pooled experiences. Hence, a continued report of cases appears to be important. Therefore a retrospective review of patients suffering from male breast cancer was carried out. Twenty-four evaluable cases were analyzed. Eight patients (1 patient with bilateral Stage I carcinoma was included) were in Stage I, 7 in Stage II, 2 in Stage IIIa, 4 in Stage IIIb, and 3 in Stage IV. Of 23 patients who were treated with mastectomy, 22 had modified radical mastectomy and postoperative irradiation to the chest wall as well as to the peripheral lymphatic areas in most cases. One patient underwent radical mastectomy. Another patient had an excision biopsy only, followed by irradiation. One of 24 patients received tamoxifen; another received cyclophosphamide, methotrexate, 5-fluorouracil, prednisone (CMF) regimen in an adjuvant setting. Local recurrence developed in one of 23 (4%) patients treated with mastectomy and radiation therapy to the chest wall and peripheral lymphatics. Four (17%) patients developed distant metastases. The 5-year overall survival (Kaplan-Maier) was 90% for the entire group, 100% for patients in Stage I-III disease, and 60% in Stage IV disease (P = < 0.005). As observed in former reports the stage of disease at initial presentation seems to be a parameter that significantly contributes to survival in male breast cancer patients. To what extent improved local control by adequate local therapy, such as surgery and postoperative radiotherapy, may improve overall survival remains to be discussed. (orig.)

  14. Cosmetic results of conservative treatment for early breast cancer

    International Nuclear Information System (INIS)

    This study was performed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients (90%) and lumpectomy or excisional biopsy for 10 patients (8.3%). Forty six patients (38%) received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the stemal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Cosmetic score was excellent or good in 76% (91/120), fair in 19% (23/120) and poor in 5% (6/ 120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (NO versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0,0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without axillary

  15. Cosmetic results of conservative treatment for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Kyoung; Shin, Seong Soo; Kim, Seong Deok; Ha, Sung Whan; Noh, Dong Young [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2001-03-01

    This study was performed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients (90%) and lumpectomy or excisional biopsy for 10 patients (8.3%). Forty six patients (38%) received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the stemal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Cosmetic score was excellent or good in 76% (91/120), fair in 19% (23/120) and poor in 5% (6/ 120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (NO versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0,0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without

  16. Three technique for non coplanar conformal field radiation treatment of breast cancer

    International Nuclear Information System (INIS)

    The radiation treatment of the breast is a challenge for radio therapists and physicists, because of the proximity of organs at risk such as lung and heart. For many years tangential irradiation technique has been the technique of choice in these cases. A novel technique described by the group Cancer Institute's work of Italian Switzerland, has been employed by us, good results. (Author)

  17. Concurrent chemo-radiotherapy in the treatment of early breast cancer: Current status

    Directory of Open Access Journals (Sweden)

    Nabil Ismaili

    2013-01-01

    Full Text Available Concurrent chemo-radiotherapy (CCRT in early breast cancer was investigated by few authors and remains controversial. This treatment is more commonly used for locally advanced breast cancer and showed high rate of complete pathological response. A search of articles published in English literature, between 1980 and November 2012, was conducted on Medline using the following terms: "breast cancer", "chemotherapy", "concurrent radiotherapy", and "Trastuzumab". We identified five phase I/II trials and three randomized phase three trials evaluating concurrent chemoradiotherapy in the adjuvant of breast cancer. In patients with early breast cancer having positive lymph nodes, phases III clinical trials showed that CCRT improved local control after conservative breast surgery. However, these randomized trials used non-standard regimen: Cyclophosphamide, methotrexate and fluorouracil (CMF or fluorouracil, mitoxantrone and cyclophosphamide (FNC. In addition, in phases II clinical trials, concurrent use of taxanes and anthracycline with standard whole-breast irradiation showed high rate of toxicity: Pulmonary toxicity with taxane; and cardiac and skin toxicity with anthracycline. Consequentely, CCRT is not be used in practice because of concerns of toxicity with the standard drugs (anthracyclines and taxanes and radiation. Anthracyclines with partial breast irradiation (PBI was feasible according to one phase I clinical trial, and should be investigated in randomized clinical trials. Concurrent Trastuzumab plus radiotherapy is safe and can be used in HER2-positive breast cancer; in this case, cardiac volume sparing and patient selections for internal mammary chain irradiation are highly recommended. The present paper aimed to review the current data evaluating the efficacy and safety of CCRT in early breast cancer.

  18. Molecular markers′ progress of breast cancer treatment efficacy

    OpenAIRE

    Dan Wang; Jingwei Xu; Guang Shi; Guanghao Yin

    2015-01-01

    Breast cancer is a famous malignant tumor which is caused by varieties of mutation in multiple genes. In order to detect breast cancer in an earlier time and take appropriate treatment which includes  predicting treatment efficacy, we need a more accurate method of discovering the occurrence of breast cancer. With the development of molecular biology and biological detection technologies continue to emerge, molecular markers of breast cancer have gaining more and more widespread attention, an...

  19. Treatment Modification in Young Breast Cancer Patients.

    Science.gov (United States)

    Scharl, Anton; Salterberg, Annette; Untch, Michael; Liedtke, Cornelia; Stickeler, Elmar; Papathemelis, Thomas

    2016-01-01

    Patients not older than 40 years are referred to as young patients. These women benefit from chemo-, endocrine and anti-HER2 therapy to a similar degree as older women. Surgery and radiation therapy also follow the same recommendations. This manuscript deals with the following topics that need special consideration in young women: endocrine therapy and ovarian suppression; fertility protection and family planning; and genetic counselling. There is an on-going debate on whether tamoxifen is sufficient as an endocrine treatment in young patients with endocrine-responsive tumours or whether suppression of ovarian function in combination with tamoxifen or aromatase inhibitor should be preferred. Recent data suggest a benefit from ovarian suppression plus exemestane in women of 35 years or younger with high-risk breast cancer. However, increased side effects bear the risk of lesser compliance, which eventually results in higher mortality. Child bearing is nowadays frequently postponed to the 4th decade of life, thereby increasing the number of women who have not yet finished their reproductive desires when diagnosed with breast cancer. These patients are in urgent need of counselling for fertility protection. Breast cancer diagnosis at young age is an indication for a possible mutation in breast cancer susceptibility genes. This has an impact on the cancer risk of the whole family, especially the offspring. Drugs that are specifically targeted to cancer cells with genetic alterations that impair DNA repair are already entering the arsenal of oncologists. PMID:27031253

  20. Breast cancer in patients previously irradiated for Hodgkin disease

    International Nuclear Information System (INIS)

    Breast cancer (BC) developing patients cured of Hodgkin disease (HD) has been only anecdotally reported. The authors identified 21 patients at Memorial Sloan Kettering Cancer Center who developed a total of 22 BCs since 1969 and had a history of cured HD. The median time interval between HD and BC was 14 years. All patients had modified or radical mastectomy with no complications. There was no unusual distribution of the lesions in the breasts. The course of BC did not differ from what is to be expected per stage of BC and length of follow-up. All patients had radiation treatment for their HD. Seven patients were also treated with chemotherapy. The radiation dose delivered was 2,000-3,000 cGy in six patients and 3,600-4,000 cGy in 12 patients. Nine patients were treated to the mantle field and nine to multiple components of a mantle-like field. The data show that BC developing in cured HD patients did not have unique characteristics. They did not identify an increased risk to develop BC attributable to technique, dose, or energy used in the radiation of these patients. It remains unclear whether HD and/or its treatment with radiation predisposes the patient to develop breast cancer

  1. Axillary irradiation omitting axillary dissection in breast cancer: is there a role for shoulder-sparing proton therapy?

    Science.gov (United States)

    Farace, P; Deidda, M A; Amichetti, M

    2015-10-01

    The recent EORTC 10981-22023 AMAROS trial showed that axillary radiotherapy and axillary lymph node dissection provide comparable local control and reduced lymphoedema in the irradiated group. However, no significant differences between the two groups in range of motion and quality of life were reported. It has been acknowledged that axillary irradiation could have induced some toxicity, particularly shoulder function impairment. In fact, conventional breast irradiation by tangential beams has to be modified to achieve full-dose coverage of the axillary nodes, including in the treatment field a larger portion of the shoulder structures. In this scenario, alternative irradiation techniques were discussed. Compared with modern photon techniques, axillary irradiation by proton therapy has the potential for sparing the shoulder without detrimental increase of the medium-to-low doses to the other normal tissues. PMID:26153903

  2. Irradiated HMEC from A-T Heterozygous Breast Tissue

    Science.gov (United States)

    Richmond, Robert; Bors, Karen; Cruz, Angela; Pettengil, Olive; Curreri, Peter A. (Technical Monitor)

    2002-01-01

    Women who are heterozygous for ataxia-telangiectasia (A-T) carry a single defective ATM gene in chromosome 11 q22-23, and have been statistically determined with high significance within a defined database to be approximately 5-fold more susceptible for developing breast cancer than their noma1 counterpart. Breast cancer susceptibility of these A-T heterozygotes has been hypothesized to include consequence of response to damage caused by low levels of ionizing radiation. Prophylactic mastectomy specimens were donated by a 41 year-old obligate A-T heterozygote who was located prior to her elective surgery through an existing pedigree. Harvest of that breast tissue provided an isolate of long-term growth human mammary epithelial cells (HMEC), designated WH612/3. An isolate of presumed normal long-term growth HMEC, designated 48R, was obtained from Dr. Martha Stampfer (Lawrence Berkeley Laboratory, University of California), and the A-T heterozygous HMEC were transformed with E6 and E7 oncogenes of human papilloma virus Type-16 in the laboratory of Dr. Ray White (Hunt- Cancer Institute, University of Utah) for use in this study. The objective of this study is to study the expression of end points that may bear on cancer outcome following irradiation of HMEC. Specific end points are cell survival, cell cycle, p53 expression, and apoptosis. Survival curves, immunostaining, and flow cytometery are used to examine these end points. Radiation-induced cell killing shows less shoulder development in the survival curve for WH61U3 compared to 48R HMEC, suggesting less repair of damage in the former HMEC. Additional information is included in the original extended abstract.

  3. Cardiac and pulmonary doses and complication probabilities in standard and conformal tangential irradiation in conservative management of breast cancer

    International Nuclear Information System (INIS)

    Background and purpose: The clinical benefit of irradiating the intact breast after lumpectomy must be weighted against the risk of severe toxicity. We present a study on cardiac and pulmonary dose-volume data and the related complication probabilities of tangential breast irradiation having the following objectives: (1) to quantify the sparing of the organs at risk (ORs), the heart and the lung, achieved by three-dimensional (3-D) conformal tangential irradiation (CTI) as compared to standard tangential irradiation (STI); (2) to elucidate the uncertainty in radiation tolerance data; and (3) to analyse the relation between the amount of OR irradiated and the resulting morbidity risk. Material and methods: Computed tomography (CT)-based 3-D treatment plans of 26 patients prescribed to CTI of the intact breast were applied. Contour-based STI has been our routine treatment, and was reconstructed for all patients. Dose-volume data and normal tissue complication probability (NTCP) predictions from the probit and relative seriality models with several cardiac and pulmonary tolerance parameterizations were analysed and compared. Results and conclusions: A significant amount of normal tissues can be spared from radiation by using CT-based CTI, resulting in a 50% reduction of the average excess cardiac mortality risk in the left-sided cases. The risks for pericarditis and pneumonitis were too low to reveal any clinically significant difference between the treatments. For the STI set-up, a regression analysis showed that the excess cardiac mortality risk increased when larger parts of the heart were inside the fields. However, the different excess cardiac mortality and pneumonitis tolerance parameters resulted in statistically significant different NTCPs, which precluded the ability to accurately predict absolute NTCPs after tangential breast irradiation. Despite this uncertainty the different series of cardiac and pulmonary risk predictions were in relatively good agreement

  4. Accelerated partial breast irradiation utilizing brachytherapy: patient selection and workflow

    Science.gov (United States)

    Wobb, Jessica; Manyam, Bindu; Khan, Atif; Vicini, Frank

    2016-01-01

    Accelerated partial breast irradiation (APBI) represents an evolving technique that is a standard of care option in appropriately selected woman following breast conserving surgery. While multiple techniques now exist to deliver APBI, interstitial brachytherapy represents the technique used in several randomized trials (National Institute of Oncology, GEC-ESTRO). More recently, many centers have adopted applicator-based brachytherapy to deliver APBI due to the technical complexities of interstitial brachytherapy. The purpose of this article is to review methods to evaluate and select patients for APBI, as well as to define potential workflow mechanisms that allow for the safe and effective delivery of APBI. Multiple consensus statements have been developed to guide clinicians on determining appropriate candidates for APBI. However, recent studies have demonstrated that these guidelines fail to stratify patients according to the risk of local recurrence, and updated guidelines are expected in the years to come. Critical elements of workflow to ensure safe and effective delivery of APBI include a multidisciplinary approach and evaluation, optimization of target coverage and adherence to normal tissue guideline constraints, and proper quality assurance methods. PMID:26985202

  5. Partial breast irradiation for early breast cancer: 3-year results of the German-Austrian phase II-trial

    International Nuclear Information System (INIS)

    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.)

  6. Impact of Radiation in Critical Organs in Radiotherapy Treatment of Breast and Lung Cancers

    Science.gov (United States)

    Pyakuryal, Anil; Chen, Chiu-Hao; Dhungana, Sudarshan

    2010-02-01

    Various 3D conformal radiotherapy (3DCRT) techniques are commonly used in the treatment of cancerous tumors at appropriate prescription doses (PDs). The purpose of this study was to analyze the impact of radiation in heart and lungs in left breast and left lung cancer patients treated using 3DCRT techniques. Treatment plans for the eight breast cancer patients (n=8), eight lung cancer patients at early stage (m=8), and eight lung cancer patients at stage II and III (k=8) were evaluated. Relative complication probabilities (RCPs) for the irradiated organs were computed from the plans using HART [Med. Phys. 36, p.2547 (2009)] program at PD. The RCPs were found to be (i) 2.3% (n=8, PD=56 Gy), 6.4% (m=8, PD=30.7 Gy), and 16.7% (k=8, PD=54.8 Gy) for the heart, (ii) 1% (n=6, PD=58.4 Gy) for the left lung, and (iii) 7% (m=6, PD=31 Gy) and 5.3% (k=8, PD=54.8 Gy) for the whole lung. Homogeneous target coverage and improved dose conformality were the major advantages in the treatment of breast cancer. Therefore, simple 3DCRT based whole-breast irradiation and partial lung treatment techniques can offer promising results while adequately sparing the organs in the treatment of breast and lung cancers. )

  7. Toremifene in the treatment of breast cancer

    Science.gov (United States)

    Mustonen, Mika VJ; Pyrhönen, Seppo; Kellokumpu-Lehtinen, Pirkko-Liisa

    2014-01-01

    Although more widespread screening and routine adjuvant therapy has improved the outcome for breast cancer patients in recent years, there remains considerable scope for improving the efficacy, safety and tolerability of adjuvant therapy in the early stage disease and the treatment of advanced disease. Toremifene is a selective estrogen receptor modifier (SERM) that has been widely used for decades in hormone receptor positive breast cancer both in early and late stage disease. Its efficacy has been well established in nine prospective randomized phase III trials compared to tamoxifen involving more than 5500 patients, as well as in several large uncontrolled and non-randomized studies. Although most studies show therapeutic equivalence between the two SERMs, some show an advantage for toremifene. Several meta-analyses have also confirmed that the efficacy of toremifene is at least as good as that of tamoxifen. In terms of safety and tolerability toremifene is broadly similar to tamoxifen although there is some evidence that toremifene is less likely to cause uterine neoplasms, serious vascular events and it has a more positive effect on serum lipids than does tamoxifen. Toremifene is therefore effective and safe in the treatment of breast cancer. It provides not only a useful therapeutic alternative to tamoxifen, but may bring specific benefits. PMID:25114854

  8. Diagnosis and treatment of breast cancer

    International Nuclear Information System (INIS)

    This paper explains the outline of the present diagnosis and treatment of breast cancer essentially based on its therapeutic guideline by the Japan Breast Cancer Society (2005) and on authors' experiences. The diagnosis item contains the medical interview of patients, observatory and palpating examinations, mammography (for this, Japan-Breast Imaging Recording and Data System), ultrasonography (guideline for sonographic diagnosis of mammary gland, 2004), fine needle aspiration (FNA) or aspiration biopsy cytology, bases of triple test (palpation, mammography and FNA) for the cancer diagnosis, core needle biopsy, and mammotome biopsy of non-palpable calcified lesion. The treatment item contains the surgery involving conservation, sentinel lymph node biopsy (for this, lymphoscintigraphy with Tc-phytate is illustrated), radiofrequency ablation, adjuvant chemotherapy essentially using anthracycline and taxane, endocrinological therapy using tamoxifen, LH-RH analogues and aromatase inhibitors, and molecular target therapy with HER2 monoclonal antibody like trastuzumab. Recent progress of systemic therapy with medicals is remarkable, and the educational promotion of experts and medicare circumstances are concluded to be important. (R.T.)

  9. Planning Hybrid Intensity Modulated Radiation Therapy for Whole-breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Farace, Paolo, E-mail: paolofarace@gmail.com [Medical Physics Department, Regional Oncological Hospital, Cagliari (Italy); Zucca, Sergio; Solla, Ignazio; Fadda, Giuseppina; Durzu, Silvia; Porru, Sergio; Meleddu, Gianfranco [Medical Physics Department, Regional Oncological Hospital, Cagliari (Italy); Deidda, Maria Assunta; Possanzini, Marco; Orru, Sivia; Lay, Giancarlo [Radiotherapy Department, Regional Oncological Hospital, Cagliari (Italy)

    2012-09-01

    Purpose: To test tangential and not-tangential hybrid intensity modulated radiation therapy (IMRT) for whole-breast irradiation. Methods and Materials: Seventy-eight (36 right-, 42 left-) breast patients were randomly selected. Hybrid IMRT was performed by direct aperture optimization. A semiautomated method for planning hybrid IMRT was implemented using Pinnacle scripts. A plan optimization volume (POV), defined as the portion of the planning target volume covered by the open beams, was used as the target objective during inverse planning. Treatment goals were to prescribe a minimum dose of 47.5 Gy to greater than 90% of the POV and to minimize the POV and/or normal tissue receiving a dose greater than 107%. When treatment goals were not achieved by using a 4-field technique (2 conventional open plus 2 IMRT tangents), a 6-field technique was applied, adding 2 non tangential (anterior-oblique) IMRT beams. Results: Using scripts, manual procedures were minimized (choice of optimal beam angle, setting monitor units for open tangentials, and POV definition). Treatment goals were achieved by using the 4-field technique in 61 of 78 (78%) patients. The 6-field technique was applied in the remaining 17 of 78 (22%) patients, allowing for significantly better achievement of goals, at the expense of an increase of low-dose ({approx}5 Gy) distribution in the contralateral tissue, heart, and lungs but with no significant increase of higher doses ({approx}20 Gy) in heart and lungs. The mean monitor unit contribution to IMRT beams was significantly greater (18.7% vs 9.9%) in the group of patients who required 6-field procedure. Conclusions: Because hybrid IMRT can be performed semiautomatically, it can be planned for a large number of patients with little impact on human or departmental resources, promoting it as the standard practice for whole-breast irradiation.

  10. Reproducibility of deep inspiration breath hold for prone left-sided whole breast irradiation

    International Nuclear Information System (INIS)

    Investigating reproducibility and instability of deep inspiration breath hold (DIBH) in the prone position to reduce heart dose for left-sided whole breast irradiation. Thirty patients were included and underwent 2 prone DIBH CT-scans during simulation. Overlap indices were calculated for the ipsilateral breast, heart and lungs to evaluate the anatomical reproducibility of the DIBH maneuver. The breathing motion of 21 patients treated with prone DIBH were registered using magnetic probes. These breathing curves were investigated to gain data on intra-fraction reproducibility and instability of the different DIBH cycles during treatment. Overlap index was 0.98 for the ipsilateral breast and 0.96 for heart and both lungs between the 2 prone DIBH-scans. The magnetic sensors reported population amplitudes of 2.8 ± 1.3 mm for shallow breathing and 11.7 ± 4.7 mm for DIBH, an intra-fraction standard deviation of 1.0 ± 0.4 mm for DIBH, an intra-breath hold instability of 1.0 ± 0.6 mm and a treatment time of 300 ± 69 s. Prone DIBH can be accurately clinically implemented with acceptable reproducibility and instability

  11. Effects of smoking and irradiated volume on inflammatory response in the lung of irradiated breast cancer patients evaluated with bronchoalveolar lavage

    International Nuclear Information System (INIS)

    Quantitative measurements of the effects of irradiation on normal tissues in humans have been hard to obtain because most tissues are inaccessible and/or direct responses are difficult to quantify in a nondestructive manner. Pneumonitis and fibrotic lung disease are adverse effects seen in varying intensity in patients treated with radiotherapy for carcinomas of the thorax, e.g., breast cancer. In the present study the aim was to evaluate the inflammatory reaction in the underlying parenchyma following postoperative irradiation with bronchoalveolar lavage technique. Twenty-one patients with breast cancer stage T1N0M0 received radiotherapy with photons to a target dose of 56 Gy following breast conservative surgery. Nineteen healthy controls were also included. The results showed a clear elevation of neutrophils, mast cells, eosinophils, and lymphocytes in the total irradiated groups, compared to controls. When subclassifying the material according to smoking habit, it was obvious that the smokers displayed a significantly decreased inflammatory reaction, i.e., reduced levels of mast cells and lymphocytes, compared to both nonsmoking controls and patients. Eosinophils were seen in an elevated number in all irradiated patients. Radiological signs of pneumonitis were observed in three patients, all in the nonsmoking group. No correlation was found between the volume of lung irradiated and the inflammatory response. It is concluded that bronchoalveolar lavage is a suitable and sensitive method for investigating radiotherapy-induced reactions in the human lung. Furthermore, ongoing smoking during the treatment depressed the inflammatory response in the lung parenchyma induced by irradiation. The present study as well as earlier observations justify further studies concerning the possibility of interaction of smoking with cancer treatment

  12. Mammography findings following electron intraoperative radiotherapy or external radiotherapy for breast cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, B.P.S.A., E-mail: pacebarbara@hotmail.com [Hospital das Clinicas da Universidade de Sao Paulo, Instituto de Radiologia, Av. Dr. Eneas de Carvalho Aguiar 255, 3o andar, Cerqueira Cesar, Sao Paulo, Sao Paulo 05403 001 (Brazil); Frasson, A.L., E-mail: alfrasson@hotmail.com [Servico de Mastologia, Hospital Sao Lucas da PUC do Rio Grande do Sul, Av. Ipiranga, 6690, conjunto 714, Jardim Botanico, Porto Alegre, Rio Grande Sul 90 610 000 (Brazil); Santos, M.M., E-mail: gringa2009@hotmail.com [Hospital Sao Lucas da PUC do Rio Grande do Sul, Av. Ipiranga, 6690, conjunto 714, Jardim Botanico, Porto Alegre, Rio Grande Sul 90 610 000 (Brazil); Barros, N. de, E-mail: nestor.barros@hotmail.com [Departamento de Radiologia, Hospital das Clinicas da Universidade de Sao Paulo, Instituto de Radiologia, Av. Dr. Eneas de Carvalho Aguiar 255, 3o andar, Cerqueira Cesar, Sao Paulo, Sao Paulo 05403 001 (Brazil)

    2011-08-15

    Radiotherapy following breast cancer conserving surgery decreases the risks of local recurrence. Because 85% of breast cancers relapse in or around the surgical bed there has been some debate on the need for irradiating the whole breast. Electron intraoperative radiotherapy (ELIOT) has been used as a viable alternative for conventional external radiotherapy (RT). While the former requires a single dose of 21 Gy in the tumoral bed, the latter requires 5-6 weeks of irradiation with a total dose of 50 Gy and a boost of 10 Gy that irradiates the surgical bed. Herein, we investigated whether any significant differences exist between the mammography findings obtained from patients submitted to one of the two techniques. Two groups of 30 patients each were included in this study. All patients had mammographies taken at 12 and 24 months after finishing treatment. The mammography findings evaluated were: cutaneous thickening (>2 mm), architectural distortion secondary to fibrosis, edema, calcifications (both benign and malignant), and fat necrosis. For all variables studied, there was no statistical difference between the two groups. This indicates that the mammography findings obtained in either 12- or 24-month follow-up periods after breast cancer conserving surgery are similar, regardless of which of the two radiotherapy techniques (ELIOT or RT) is employed as a treatment for breast cancer.

  13. Toxicological evaluation of chicken-breast meat with high-dose irradiation

    International Nuclear Information System (INIS)

    In this paper, toxicity and safety of high-dose irradiated chicken-breast meat were evaluated. For assays of acute toxicity, genetic toxicity, and sub-chronic toxicity, ames test, mice bone marrow erythrocyte micronucleus, and mice sperm abnormality were performed. The results showed that, in the acute oral toxicity tests, median lethal dose (more than 10 000 mg kg-1) in male and female ICR mice showed no toxicological signs. For subacute 30-d oral toxicology of irradiated chicken-breast meat with dose of 10, 15 and 25 kGy in both male and female SD rats, no noticeable toxicological effects were observed. It is concluded that chicken-breast meat with high-dose irradiation has no acute toxicity and no genotoxicity, nor harmful effects on the animal body at the tested dosage range. Therefore, high-dose irradiated chicken-breast meat is safe for pet consumption

  14. Comparison of acute adverse effect between hypofractionated and conventionally fractionated whole-breast irradiation in early breast cancer patients

    International Nuclear Information System (INIS)

    We have conducted a clinical trial to evaluate whether the hypofractionated whole-breast irradiation (HF-WBI) is equally effective and safe with conventional fractionated whole-breast irradiation (CF-WBI) The HF-WBI consisted of 43.2 Gy/16 f to the whole breast with additional tumor bed boost of 8.1 Gy/3 f for positive or less than 5 mm surgical margins. From 1 of April 2006 to 31 of December 2009, 831 cases were registered and 848 breasts were treated. Grade 2 acute skin reactions were observed in 21 cases (4%) in HF-WBI and 40 cases (13%) in CF-WBI (p<0.001). In short-term results, we might conclude that HF-WBI has almost the same effectiveness and safety as CF-WBI. (author)

  15. Advances in the surgical treatment of breast cancer.

    Science.gov (United States)

    Xing, Lei; He, Qiang; Wang, Yuan-Yuan; Li, Hong-Yuan; Ren, Guo-Sheng

    2016-06-01

    Breast cancer has become the top malignant neoplasm in Chinese women with an increasing risk of morbidity and mortality. As a crucial part of comprehensive treatment of breast cancer, breast surgical technique is ceaselessly ameliorating and enriching its features. With the purpose of achieving minimal surgical intervention and satisfactory cosmetic results, the trend of mammary surgery is focusing on minimally invasive treatment and aesthetics in the 21st century. This article gives an overview of the most representative surgical procedures, such as breast conservative surgery, sentinel lymph node dissection, oncoplastic technique and breast reconstructive surgery. PMID:27265302

  16. 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

  17. Surgical Clips Assist in the Visualization of the Lumpectomy Cavity in Three-Dimensional Conformal Accelerated Partial-Breast Irradiation

    International Nuclear Information System (INIS)

    Purpose: To determine to what extent the placement of surgical clips helps delineate the cavity in three-dimensional conformal accelerated partial-breast irradiation. Patients and Methods: Planning CT images of 100 lumpectomy cavities were reviewed in a cohort of 100 consecutive patients. The cavities were determined and categorized by two radiation oncologists according to cavity visualization score criteria and the breast density score. The two physicians first attempted to delineate the lumpectomy cavity without clips and then with clips. Results: In the case of high-density mammary tissue, the breast remodeling done during surgery does not enable the lumpectomy cavity to be sufficiently visualized. The use of surgical clips significantly improved the ability to visualize the lumpectomy cavity, with a 69% rate of concordance between physicians regardless of the breast tissue density. Conclusion: The placement of surgical clips at lumpectomy enables visualization of the lumpectomy cavity and allows upgrading of the cavity visualization score on CT scans obtained for accelerated partial-breast irradiation treatment planning.

  18. Attitudes and treatment outcome of breast conservation therapy for stage I and II breast cancer using peroperative iridium-192 implant boost to the tumour bed

    International Nuclear Information System (INIS)

    Breast conservation therapy for early breast cancer is an established but grossly under-utilized treatment option in India for various reasons. Breast conservation therapy was offered to 200 suitable breast cancer patients between June 1993 and June 1998. Fifty-one patients (25%) opted for breast conservation and the remaining preferred mastectomy. In patients agreeing to conservation therapy, surgery was performed first along with peroperative implantation of iridium-192 to deliver a boost. Whole breast irradiation of 45 Gy was delivered 3-4 weeks after the boost. Cosmesis was assessed at the end of 6 months from completion of therapy. The main reason for refusal of breast conservation therapy was fear of recurrence in the remaining breast (60%). There were no loco-regional failures in our study at a median follow up of 42 months; one patient experienced a systemic relapse. Cosmesis was good to excellent in 80% of patients. Breast conservation therapy using peroperative iridium-192 implant provides excellent loco-regional disease control and cosmesis. The results of our study indicate that patient preference for mastectomy is an important reason for the under-utilization of breast conservation therapy in India. Copyright (2001) Blackwell Science Pty Ltd

  19. Chloroquine Engages the Immune System to Eradicate Irradiated Breast Tumors in Mice

    International Nuclear Information System (INIS)

    Purpose: This study used chloroquine to direct radiation-induced tumor cell death pathways to harness the antitumor activity of the immune system. Methods and Materials: Chloroquine given immediately after tumor irradiation increased the cure rate of MCaK breast cancer in C3H mice. Chloroquine blocked radiation-induced autophagy and drove MCaK cells into a more rapid apoptotic and more immunogenic form of cell death. Results: Chloroquine treatment made irradiated tumor vaccines superior at inducing strong interferon gamma-associated immune responses in vivo and protecting mice from further tumor challenge. In vitro, chloroquine slowed antigen uptake and degradation by dendritic cells, although T-cell stimulation was unaffected. Conclusions: This study illustrates a novel approach to improve the efficacy of breast cancer radiation therapy by blocking endosomal pathways, which enhances radiation-induced cell death within the field and drives antitumor immunity to assist therapeutic cure. The study illuminates and merges seemingly disparate concepts regarding the importance of autophagy in cancer therapy

  20. Chloroquine Engages the Immune System to Eradicate Irradiated Breast Tumors in Mice

    Energy Technology Data Exchange (ETDEWEB)

    Ratikan, Josephine Anna [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States); Sayre, James William [Public Health Biostatistics/Radiology at UCLA, David Geffen School of Medicine at UCLA, Los Angeles, California (United States); Schaue, Dörthe, E-mail: dschaue@mednet.ucla.edu [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States)

    2013-11-15

    Purpose: This study used chloroquine to direct radiation-induced tumor cell death pathways to harness the antitumor activity of the immune system. Methods and Materials: Chloroquine given immediately after tumor irradiation increased the cure rate of MCaK breast cancer in C3H mice. Chloroquine blocked radiation-induced autophagy and drove MCaK cells into a more rapid apoptotic and more immunogenic form of cell death. Results: Chloroquine treatment made irradiated tumor vaccines superior at inducing strong interferon gamma-associated immune responses in vivo and protecting mice from further tumor challenge. In vitro, chloroquine slowed antigen uptake and degradation by dendritic cells, although T-cell stimulation was unaffected. Conclusions: This study illustrates a novel approach to improve the efficacy of breast cancer radiation therapy by blocking endosomal pathways, which enhances radiation-induced cell death within the field and drives antitumor immunity to assist therapeutic cure. The study illuminates and merges seemingly disparate concepts regarding the importance of autophagy in cancer therapy.

  1. Heart dose reduction by prone deep inspiration breath hold in left-sided breast irradiation

    International Nuclear Information System (INIS)

    Background and purpose: Cardiac disease has been related to heart dose after left-sided breast radiotherapy. This trial evaluates the heart sparing ability and feasibility of deep inspiration breath hold (DIBH) in the prone position for left-sided whole breast irradiation (WBI). Materials and methods: Twelve patients underwent CT-simulation in supine shallow breathing (SB), supine DIBH, prone SB and prone DIBH. A validation cohort of 38 patients received prone SB and prone DIBH CT-scans; the last 30 patients were accepted for prone DIBH treatment. WBI was planned with a prescription dose of 40.05 Gy. Results: DIBH was able to reduce (p < 0.001) heart dose in both positions, with results for prone DIBH at least as favorable as for supine DIBH. Mean heart dose was lowered from 2.2 Gy for prone SB to 1.3 Gy for prone DIBH (p < 0.001), while preserving the lung sparing ability of prone positioning. Moreover prone DIBH nearly consistently reduced mean heart dose to less then 2 Gy, regardless of breast volume. All patients were able to perform the simulation procedure, 28/30 patients were treated with prone DIBH. Conclusions: This trial demonstrates the ability and feasibility of prone DIBH to acquire optimal heart and lung sparing for left-sided WBI

  2. Microscopic residual disease is a risk factor in the primary treatment of breast cancer

    International Nuclear Information System (INIS)

    Objectives: In the primary treatment of breast cancer, postoperative radiotherapy is performed in high-risk patients after mastectomy and in patients who received breast conserving surgery. In a retrospective analysis, our mono-institutional results of postoperative irradiation have been evaluated. Patients and Methods: Between 1992 and 1996, 500 patients have been irradiated after surgery for primary breast cancer. Of these, 489 patients had no initial metastases. 89 patients with loco-regional disease had a mastectomy, 400 patients were irradiated after breast conserving surgery. Radiotherapy at the chest wall was performed with 50 Gy and 2 Gy fractions. After microscopically incomplete resection, an electron boost of 10 Gy was given. The ipsilateral lymph nodes were irradiated with 50 Gy when there was extensive lymph node involvement or invasion of tumor in the axillary fat tissue. Results: The 5-year local control rate after mastectomy was 97.4% and 91.2% after breast conserving surgery. The only statistically significant risk factor for local failure was microscopically incomplete resection. The corresponding 5-year local control rates for microscopically incomplete and complete resections were 76.4% and 92.7% (p = 0.01). The risk of local relapse was increased with both marginal invasive and marginal DCIS-tissue, 86.6% of local relapses were in the same quadrant. Conclusions: High-risk patients after mastectomy and patients with breast conserving surgery achieve a high local control rate with postoperative irradiation. After microscopically incomplete resection, there is an increased risk for local relapse. (orig.)

  3. Treatment of chromophobe adenomas with megavoltage irradiation

    International Nuclear Information System (INIS)

    From 1956 to 1972, 62 previously untreated patients with chromophobe adenomas received high-dose (average equivalent dose: 5700 rads in 6 weeks) megavoltage (4 to 4.8 MeV) irradiation at Stanford, 33 postoperatively and 29 as the only intended treatment. Initial treatment failure rates were 18 percent and 41 percent, respectively; however, overall control was 85 percent and 90 percent, despite 2 uncontrolled invasive adenomas in each group. Nine of the 12 failures in the group treated by irradiation alone had cystic tumors, and 9 of the 12 failed in less than 3 months. Despite a considerably greater degree of abnormal vision initially in the postoperative irradiation group, improvement of vision with treatment in that group was 83 percent (39 percent returned to normal) compared to 46 percent (only 8 percent to normal) in the irradiation alone group. Based upon an evaluation of the extent of findings at diagnosis and our results, we recommend surgical decompression followed by 5000 rads in 5 weeks for patients with any one or more of the following findings: (1) more than minimal depression of peripheral visual fields; (2) corrected visual actuity of less than 20/30 in either eye; or (3) more than 1-cm suprasellar extension of tumor. (U.S.)

  4. First report of a permanent breast 103Pd seed implant as adjuvant radiation treatment for early-stage breast cancer

    International Nuclear Information System (INIS)

    Purpose: A new technique of adjuvant partial breast irradiation using 103Pd permanent breast seed implants (PBSI) is presented. The procedure is performed in a single 1-hour session under local anesthesia. Methods and Materials: Patients referred to a single institution for adjuvant radiotherapy after lumpectomy for an infiltrating ductal carcinoma ≤3 cm in diameter, surgical margin ≥2 mm, no extensive in situ carcinoma, no lymphovascular invasion, and minimal or negative lymph node involvement were offered a PBSI. Results: Between May and December 2004, 31 eligible patients underwent CT scan and ultrasound simulations assessing PBSI feasibility. Fifteen were excluded because of feasibility issues, and 16 received PBSI. A minimal peripheral dose of 90 Gy was prescribed to the planning target volume corresponding to the clinical target volume identified on the CT scan plus a margin of 1 cm. The procedure was well tolerated; 56% of the patients reported no pain during the procedure, and 46% of the patients developed National Cancer Institute Common Toxicity Criteria Grade 1 acute reaction. None experienced toxicity Grade 2 or 3. Conclusions: Permanent breast seed implantation seems feasible and well tolerated on these preliminary clinical data and represents an ultimate step in the reduction of treatment fraction for partial breast irradiation

  5. The general application of irradiation technology in quarantine treatment

    International Nuclear Information System (INIS)

    The applications that necessity of irradiation used for quarantine treatment, the principle and effect on insecticidal action and sterilization, the influence of irradiation to product quality, the economic feasibility of the irradiation and so on, were introduced in this article. And several suggestions were proposed that energetically apply irradiation as a quarantine treatment method in our country. (authors)

  6. Conservative treatment for breast cancer. Complications requiring reconstructive surgery

    International Nuclear Information System (INIS)

    Women who select conservative treatment for carcinoma of the breast (tumor excision followed by supervoltage radiation therapy) place a premium on breast preservation and aesthetics. When local control fails and they require a mastectomy, or when the aesthetic appearance is unacceptable, they may request breast reconstruction. The goal of this study is to evaluate a series of 10 patients who required reconstructive breast surgery after complications of conservative treatment. Patient classification: I. Breast or chest wall necrosis (3). II. Breast fibrosis and gross asymmetry (3). III. Local recurrence of breast cancer (5). IV. Positive margins after the initial lumpectomy (1). The mean age was 34 years. Radiation dosage average was 5252 rads with two patients receiving iridium-192 implant boosts. The reconstructive management was complex and usually required a major musculocutaneous flap because of the radiation effects

  7. Exhaust gas treatment by electron beam irradiation

    International Nuclear Information System (INIS)

    Among global environmental problems, atmospheric pollution has been discussed since relatively old days, and various countermeasures have been taken, but recently in connection with acid rain, the efficient and economical treatment technology is demanded. As the denitration and desulfurization technology for the exhaust gas from the combustion of fossil fuel, the incineration of city trash and internal combustion engines, three is the treatment method by electron beam irradiation. By irradiating electron beam to exhaust gas, nitrogen oxides and sulfur oxides are oxidized to nitric acid and sulfuric acid, and by promoting the neutralization of these acids with injected alkali, harmless salts are recovered. This method has the merit that nitrogen oxides and surfur oxides can be removed efficiently with a single system. In this report, as for the exhaust gas treatment by electron beam irradiation, its principle, features, and the present status of research and development are described, and in particular, the research on the recent exhaust gas treatment in city trash incineration is introduced. This treatment method is a dry process, accordingly, waste water disposal is unnecessary. The reaction products are utilized as fertilizer, and waste is not produced. (K.I.)

  8. Detection of irradiation treatment of foods

    International Nuclear Information System (INIS)

    Detection of irradiated foods is important for the regulative authorities, consumers, traders and food industry. Most of the physical, chemical and biological changes in foods caused by irradiation are not unique to radiation treatment nor stable enough to be detected for a long period. International collaboration, however, will result in several reliable methods for detecting irradiated foods. FAO/IAEA is conducting Co-ordinated Research Programme on Analytical Detection Methods for Irradiation Treatment of Foods (ADMIT) from 1990 to 1994. The Community Bureau of Reference of the Commission of the European Communities (BCR) conducts another research project on the identification of irradiated foods. The ADMIT and BCR projects are expected to collaborate each other in order to avoid duplication of effort and ensure comparability of results. The ADMIT has established 8 groups to efficiently carry out collaborative research on each method; 'ESR', 'thermoluminescence', 'volatile hydrocarbon', '2-alkyl-cyclobutanone', 'DNA', 'lipid hydroperoxide', 'physical methods', and 'microbiological and biological methods'. The methods which have been reported to be promising are to be evaluated on an inter-laboratory basis in the projects, and 5 methods have already been subjected to inter-laboratory tests with successful results; 'ESR' for animal and poultry meats containing bones, 'thermoluminescence' for spices and dehydrated vegetables, 'lipid volatile hydrocarbons' and 'cyclobutanone' for animal meats, and 'DEFT/APC(microbiological method)' for spices. Protocols for useful and reliable methods have been prepared and their analytical procedures will be compiled. Germany and UK have officially authorized 'thermoluminescence' as a method to detect irradiated spices. (author)

  9. Design and implementation of a rotational radiotherapy technique for breast cancer treatment and their comparison with 3-D-Crt irradiation technique; Diseno e implementacion de una tecnica de radioterapia rotacional para tratamiento de cancer de mama y su comparacion contra la tecnica 3D-CRT de irradiacion

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez M, J. G.; Lopez V, A.; Rivera M, T. [IPN, Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada, Av. Legaria 694, Col. Irrigacion, 11500 Mexico D. F. (Mexico); Velazquez T, J. J.; Adame G, C. S. [Centro Medico Nacional Siglo XXI, Hospital de Oncologia, Departamento de Fisica Medica, Av. Cuauhtemoc No. 330, Col. Doctores, 06720 Mexico D. F. (Mexico); Rubio N, O.; Chagoya G, A.; Hernandez G, J. C., E-mail: jggm25@yahoo.com.mx [Centro Medico Nacional Siglo XXI, Hospital de Oncologia, Departamento de Radioterapia, Av. Cuauhtemoc No. 330, Col. Doctores, 06720 Mexico D. F. (Mexico)

    2015-10-15

    Breast cancer is one of oncological diseases worldwide, as well in Mexico, which causes even more deaths than cervical cancer; this condition is the second death cause in women aged 30-54 years and threatens all socio-economic groups. The treatment is highly dependent on the stage which is detected and based on protocols that include a combination of surgery, chemotherapy and radiotherapy. This paper studies the main irradiation technique for patients with mastectomy, breast full cycle (irradiation of the chest well and supraclavicular nodes) in their mode Three Dimensional - Conformal Radiation Therapy (3-D-Crt), and compared with the Volumetric Modulated Arc Therapy (VMAT) technique proposed in this paper. In both techniques the prescription was 50 Gy divided into 25 fractions. The techniques were applied in three female patients (being an initial study) with disease of the left side, the target volume and organs at risk were delineated by the medical treating radiation oncologist, the planning system used was Eclipse version 10; for quantitative comparison of both plans indexes of homogeneity were used, con formality, the target volume coverage and normal tissue, sub factors and overdosing, the conformation number and coverage quality. They were evaluated and compared the media, maximum and minimum dose of the organs at risk, based on the fact that the coverage of the target volume, dose gradient and dose at risk organs are acceptable (prescription dose greater that 90% coverage, gradient less that 20% and organs at risk in accordance with the Quantec limitations for both versions). (Author)

  10. Irradiation treatment of sewage sludge: History and prospects

    International Nuclear Information System (INIS)

    This paper first reviews the history of irradiation treatment of sewage sludge in the world. The first sludge irradiation plant was built in Geiselbullach, West Germany in 1973 and used 60Co as irradiation source. Since then, many sludge irradiators were constructed in U.S.A., India, Japan, Canada, Poland, etc., which used 60Co, 137Cs or electron beam as irradiation sources. The paper then describes some basic research on irradiation treatment of sewage sludge including optimization of irradiation parameters, synergistic effect of radiation with heat, oxygenation, irradiation-composting and potential applications of treated sludge. Some proposals have been suggested for further development of this technology in the future

  11. Nonisocentric Treatment Strategy for Breast Radiation Therapy: A Proof of Concept Study

    International Nuclear Information System (INIS)

    Purpose: To propose a nonisocentric treatment strategy as a special form of station parameter optimized radiation therapy, to improve sparing of critical structures while preserving target coverage in breast radiation therapy. Methods and Materials: To minimize the volume of exposed lung and heart in breast irradiation, we propose a novel nonisocentric treatment scheme by strategically placing nonconverging beams with multiple isocenters. As its name suggests, the central axes of these beams do not intersect at a single isocenter as in conventional breast treatment planning. Rather, the isocenter locations and beam directions are carefully selected, in that each beam is only responsible for a certain subvolume of the target, so as to minimize the volume of irradiated normal tissue. When put together, the beams will provide an adequate coverage of the target and expose only a minimal amount of normal tissue to radiation. We apply the nonisocentric planning technique to 2 previously treated clinical cases (breast and chest wall). Results: The proposed nonisocentric technique substantially improved sparing of the ipsilateral lung. Compared with conventional isocentric plans using 2 tangential beams, the mean lung dose was reduced by 38% and 50% using the proposed technique, and the volume of the ipsilateral lung receiving ≥20 Gy was reduced by a factor of approximately 2 and 3 for the breast and chest wall cases, respectively. The improvement in lung sparing is even greater compared with volumetric modulated arc therapy. Conclusions: A nonisocentric implementation of station parameter optimized radiation therapy has been proposed for breast radiation therapy. The new treatment scheme overcomes the limitations of existing approaches and affords a useful tool for conformal breast radiation therapy, especially in cases with extreme chest wall curvature

  12. Accelerated Partial Breast Irradiation With Interstitial Implants: Risk Factors Associated With Increased Local Recurrence

    International Nuclear Information System (INIS)

    Purpose: To analyze patient, disease, and treatment-related factors regarding their impact on local control after interstitial multicatheter accelerated partial breast irradiation (APBI). Methods and Materials: Between November 2000 and April 2005, 274 patients with early breast cancer were recruited for the German-Austrian APBI Phase II trial ( (ClinicalTrials.gov) identifier: NCT00392184). In all, 64% (175/274) of the patients received pulsed-dose-rate (PDR) brachytherapy and 36% (99/274) received 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 to 4 days. Results: The median follow-up time was 64 months (range, 9-110). The actuarial 5-year local recurrence free survival rate (5-year LRFS) was 97.7%. Comparing patients with an age <50 years (49/274) vs. ≥50 years (225/274), the 5-year LRFS resulted in 92.5% and 98.9% (exact p = 0.030; 99% confidence interval, 0.029-0.032), respectively. Antihormonal treatment (AHT) was not applied in 9% (24/274) of the study population. The 5-year LRFS was 99% and 84.9% (exact p = 0.0087; 99% confidence interval, 0.0079-0.0094) in favor of the patients who received AHT. Lobular histology (45/274) was not associated with worse local control compared with all other histologies (229/274). The 5-year LRFS rates were 97.6% and 97.8%, respectively. Conclusions: Local control at 5 years is excellent and comparable to therapeutic successes reported from corresponding whole-breast irradiation trials. Our data indicate that patients <50 years of age ought to be excluded from APBI protocols, and that patients with hormone-sensitive breast cancer should definitely receive adjuvant AHT when interstitial multicatheter APBI is performed. Lobular histology need not be an exclusion criterion for future APBI trials.

  13. Setup accuracy for prone and supine whole breast irradiation

    International Nuclear Information System (INIS)

    To evaluate cone-beam computed tomography (CBCT) based setup accuracy and margins for prone and supine whole breast irradiation (WBI). Setup accuracy was evaluated on 3559 CBCT scans of 242 patients treated with WBI and uncertainty margins were calculated using the van Herk formula. Uni- and multivariate analysis on individual margins was performed for age, body mass index (BMI) and cup size. The population-based margin in vertical (VE), lateral (LA) and longitudinal (LO) directions was 10.4/9.4/9.4 mm for the 103 supine and 10.5/22.4/13.7 mm for the 139 prone treated patients, being significantly (p < 0.01) different for the LA and LO directions. Multivariate analysis identified a significant (p < 0.05) correlation between BMI and the LO margin in supine position and the VE/LA margin in prone position. In this series, setup accuracy is significantly worse in prone compared to supine position for the LA and LO directions. However, without proper image-guidance, uncertainty margins of about 1 cm are also necessary for supine WBI. For patients with a higher BMI, larger margins are required. (orig.)

  14. Breast cancer treatment in mutation carriers: surgical treatment.

    Science.gov (United States)

    Biglia, Nicoletta; D'Alonzo, Marta; Sgro, Luca G; Tomasi Cont, Nicoletta; Bounous, Valentina; Robba, Elisabetta

    2016-10-01

    The surgical option which should be reserved for patients with BRCA1/2 mutation and breast cancer diagnosis is still debated. Several aspects should be considered before the surgical decision-making: the risk of ipsilateral breast recurrence (IBR), the risk of contralateral breast cancer (CBC), the potential survival benefit of prophylactic mastectomy, and the possible risk factors that could either increase or decrease the risk for IBR or CBC. Breast conservative treatment (BCT) does not increase the risk for IBR in BRCA mutation carriers compared to non-carriers in short term follow-up; however, an increased risk for IBR in carriers was observed in studies with long follow-up. In spite of the increased risk for IBR in patients who underwent BCT than patients with mastectomy, no significant difference in breast-cancer specific or overall survival was observed by local treatment type at 15 years. Patients with BRCA mutation had a higher risk for CBC compared with non-carriers and BRCA1-mutation carriers had an increased risk for CBC compared to BRCA2-mutation carriers. Bilateral mastectomy is intended to prevent CBC in BRCA mutation carriers, however, no difference in survival was found if a contralateral prophylactic mastectomy was performed or not. For higher-risk groups of BRCA mutated patients, a more-aggressive surgical approach may be preferable, but there are some aspects that should be considered in the surgical decision-making process. The use of adjuvant chemotherapy and performing oophorectomy are associated with a decreased risk for IBR. When considering the risk for CBC, three risk factors were associated with significantly decreased risk: the use of adjuvant tamoxifen, performing oophorectomy and older age at first breast cancer diagnosis. As a result, we could identify a group of patients that might benefit from a more aggressive surgical approach (unilateral mastectomy or unilateral therapeutic mastectomy with concomitant contralateral prophylactic

  15. Accelerated partial breast irradiation using 3D conformal radiation therapy (3D-CRT)

    International Nuclear Information System (INIS)

    Purpose: We present a novel three-dimensional conformal radiation therapy (3D-CRT) technique to treat the lumpectomy cavity, plus a 1.5-cm margin, in patients with early-stage breast cancer and study its clinical feasibility. Methods and Materials: A 3D-CRT technique for partial-breast irradiation was developed using archived CT scans from 7 patients who underwent an active breathing control study. The clinical feasibility of this technique was then assessed in 9 patients who were prospectively enrolled on an Investigational Review Board-approved protocol of partial-breast irradiation. The prescribed dose was 34 Gy in 5 patients and 38.5 Gy in 4 patients, delivered in 10 fractions twice daily over 5 consecutive days. The impact of both breathing motion and patient setup uncertainty on clinical target volume (CTV) coverage was studied, and an appropriate CTV-to-PTV (planning target volume) margin was calculated. Results: By adding a CTV-to-PTV 'breathing-only' margin of 5 mm, 98%-100% of the CTV remained covered by the 95% isodose surface at the extremes of normal inhalation and normal exhalation. The 'total' CTV-to-PTV margin employed to accommodate organ motion and setup error (10 mm) was found to be sufficient to accommodate the observed uncertainty in the delivery precision. Patient tolerance was excellent, and acute toxicity was minimal. No skin changes were noted during treatment, and at the initial 4-8-week follow-up visit, only mild localized hyperpigmentation and/or erythema was observed. No instances of symptomatic radiation pneumonitis have occurred. Conclusions: Accelerated partial-breast irradiation using 3D-CRT is technically feasible, and acute toxicity to date has been minimal. A CTV-to-PTV margin of 10 mm seems to provide coverage for most 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

  16. Tailored tamoxifen treatment for breast cancer patients : A perspective

    NARCIS (Netherlands)

    Jager, Nynke G L; Linn, Sabine C.; Schellens, Jan H M; Beijnen, Jos H.

    2015-01-01

    Tamoxifen, an endocrine agent, is widely used in the treatment of estrogen receptor-positive breast cancer. It has greatly reduced disease recurrence and mortality rates of breast cancer patients, however, not all patients benefit from tamoxifen treatment because in approximately 25% to 30% of the p

  17. Tailored Tamoxifen Treatment for Breast Cancer Patients : A Perspective

    NARCIS (Netherlands)

    Jager, Nynke G. L.; Linn, Sabine C.; Schellens, Jan H. M.; Beijnen, Jos H.

    2015-01-01

    Tamoxifen, an endocrine agent, is widely used in the treatment of estrogen receptor-positive breast cancer. It has greatly reduced disease recurrence and mortality rates of breast cancer patients, however, not all patients benefit from tamoxifen treatment because in approximately 25% to 30% of the p

  18. Preoperative distress predicts persistent pain after breast cancer treatment

    DEFF Research Database (Denmark)

    Mejdahl, Mathias Kvist; Mertz, Birgitte Goldschmidt; Bidstrup, Pernille Envold Hansen;

    2015-01-01

    PURPOSE: Persistent pain after breast cancer treatment (PPBCT) affects 25% to 60% of breast cancer survivors and is recognized as a clinical problem, with 10% to 15% reporting moderate to severe pain several years after treatment. Psychological comorbidity is known to influence pain perception, and...

  19. Persistent pain and sensory disturbances after treatment for breast cancer

    DEFF Research Database (Denmark)

    Mejdahl, Mathias Kvist; Andersen, Kenneth Geving; Gärtner, Rune;

    2013-01-01

    To examine the development of persistent pain after treatment for breast cancer and to examine risk factors associated with continuing pain.......To examine the development of persistent pain after treatment for breast cancer and to examine risk factors associated with continuing pain....

  20. Diagnosis and minimally invasive treatment of early stage breast carcinoma

    NARCIS (Netherlands)

    van Esser, S.

    1979-01-01

    In this thesis the diagnostic work up and minimally invasive surgical treatment of early stage breast carcinoma is studied. Although the surgical treatment of breast carcinoma has improved significantly over the past decades, there is still room for improvement. On the one hand the focus is on early

  1. Dosimetric evaluation in teletherapy for male breast cancer treatment

    International Nuclear Information System (INIS)

    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)

  2. 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)

  3. Randomized Trial of Pentoxifylline and Vitamin E vs Standard Follow-up After Breast Irradiation to Prevent Breast Fibrosis, Evaluated by Tissue Compliance Meter

    International Nuclear Information System (INIS)

    Purpose: To conduct a randomized clinical trial to determine whether the combination of pentoxifylline (PTX) and vitamin E given for 6 months after breast/chest wall irradiation effectively prevents radiation-induced fibrosis (RIF). Methods and Materials: Fifty-three breast cancer patients with localized disease were enrolled and randomized to treatment with oral PTX 400 mg 3 times daily and oral vitamin E 400 IU daily for 6 months after radiation (n=26), or standard follow up (n=27). Tissue compliance meter (TCM) measurements were obtained at 18 months to compare tissue compliance in the irradiated and untreated breast/chest wall in treated subjects and controls. Measurements were obtained at 2 mirror image sites on each breast/chest wall, and the average difference in tissue compliance was scored. Differences in TCM measurements were compared using a t test. Subjects were followed a minimum of 2 years for local recurrence, disease-free survival, and overall survival. Results: The mean difference in TCM measurements in the 2 groups was 0.88 mm, median of 1.00 mm (treated) and 2.10 mm, median of 2.4 mm (untreated). The difference between the 2 groups was significant (P=.0478). Overall survival (100% treated, 90.6% controls at 5 years) and disease-free survival (96.2% treated, 86.8% controls at 5 years) were not significantly different in the 2 groups. Conclusions: This study of postirradiation breast cancer patients treated with PTX/vitamin E or standard follow-up indicated a significant difference in radiation-induced fibrosis as measured by TCM. There was no observed impact on local control or survival within the first 2 years of follow-up. The treatment was safe and well tolerated. Pentoxifylline/vitamin E may be clinically useful in preventing fibrosis after radiation in high-risk patients

  4. Randomized Trial of Pentoxifylline and Vitamin E vs Standard Follow-up After Breast Irradiation to Prevent Breast Fibrosis, Evaluated by Tissue Compliance Meter

    Energy Technology Data Exchange (ETDEWEB)

    Jacobson, Geraldine, E-mail: geraldine-jacobson@uiowa.edu [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Bhatia, Sudershan [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Smith, Brian J.; Button, Anna M. [Biostatistics Core, Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Bodeker, Kellie; Buatti, John [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States)

    2013-03-01

    Purpose: To conduct a randomized clinical trial to determine whether the combination of pentoxifylline (PTX) and vitamin E given for 6 months after breast/chest wall irradiation effectively prevents radiation-induced fibrosis (RIF). Methods and Materials: Fifty-three breast cancer patients with localized disease were enrolled and randomized to treatment with oral PTX 400 mg 3 times daily and oral vitamin E 400 IU daily for 6 months after radiation (n=26), or standard follow up (n=27). Tissue compliance meter (TCM) measurements were obtained at 18 months to compare tissue compliance in the irradiated and untreated breast/chest wall in treated subjects and controls. Measurements were obtained at 2 mirror image sites on each breast/chest wall, and the average difference in tissue compliance was scored. Differences in TCM measurements were compared using a t test. Subjects were followed a minimum of 2 years for local recurrence, disease-free survival, and overall survival. Results: The mean difference in TCM measurements in the 2 groups was 0.88 mm, median of 1.00 mm (treated) and 2.10 mm, median of 2.4 mm (untreated). The difference between the 2 groups was significant (P=.0478). Overall survival (100% treated, 90.6% controls at 5 years) and disease-free survival (96.2% treated, 86.8% controls at 5 years) were not significantly different in the 2 groups. Conclusions: This study of postirradiation breast cancer patients treated with PTX/vitamin E or standard follow-up indicated a significant difference in radiation-induced fibrosis as measured by TCM. There was no observed impact on local control or survival within the first 2 years of follow-up. The treatment was safe and well tolerated. Pentoxifylline/vitamin E may be clinically useful in preventing fibrosis after radiation in high-risk patients.

  5. Cosmetic Outcomes and Complications Reported by Patients Having Undergone Breast-Conserving Treatment

    International Nuclear Information System (INIS)

    Purpose: Over the past 30 years, much work in treatment of breast cancer has contributed to improvement of cosmetic and functional outcomes. The goal of breast-conservation treatment (BCT) is avoidance of mastectomy through use of lumpectomy and adjuvant radiation. Modern data demonstrate “excellent” or “good” cosmesis in >90% of patients treated with BCT. Methods and Materials: Patient-reported data were gathered via a convenience sample frame from breast cancer survivors using a publically available, free, Internet-based tool for creation of survivorship care plans. During use of the tool, breast cancer survivors are queried as to the cosmetic appearance of the treated breast, as well as perceived late effects. All data have been maintained anonymously with internal review board approval. Results: Three hundred fifty-four breast cancer survivors having undergone BCT and voluntarily using this tool were queried with regard to breast cosmesis and perceived late effects. Median diagnosis age was 48 years, and median current age 52 years. “Excellent” cosmesis was reported by 27% (n = 88), “Good” by 44% (n = 144), “Fair” by 24% (n = 81), and “Poor” by 5% (n = 18). Of the queries posted to survivors after BCT, late effects most commonly reported were cognitive changes (62%); sexual concerns (52%); changes in texture and color of irradiated skin (48%); chronic pain, numbness, or tingling (35%); and loss of flexibility in the irradiated area (30%). Survivors also described osteopenia/osteoporosis (35%), cardiopulmonary problems (12%), and lymphedema (19%). Conclusions: This anonymous tool uses a convenience sample frame to gather patient reported assessments of cosmesis and complications after breast cancer. Among the BCT population, cosmetic assessment by survivors appears less likely to be “excellent” or “good” than would be expected, with 30% of BCT survivors reporting “fair” or “poor” cosmesis. Patient reported incidence of

  6. Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kowalchik, Kristin V. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); Vallow, Laura A., E-mail: vallow.laura@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); McDonough, Michelle [Department of Radiology, Mayo Clinic, Jacksonville, Florida (United States); Thomas, Colleen S.; Heckman, Michael G. [Section of Biostatistics, Mayo Clinic, Jacksonville, Florida (United States); Peterson, Jennifer L. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); Adkisson, Cameron D. [Department of General Surgery, Mayo Clinic, Jacksonville, Florida (United States); Serago, Christopher [Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida (United States); McLaughlin, Sarah A. [Department of General Surgery, Mayo Clinic, Jacksonville, Florida (United States)

    2013-09-01

    Purpose: To study the utility of preoperative breast MRI for partial breast irradiation (PBI) patient selection, using multivariable analysis of significant risk factors to create a classification rule. Methods and Materials: Between 2002 and 2009, 712 women with newly diagnosed breast cancer underwent preoperative bilateral breast MRI at Mayo Clinic Florida. Of this cohort, 566 were retrospectively deemed eligible for PBI according to the National Surgical Adjuvant Breast and Bowel Project Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. Magnetic resonance images were then reviewed to determine their impact on patient eligibility. The patient and tumor characteristics were evaluated to determine risk factors for altered PBI eligibility after MRI and to create a classification rule. Results: Of the 566 patients initially eligible for PBI, 141 (25%) were found ineligible because of pathologically proven MRI findings. Magnetic resonance imaging detected additional ipsilateral breast cancer in 118 (21%). Of these, 62 (11%) had more extensive disease than originally noted before MRI, and 64 (11%) had multicentric disease. Contralateral breast cancer was detected in 28 (5%). Four characteristics were found to be significantly associated with PBI ineligibility after MRI on multivariable analysis: premenopausal status (P=.021), detection by palpation (P<.001), first-degree relative with a history of breast cancer (P=.033), and lobular histology (P=.002). Risk factors were assigned a score of 0-2. The risk of altered PBI eligibility from MRI based on number of risk factors was 0:18%; 1:22%; 2:42%; 3:65%. Conclusions: Preoperative bilateral breast MRI altered the PBI recommendations for 25% of women. Women who may undergo PBI should be considered for breast MRI, especially those with lobular histology or with 2 or more of the following risk factors: premenopausal, detection by palpation, and first-degree relative with a history of

  7. Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Purpose: To study the utility of preoperative breast MRI for partial breast irradiation (PBI) patient selection, using multivariable analysis of significant risk factors to create a classification rule. Methods and Materials: Between 2002 and 2009, 712 women with newly diagnosed breast cancer underwent preoperative bilateral breast MRI at Mayo Clinic Florida. Of this cohort, 566 were retrospectively deemed eligible for PBI according to the National Surgical Adjuvant Breast and Bowel Project Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. Magnetic resonance images were then reviewed to determine their impact on patient eligibility. The patient and tumor characteristics were evaluated to determine risk factors for altered PBI eligibility after MRI and to create a classification rule. Results: Of the 566 patients initially eligible for PBI, 141 (25%) were found ineligible because of pathologically proven MRI findings. Magnetic resonance imaging detected additional ipsilateral breast cancer in 118 (21%). Of these, 62 (11%) had more extensive disease than originally noted before MRI, and 64 (11%) had multicentric disease. Contralateral breast cancer was detected in 28 (5%). Four characteristics were found to be significantly associated with PBI ineligibility after MRI on multivariable analysis: premenopausal status (P=.021), detection by palpation (P<.001), first-degree relative with a history of breast cancer (P=.033), and lobular histology (P=.002). Risk factors were assigned a score of 0-2. The risk of altered PBI eligibility from MRI based on number of risk factors was 0:18%; 1:22%; 2:42%; 3:65%. Conclusions: Preoperative bilateral breast MRI altered the PBI recommendations for 25% of women. Women who may undergo PBI should be considered for breast MRI, especially those with lobular histology or with 2 or more of the following risk factors: premenopausal, detection by palpation, and first-degree relative with a history of

  8. Pathology of breast cancer in women irradiated for acute postpartum mastitis

    International Nuclear Information System (INIS)

    The gross and microscopic pathology of breast cancers in women irradiated for acute postpartum mastitis was compared to the breast cancers found in the sisters of the irradiated women. In considering the lesions in the two populations, the size, location, histologic type, histologic grade, inflammatory response, lymphatic and blood vascular invasion, nipple involvement, axillary lymph node metastases, and menopausal status at the time of diagnosis were statistically indistinguishable. The only parameter that was different in the two populations was the desmoplastic response to the malignant lesion. The control population had more marked fibrosis within the cancers compared with the irradiated women

  9. Irradiation as an alternative post harvest treatment

    International Nuclear Information System (INIS)

    This current world population has significantly added to the pressures placed upon our finite resources and our resulting ability to feed ourselves. In order to cope with current and future demands, the two established lines of action, that is, reduced population growth and expansion of agricultural production, must be supplemented with the parallel activity of reducing food losses during and after harvest. For developing countries in particular, enormous post-harvest losses result from spillage, contamination, pests and physiological deterioration during storage. Studies in these countries indicate that post-harvest losses are enormous and amount to tens of millions of tons per year valued at billions of dollars. Programs to reduce post-harvest losses, if applied properly, can result in realistic yield increases between 10 and 30%, which can be directly converted into increased consumption for humans. Post-harvest losses vary greatly and are a function of the crop variety, pest combinations in the environment, climate, the system of harvesting, storage, handling, marketing, and even the social and cultural environment. Pests are among the most criticals of these factors. Because of the disastrous potential consequences of such pests, quarantine regulations prohibit the entrance of plants or products which might hide the unwanted pest from countries where it is known to exist. Quarantine treatments are can be chemical, physical or ionizing radiation treatment. Numerous investigations on the use of ionizing radiation for the disinfestation of fresh plant materials indicate that rather low dosages will control fruit-fly problems, thus making it well suited for quarantine treatment. The effectiveness of the irradiation as a broad spectrum quarantine treatment of fresh fruits and vegetables was recognized by the several plant protection organizations around the world. Currently, some 40 countries have approved one or more irradiated food items or groups of food

  10. Irradiation as an alternative post harvest treatment

    Energy Technology Data Exchange (ETDEWEB)

    Satin, M. [Agricultural Industries and Post-harvest Management Service, FAO, Rome (Italy); Loaharanu, P. [Head, Food Preservation Section, Joint FAO/ IAEA Division of Nuclear Techniques in Food and Agriculture, Wagramerstr. 5, A-1400, Vienna (Austria)

    1997-12-31

    This current world population has significantly added to the pressures placed upon our finite resources and our resulting ability to feed ourselves. In order to cope with current and future demands, the two established lines of action, that is, reduced population growth and expansion of agricultural production, must be supplemented with the parallel activity of reducing food losses during and after harvest. For developing countries in particular, enormous post-harvest losses result from spillage, contamination, pests and physiological deterioration during storage. Studies in these countries indicate that post-harvest losses are enormous and amount to tens of millions of tons per year valued at billions of dollars. Programs to reduce post-harvest losses, if applied properly, can result in realistic yield increases between 10 and 30%, which can be directly converted into increased consumption for humans. Post-harvest losses vary greatly and are a function of the crop variety, pest combinations in the environment, climate, the system of harvesting, storage, handling, marketing, and even the social and cultural environment. Pests are among the most criticals of these factors. Because of the disastrous potential consequences of such pests, quarantine regulations prohibit the entrance of plants or products which might hide the unwanted pest from countries where it is known to exist. Quarantine treatments are can be chemical, physical or ionizing radiation treatment. Numerous investigations on the use of ionizing radiation for the disinfestation of fresh plant materials indicate that rather low dosages will control fruit-fly problems, thus making it well suited for quarantine treatment. The effectiveness of the irradiation as a broad spectrum quarantine treatment of fresh fruits and vegetables was recognized by the several plant protection organizations around the world. Currently, some 40 countries have approved one or more irradiated food items or groups of food

  11. Fractionation for Whole Breast Irradiation: An American Society for Radiation Oncology (ASTRO) Evidence-Based Guideline

    International Nuclear Information System (INIS)

    Purpose: In patients with early-stage breast cancer treated with breast-conserving surgery, randomized trials have found little difference in local control and survival outcomes between patients treated with conventionally fractionated (CF-) whole breast irradiation (WBI) and those receiving hypofractionated (HF)-WBI. However, it remains controversial whether these results apply to all subgroups of patients. We therefore developed an evidence-based guideline to provide direction for clinical practice. Methods and Materials: A task force authorized by the American Society for Radiation Oncology weighed evidence from a systematic literature review and produced the recommendations contained herein. Results: The majority of patients in randomized trials were aged 50 years or older, had disease Stage pT1-2 pN0, did not receive chemotherapy, and were treated with a radiation dose homogeneity within ±7% in the central axis plane. Such patients experienced equivalent outcomes with either HF-WBI or CF-WBI. Patients not meeting these criteria were relatively underrepresented, and few of the trials reported subgroup analyses. For patients not receiving a radiation boost, the task force favored a dose schedule of 42.5 Gy in 16 fractions when HF-WBI is planned. The task force also recommended that the heart should be excluded from the primary treatment fields (when HF-WBI is used) due to lingering uncertainty regarding late effects of HF-WBI on cardiac function. The task force could not agree on the appropriateness of a tumor bed boost in patients treated with HF-WBI. Conclusion: Data were sufficient to support the use of HF-WBI for patients with early-stage breast cancer who met all the aforementioned criteria. For other patients, the task force could not reach agreement either for or against the use of HF-WBI, which nevertheless should not be interpreted as a contraindication to its use.

  12. Food irradiation as a quarantine treatment

    International Nuclear Information System (INIS)

    Because of multiplicity of invertebrate pests of fresh and durable agricultural products which are treaded internationally there are frequent instances were products are unacceptable without an approved prior disinfestation treatment. The majority of these pests are regulated by quarantine inspections at the ports of exit and entry. Where there is risk of rejection of products if quarantine pests are found at inspection it is frequently prudent to apply a disinfestation treatment. Control of these pests in agriculture produce by fumigation is no longer desirable from the points of human health and global environment. Irradiation could be feasible and practical alternative with a broad applicability to commodities and pests. Quarantine disinfestation of most agricultural products seems to be achievable at the recommended generic dose of 300 Gy. Because irradiation applied at doses ranging about 300 Gy does not cause immediate mortality of all insects, mites or nematodes, live pests could be present after treatment of agricultural produce intended for international trade. In such case a marker of irradiation that is easily applied may be very useful in allaying concerns of some quarantine inspectors that inevitably occur when a living insect of quarantine importance is found in a shipment. (author)

  13. Comparison of classic simulation and virtual simulation in breast irradiation: prospective study on 14 patients

    International Nuclear Information System (INIS)

    Purpose. - To compare conventional 2D simulation and virtual simulation on 14 patients with breast cancer. Patients and methods. - Patients were simulated for treatment using standard procedure. They subsequently underwent CT scan in the treatment position. The CTV was defined as breast tissue. The PTV was obtained by adding a 3D margin of 1 cm around CTV. Organs at risk (lungs and heart) were outlined. Ballistics and dose distribution obtained with the two planning methods were compared. Results. - With conventional simulation, 95% of CTV received 95% of the dose prescribed. Virtual simulation significantly improved dosimetric coverage of PTV without increasing irradiation volume of lung and heart. In 2D simulation, using three slices allowed optimisation by adjusting wedge angle. The five-slice plan was a much better predictor of the maximum dose regions when compared to the three-slice plan. Using entire CT data did not give any benefit. Conclusion. - Variations in CTV delineation and PTV definition limit interest of virtual simulation. In classic simulation, a 5 CT slice-plan can be used to optimise dose distribution. (author)

  14. Angiosarcoma arising in the non-operated, sclerosing breast after primary irradiation, surviving 6 years post-resection: A case report and review of the Japanese literature

    Directory of Open Access Journals (Sweden)

    Takaaki Ito

    2016-01-01

    Conclusion: Angiosarcoma may occur in the non-operated breast, post irradiation. The potential difficulties of diagnosing angiosarcoma against background fibrosis should be kept in mind. Initial radical surgery currently represents the only effective treatment for improving survival in these patients.

  15. Pain in Breast Cancer Treatment: Aggravating Factors and Coping Mechanisms

    OpenAIRE

    Maria de Fatima Guerreiro Godoy; Livia Maria Pereira de Godoy; Stelamarys Barufi; José Maria Pereira de Godoy

    2014-01-01

    The objective of this study was to evaluate pain in women with breast cancer-related lymphedema and the characteristics of aggravating factors and coping mechanisms. The study was conducted in the Clinica Godoy, São Jose do Rio Preto, with a group of 46 women who had undergone surgery for the treatment of breast cancer. The following variables were evaluated: type and length of surgery; number of radiotherapy and chemotherapy sessions; continued feeling of the removed breast (phantom limb), i...

  16. Choice of treatment and diagnostic tactics at nonpalpable breast tumors

    Directory of Open Access Journals (Sweden)

    Ye. P. Kulikov

    2013-01-01

    Full Text Available Results of inspection, treatment and dynamic supervision of 166 patients with nonpalpable breast tumors are presented. Distribution of tumors on BI-RADS system is given. Possibilities of a mammography and ultrasonography in diagnostics of a preclinical breast cancer are shown. Practical recommendations about a choice of an optimum way of presurgical verification of nonpalpable tumors are offered. Indications for surgical treat- ment and dynamic supervision are specified at nonpalpable breast tumors.

  17. Re-surgery and chest wall re-irradiation for recurrent breast cancer - a second curative approach

    International Nuclear Information System (INIS)

    Repeat radiation is a rarely used treatment strategy that must be performed with caution. The efficacy and toxicity of a second curative radiotherapy series was investigated in cases of recurrent breast cancer. Forty-two patients treated from 1993 to 2003 with resection (n = 30) and postoperative re-irradiation or definitive re-irradiation (n = 12) for recurrent breast cancer were enrolled in the study. Concurrent hyperthermia was performed in 29 patients. The median age was 57 years. The median pre-radiation exposure was 54Gy. Re-irradiation was conventionally fractionated to a median total dose of 60Gy. After a median follow-up of 41 months (range 3-92 months) higher graded late toxicity > G3 according to CTC 3.0 and LENT-SOMA was not observed. The estimated 5-year local control rate reached 62%. The estimated 5-year overall survival rate was 59%. Significantly inferior survival was associated with recurrence within two years (40 vs. 71%, p < ([0-9]).01) and presence of macroscopic tumour load (24 vs. 75%, p = 0.03). Repeat radiotherapy for recurrent breast cancer with total radiation doses of 60 Gy and the addition of hyperthermia in the majority of patients was feasible, with acceptable late morbidity and improved prognosis, particularly in patients with previous resection of recurrent tumours

  18. Irradiation of mangoes as a quarantine treatment

    International Nuclear Information System (INIS)

    This research project was conducted following guidelines of research protocols for post-harvest treatments developed by the United States Department of Agriculture CUSA. Laboratory bioassays included the irradiation of mangoes infested with third instar larvae of Anastrepha serpentina (Wied), A. ludens (Loew), A. obliqua (Macquart) and Ceratitis capitata (Wied) , at doses from 10 to 250 Gy. Irradiation doses were applied using a Co-60 AECL Model JS-7400 irradiator. The design was chosen to obtain a maximum to minimum ratio equal to, or less than, 1.025. C. capitata was the species most tolerant to irradiation. A dose of 60 Gy applied to third instar fruit fly larvae sterilized this species and prevented emergence of adults of the other three species. A dose of 250 Gy was required to prevent emergence of C. capitata. In fertility tests using emerged adults of A . Iudens, and A. obliqua a dose of 30 Gy gave 45 % and 27 % fertility, respectively. Adults of A. serpentina that emerged, died before reaching sexual maturity. The confirmatory tests, at probit-9 security level, were done at 100 Gy for the three species of Anastrepha and at 150 Gy for C. capitata. The quality of mangoes irradiated up to 1000 Gy was evaluated by chemical, physiological, and sensorial tests. The determination of vitamin C indicated that there was no loss of the nutritive value of the fruit. It also was observed that fruit metabolism was not accelerated since no significant increase in respiration or transpiration was registered and consumers accepted both treated and untreated fruit in the same way. (Author)

  19. Irradiation of mangoes as a quarantine treatment

    International Nuclear Information System (INIS)

    This research project was conducted following the guidelines of research protocols for post-harvest treatments developed by the United States Department of Agriculture. Laboratory bioassays included the irradiation of mangoes (Mangifera indica L.) infested with third instar larvae of Anastrepha serpentina (Wiedemann), A. Ludens (Loew), A. obliqua (Macquart) and Ceratitis capitata (Wiedemann) at doses of 10-250 Gy. Irradiation doses were applied using a 60Co Atomic Energy of Canada Limited Model JS-7400 irradiator. The design was chosen to obtain a maximum/minimum ratio equal to, or less than, 1025, C. capitata was the species most tolerant to irradiation. A dose of 60 Gy, applied to third instar fruit fly larvae in the infested fruits, sterilized this species and prevented the emergence of adults of the other three species. A dose of 250 Gy was required to prevent emergence of C. capitata. In fertility tests using emerged adults of A. ludens and A. obliqua, a dose of 30 Gy gave 45 and 27% fertility, respectively. The adults of A. serpentina that emerged died before reaching sexual maturity. Confirmatory tests, at the probit 9 security level, were done at 100 Gy for the three species of Anastrepha and at 150 Gy for C. capitata. The quality of fruits irradiated up to 1000 Gy was evaluated by chemical, physiological and sensorial tests. Determination of vitamin C indicated that there was no loss in the nutritive value of the fruit. It also was observed that fruit metabolism, was not accelerated, since no significant increase in respiration or transpiration was registered and consumers accepted both the treated and untreated fruits in the same way. (author). 11 refs, 2 figs, 9 tabs

  20. Investigation of irradiation conditions for recurrent breast cancer in JRR-4

    Energy Technology Data Exchange (ETDEWEB)

    Horiguchi, H., E-mail: horiguchi.hironori@jaea.go.jp [Department of Research Reactor and Tandem Accelerator, Japan Atomic Energy Agency, Tokai, Ibaraki (Japan); Nakamura, T. [Department of Research Reactor and Tandem Accelerator, Japan Atomic Energy Agency, Tokai, Ibaraki (Japan); Kumada, H. [Proton Medical Research Centre, University of Tsukuba, Tsukuba, Ibaraki (Japan); Yanagie, H. [Department of Nuclear Engineering and management, Graduate School of Tokyo, Tokyo (Japan)] [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Suzuki, M. [Particle Radiation Oncology Research Center, Kyoto University, Osaka (Japan); Sagawa, H. [Department of Research Reactor and Tandem Accelerator, Japan Atomic Energy Agency, Tokai, Ibaraki (Japan)

    2011-12-15

    Clinical trials of boron neutron capture therapy (BNCT) for recurrent breast cancers are considered at Japan Research Reactor No. 4 (JRR-4). In this study, the irradiation technique for a total mastectomy patient with recurrent cancer was optimized by dosimetric calculations using JAEA computational dosimetry system (JCDS). The evaluation was performed using an en face technique and a tangents technique with thermal neutron beam mode at JRR-4. The results revealed that equivalent doses of lung, heart, liver and skin were similar in each irradiation technique due to the isotropic scattering of thermal neutrons in the body. On the other hand, the irradiation time with the tangents technique was a few times longer than with the en face technique. We concluded that the en face technique was an optimal irradiation technique for recurrent breast cancers using thermal neutron beam mode in terms of shorter irradiation time and easier patient positioning.

  1. Predictors of Local Recurrence Following Accelerated Partial Breast Irradiation: A Pooled Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag; Wilkinson, John Ben [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Lyden, Maureen [Biostat Inc., Tampa, Florida (United States); Beitsch, Peter [Dallas Breast Center, Dallas, Texas (United States); Vicini, Frank A., E-mail: fvicini@pol.net [Department of Radiation Oncology, Beaumont Cancer Institute, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)

    2012-04-01

    Purpose: To analyze a pooled set of nearly 2,000 patients treated on the American Society of Breast Surgeons (ASBS) Mammosite Registry Trial and at William Beaumont Hospital (WBH) to identify factors associated with local recurrence following accelerated partial breast irradiation (APBI). Methods and Materials: A total of 1,961 women underwent partial breast irradiation between April 1993 and November 2010 as part of the ASBS Registry Trial or at WBH. Rates of ipsilateral breast tumor recurrence (IBTR), regional recurrence (RR), distant metastases (DM), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS) were analyzed for each group and for the pooled cohort. Clinical, pathologic, and treatment-related variables were analyzed including age, tumor stage/size, estrogen receptor status, surgical margins, and lymph node status to determine their association with IBTR. Results: The two groups weres similar, but WBH patients were more frequently node positive, had positive margins, and were less likely to be within the American Society for Radiation Oncology-unsuitable group. At 5 years, the rates of IBTR, RR, DM, DFS, CSS, and OS for the pooled group of patients were 2.9%, 0.5%, 2.4%, 89.1%, 98.5%, and 91.8%, respectively. The 5-year rate of true recurrence/marginal miss was 0.8%. Univariate analysis of IBTR found that negative estrogen receptor status (odds ratio [OR], 2.83, 95% confidence interval 1.55-5.13, p = 0.0007) was the only factor significantly associated with IBTR, while a trend was seen for age less than 50 (OR 1.80, 95% confidence interval 0.90-3.58, p = 0.10). Conclusions: Excellent 5-year outcomes were seen following APBI in over 1,900 patients. Estrogen receptor negativity was the only factor associated with IBTR, while a trend for age less than 50 was noted. Significant differences in factors associated with IBTR were noted between cohorts, suggesting that factors driving IBTR may be predicated based on the risk

  2. Predictors of Local Recurrence Following Accelerated Partial Breast Irradiation: A Pooled Analysis

    International Nuclear Information System (INIS)

    Purpose: To analyze a pooled set of nearly 2,000 patients treated on the American Society of Breast Surgeons (ASBS) Mammosite Registry Trial and at William Beaumont Hospital (WBH) to identify factors associated with local recurrence following accelerated partial breast irradiation (APBI). Methods and Materials: A total of 1,961 women underwent partial breast irradiation between April 1993 and November 2010 as part of the ASBS Registry Trial or at WBH. Rates of ipsilateral breast tumor recurrence (IBTR), regional recurrence (RR), distant metastases (DM), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS) were analyzed for each group and for the pooled cohort. Clinical, pathologic, and treatment-related variables were analyzed including age, tumor stage/size, estrogen receptor status, surgical margins, and lymph node status to determine their association with IBTR. Results: The two groups weres similar, but WBH patients were more frequently node positive, had positive margins, and were less likely to be within the American Society for Radiation Oncology-unsuitable group. At 5 years, the rates of IBTR, RR, DM, DFS, CSS, and OS for the pooled group of patients were 2.9%, 0.5%, 2.4%, 89.1%, 98.5%, and 91.8%, respectively. The 5-year rate of true recurrence/marginal miss was 0.8%. Univariate analysis of IBTR found that negative estrogen receptor status (odds ratio [OR], 2.83, 95% confidence interval 1.55–5.13, p = 0.0007) was the only factor significantly associated with IBTR, while a trend was seen for age less than 50 (OR 1.80, 95% confidence interval 0.90–3.58, p = 0.10). Conclusions: Excellent 5-year outcomes were seen following APBI in over 1,900 patients. Estrogen receptor negativity was the only factor associated with IBTR, while a trend for age less than 50 was noted. Significant differences in factors associated with IBTR were noted between cohorts, suggesting that factors driving IBTR may be predicated based on the risk

  3. Psychotropic medication during endocrine treatment for breast cancer

    NARCIS (Netherlands)

    de Bock, G.H.; Musters, R.F.; Bos, H.J.; Schroder, C.P.; Mourits, M.J.; de Jong-van den Berg, [No Value

    2012-01-01

    Psychological problems are frequently mentioned in women treated for breast cancer in whom depression is mentioned as the most common disorder. The aim was to study the prescription of psychotropic medication in women with endocrine treatment for breast cancer in women in our prospective and consecu

  4. Concerns on diagnosis and treatment of breast cancer in China

    Institute of Scientific and Technical Information of China (English)

    WANG Shen-ming

    2007-01-01

    @@ Breast cancer is one of the neoplasms that have greatest negative psychological impact on the sufferers. Although China is among the low morbidity country of breast cancer, its yearly increasing rate in China is 1%-2% higher than the average rate of the word.1 Due to its largest population in the word, China tops the world in its breast cancer cases but general medical care for the patients still lags behind the developed countries. These issues are related to the diagnosis and treatment of breast cancer in China.

  5. Virtual lymph node analysis to evaluate axillary lymph node coverage provided by tangential breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Shin Hyung; Kim, Jae Chul; Lee, Jeong Eun; Park, In Kyu [Dept.of Radiation Oncology, Kyungpook National University Hospital, Daegu(Korea, Republic of)

    2015-03-15

    To investigate the coverage of axillary lymph node with tangential breast irradiation fields by using virtual lymph node (LN) analysis. Forty-eight women who were treated with whole breast irradiation after breast-conserving surgery were analyzed. The axillary and breast volumes were delineated according to the Radiation Therapy Oncology Group (RTOG) contouring atlas. To generate virtual LN contours, preoperative fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans with identifiable LN were fused with the CT scans, and the virtual LN contour were delineated on the CT. The median level I and II axillary volume coverage percentages at the VD95% line were 33.5% (range, 5.3% to 90.4%) and 0.6% (range, 0.0% to 14.6%), respectively. Thirty-one LNs in 18 patients were delineated (26 in level I and 5 in level II). In the level I axilla, 84.6% of virtual LNs were encompassed by the 95% isodose line. In the level II axilla, by contrast, none of the virtual LNs were encompassed by the 95% isodose volumes. There was a substantial discrepancy between the RTOG contouring atlas-based axillary volume analysis and the virtual LN analysis, especially for the level I axillary coverage. The axillary volume coverage was associated with the body mass index (BMI) and breast volume. The tangential breast irradiation did not deliver adequate therapeutic doses to the axillary region, particularly those in the level II axilla. Patients with small breast volumes or lower BMI showed reduced axillary coverage from the tangential breast fields. For axillary LN irradiation, individualized anatomy-based radiation fields for patients would be necessary.

  6. Changes in local pulmonary injury up to 48 months after irradiation for lymphoma and breast cancer

    International Nuclear Information System (INIS)

    Purpose: To assess the recovery from early local pulmonary injury after irradiation and to determine whether regional differences exist. Methods: For 110 patients treated for breast cancer or malignant lymphoma, single photon emission computed tomography (SPECT) perfusion and ventilation scans and CT scans were made before, 3, 18, and 48 months after radiotherapy. Dose-effect relations for changes in local perfusion, ventilation, and density were determined for each individual patient using spatially correlated SPECT and CT data sets, for each follow-up period. Average dose-effect relations for both subgroups were determined, as well as dose-effect relations for different regions. Results: In general, partial improvement of local pulmonary injury was observed between 3 and 18 months for each of the three endpoints. After 18 months, no further improvement was seen. Patients with breast cancer and malignant lymphoma showed a similar improvement (except for the perfusion parameter), which was attributed to a recovery from the early radiation response and could not be explained by contraction effects of fibrosis of lung parenchyma. No regional differences in radiosensitivity 18 months after treatment were observed, except for the dorsal versus ventral region. This difference was attributed to a gravity-related effect in the measuring procedure. Conclusion: For all patients, a partial recovery from early local perfusion, ventilation, and density changes, was seen between 3 and 18 months after radiotherapy. After 18 months, local lung function did not further improve (lymphoma patients)

  7. Toxicity and cosmesis outcomes after single fraction partial breast irradiation in early stage breast cancer

    International Nuclear Information System (INIS)

    To report the clinical outcome after a Single Shot 3D-CRT PBI (SSPBI) in breast cancer patients after conservative surgery (ClinicalTrials.gov Identifier: NCT01316328). A dose of 18Gy (in the first 4 patients) and 21Gy (in the remaining 60 patients) was prescribed in a single session and delivered to the index area (i.e. the area of breast including the primary tumor bed and the surrounding tissue) using 3D-CRT with patients in prone position. Acute and late toxicity was assessed using the National Cancer Institute's CTC for Adverse Events. Cosmesis was defined based on modified Harvard criteria. Differences between dosimetric or clinical parameters of patients with/without G2 or more late toxicity or unsatisfactory (poor or fair) cosmetic outcome were evaluated with the Mann-Whitney test. Odds ratios and 95% confidence interval were calculated for cosmesis and fibrosis. Univariate and multivariate analyses(UVA/MVA) were used to determine covariates associated with an increase in fibrosis or fat necrosis rate. Sixty four patients were enrolled. With a median follow-up of 3 years, G2 and G3 subcutaneous fibrosis was detected in 20(31%) and in 8(13%) patients, and ≥G2 fat necrosis was observed in 2(3%) patients. Good to excellent, fair and poor cosmesis was observed in 38(59%), 23(36%) and 3(5%) patients, respectively. Based on UVA, the breast volume receiving more than 21Gy (V21Gy) was found to be a predictor of the ≥G1 or ≥G2 fibrosis/fat necrosis. Based on MVA, V21Gy was confirmed as a predictor for ≥G1 fibrosis/fat necrosis, the results correlated as a trend for ≥G2. Cosmesis was correlated with whole breast (WB) mean dose (p = 0.030). Our choice of a single dose of 21Gy significantly increased the treatment related toxicity. However, this should not discourage novel SSPBI approaches with lower equivalent doses

  8. Postoperative radiotherapy in a shorter overall treatment time for patients with breast cancer

    International Nuclear Information System (INIS)

    Clinical data suggests that irradiation given in a shorter overall treatment time with 2.25 and 2.5 Gy dose per fraction is equivalent to conventional treatment with 2 Gy per fraction. This change from conventional fractionation to a short term schedule has been introduced as the basis of a prospective, population based (phase IV) trial. A vast majority of radiotherapy departments (16) in Poland have entered the study. Patients with breast cancer following mastectomy or breast conservative therapy (BCT) who require postoperative radiotherapy will enter this study. The conventional fractionation regimen (2 Gy per fraction /5 weeks) has been replaced by two schedules given in a shorter overall treatment time. Patients undergoing BCT will now receive 42.5 Gy in 2.5 Gy per fraction over 3.5 weeks while postmastectomy patients will receive 45 Gy in 2.25 Gy per fraction over 4 weeks. The study has been designed for 2000 patients and the anticipated accrual time is 1.5 year. Early and late complications will be evaluated at 1, 3, 5, 10 and 15 years. The principal aim of the study is to assess immediate and late post-irradiation complications. Cardiotoxicity will be assessed by comparison of events (myocardial infarction and/or cardiovascular deaths) between patients with tumours of the left breast and of the right breast. Additional evaluation covers local control, recurrence-free survival, overall survival and the aesthetic effects. Implementation of the short term radiotherapy schedule will reduce the waiting list for radiotherapy and thus allow for the treatment of more patients. We hope to reduce the cost of the treatment by approximately 25% and improve the quality of irradiation through its standardization. (author)

  9. 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.

  10. Correlation between atopic manifestation and lung toxicity following chest irradiation for breast cancer

    International Nuclear Information System (INIS)

    The purpose of this study was to identify the impact of atopic manifestations on the occurrence of the lung toxicity following chest irradiation for breast cancer. Collection of 1,173 patients who had undergone radiotherapy on their 1,177 chest walls or postsurgical mammary glands at 9 institutions including ours. They received treatment consecutively from December 1980 through October 2005, with which we formed the basis of this analysis. Patients with any of the following medical history were defined as having atopic manifestations (n=111): asthma, allergic rhinitis, atopic dermatitis, contact dermatitis, and allergy to food or drug. Of them, patients who were observed for at least 6 months or who suffered from lung toxicity at any time, were classified as Group A (n=85). On the other hand, patients in our institute who were observed for at least 6 months or who suffered from lung toxicity at any time regardless of atopic manifestations, were classified as Group B (n=113), and patients without any atopic manifestation were classified as Group C (n=92). Grade 3 or higher lung toxicity in National Cancer Institute, Common Toxicity Criteria for Adverse Events (NCI-CTCAE) (v 3.0), occurred in 8.2%, id est (i.e.) 7 cases, of Group A, 2.7% of Group B, and 1.1% of Group C (p=0.0293 Group C against Group A). Three cases were classified as classical pneumonitis, and the other 4 sporadic pneumonitis such as Cryptogenic Organizing Pneumonia and Chronic Eosinophilic Pneumonia. Both of the histologically proven COP and CEP patients showed atopic manifestations in our institute. The detail clinical features are described in the main text. Having atopic manifestations suggests that there may be risk of lung toxicity following chest irradiation for breast cancer. (author)

  11. Changes in Pulmonary Function Up to 10 Years After Locoregional Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Erven, Katrien, E-mail: Katrien.erven@uzleuven.be [Department of Radiotherapy, University Hospital Gasthuisberg, Leuven (Belgium); Weltens, Caroline [Department of Radiotherapy, University Hospital Gasthuisberg, Leuven (Belgium); Nackaerts, Kristiaan [Department of Pulmonology, University Hospital Gasthuisberg, Leuven (Belgium); Fieuws, Steffen [I-BioStat, Catholic University Leuven and Hasselt University, Leuven (Belgium); Decramer, Marc [Department of Pulmonology, University Hospital Gasthuisberg, Leuven (Belgium); Lievens, Yolande [Department of Radiotherapy, University Hospital Gasthuisberg, Leuven (Belgium)

    2012-02-01

    Purpose: To evaluate the long-term impact of locoregional breast radiotherapy (RT) on pulmonary function tests (PFTs). Methods and Materials: This study included 75 women who underwent postoperative locoregional breast RT. PFTs were performed before RT and 3, 6, and 12 months and 8 to 10 years after RT. By use of univariate and multivariate analyses, the impact of treatment- and patient-related factors on late changes in PFTs was evaluated. Results: During the first year after RT, all PFTs significantly worsened at 3 to 6 months after RT (p < 0.05). At 12 months, forced vital capacity (FVC), vital capacity (VC), and forced expiratory volume in 1 second (FEV{sub 1}) recovered almost to baseline values, whereas total lung capacity (TLC) and diffusion capacity of carbon monoxide (DL{sub CO}) recovered only slightly and were still found to be decreased compared with baseline (p < 0.05). At 8 to 10 years after RT, mean reductions in FEV{sub 1} of 4% (p = 0.03) and in VC, DL{sub CO}, and TLC of 5%, 9%, and 11% (all p < 0.0001), respectively, were observed compared with pre-RT values. On multivariate analysis, tamoxifen use negatively affected TLC at 8 to 10 years after RT (p = 0.033), whereas right-sided irradiation was associated with a late reduction in FEV{sub 1} (p = 0.027). For FEV{sub 1} and DL{sub CO}, an early decrease was predictive for a late decrease (p = 0.003 and p = 0.0009, respectively). Conclusions: The time course of PFT changes after locoregional RT for breast cancer follows a biphasic pattern. An early reduction in PFTs at 3 to 6 months with a partial recovery at 12 months after RT is followed by a late, more important PFT reduction up to 8 to 10 years after RT. Tamoxifen use may have an impact on this late decline in PFTs.

  12. Late effects of breast cancer treatment and potentials for rehabilitation

    DEFF Research Database (Denmark)

    Ewertz, Marianne; Jensen, Anders Bonde

    2011-01-01

    from the Nordic countries. Results. Local therapies such as breast cancer surgery and radiotherapy may cause persistent pain in the breast area, arm, and shoulder reported by 30-50% of patients after three to five years, lymphedema in 15-25% of patients, and restrictions of arm and shoulder movement in...... treatment in postmenopausal women. Awareness of cardiotoxicity is needed since anthracyclines, trastuzumab, and radiotherapy can damage the heart. Breast cancer survivors have an increased risk of a major depression and far from all receive adequate anti-depressive treatment. Other psychological symptoms......Abstract Background. Breast cancer is the most frequent malignant disease among women world wide. Survival has been improving leading to an increasing number of breast cancer survivors, in the US estimated to about 2.6 million. Material and methods. The literature was reviewed with focus on data...

  13. Breast cancer recurrence: follow up after treatment for primary breast cancer

    OpenAIRE

    Hiramanek, N

    2004-01-01

    Background: Breast cancer will affect one in 12 Australian women in their lifetime. After potentially curative treatment, it is usual for patients to be followed up for many years. However, controversies surround follow up, and its value is uncertain.

  14. Dietary omega-3 fatty acids and ionizing irradiation on human breast cancer xenograft growth and angiogenesis

    Directory of Open Access Journals (Sweden)

    Cameron Ivan L

    2005-04-01

    Full Text Available Abstract Background The effects of an omega-3 (n-3 fatty acid enriched diet alone and in combination with gamma irradiation (IR therapy in nude mice bearing a human MDA-MB231 breast cancer xenograft were tested. The cancer cells were injected into the mammary fat pad of young female mice. Six weeks later, mice were randomly divided into two diet groups: 1 mice with 10% corn oil (rich in omega 6 fatty acids in their food, 2 mice consuming a 10% fat diet that was enriched in n-3 fatty acids. After two weeks on the diet, treatment with 200 cGy of IR every second day for four treatments (total 800 cGy was initiated on half of the mice from each diet group. Some mice in each of the 4 groups were euthanized 24 hours after the end of IR while the remaining mice were followed for 3 additional weeks. Tumor sections were stained for endothelial cells with CD31 and PAS and for hypoxia inducible factor 1α (HIF-α. Results The tumor cortex within 100 microns of the well-vascularized capsule had little vascularization. Blood vessels, capillaries, and endothelial pseudopods were found at areas greater than 100 microns from the capsule (subcortex. Mice on the corn oil diet and treated with IR 24 hours previously or non-irradiated mice fed the n-3 diet had tumors with fewer blood vessels in the subcortex and more endothelial pseudopods projecting into hypoxic (HIF- α positive areas than did mice from the non-irradiated corn oil fed group. The tumor growth rate of mice that received IR or that were fed the n-3 fatty acid enriched diet was significantly slower than in the mice fed the 10% corn oil diet. Harmful side effects were found only in the IR treated mice. Conclusion The omega-3 fatty acid enriched diet proved to be a safe means for retarding tumor growth and vascularization.

  15. Anti-angiogenic activity in metastasis of human breast cancer cells irradiated by a proton beam

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyu-Shik; Shin, Jin-Sun; Nam, Kyung-Soo [Dongguk University, Gyeongju (Korea, Republic of); Shon, Yun-Hee [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2012-07-15

    Angiogenesis is an essential process of metastasis in human breast cancer. We investigated the effects of proton beam irradiation on angiogenic enzyme activities and their expressions in MCF-7 human breast cancer cells. The regulation of angiogenic regulating factors, of transforming growth factor-β (TGF-β) and of vesicular endothelial growth factor (VEGF) expression in breast cancer cells irradiated with a proton beam was studied. Aromatase activity and mRNA expression, which is correlated with metastasis, were significantly decreased by irradiation with a proton beam in a dose-dependent manner. TGF-β and VEGF transcriptions were also diminished by proton beam irradiation. In contrast, transcription of tissue inhibitors of matrix metalloproteinases (TIMPs), also known as biological inhibitors of matrix metalloproteinases (MMPs), was dose-dependently enhanced. Furthermore, an increase in the expression of TIMPs caused the MMP-9 activity to be diminished and the MMP-9 and the MMP-2 expressions to be decreased. These results suggest that inhibition of angiogenesis by proton beam irradiation in breast cancer cells is closely related to inhibitions of aromatase activity and transcription and to down-regulation of TGF-β and VEGF transcription.

  16. Anti-angiogenic activity in metastasis of human breast cancer cells irradiated by a proton beam

    Science.gov (United States)

    Lee, Kyu-Shik; Shin, Jin-Sun; Nam, Kyung-Soo; Shon, Yun-Hee

    2012-07-01

    Angiogenesis is an essential process of metastasis in human breast cancer. We investigated the effects of proton beam irradiation on angiogenic enzyme activities and their expressions in MCF-7 human breast cancer cells. The regulation of angiogenic regulating factors, of transforming growth factor- β (TGF- β) and of vesicular endothelial growth factor (VEGF) expression in breast cancer cells irradiated with a proton beam was studied. Aromatase activity and mRNA expression, which is correlated with metastasis, were significantly decreased by irradiation with a proton beam in a dose-dependent manner. TGF- β and VEGF transcriptions were also diminished by proton beam irradiation. In contrast, transcription of tissue inhibitors of matrix metalloproteinases (TIMPs), also known as biological inhibitors of matrix metalloproteinases (MMPs), was dose-dependently enhanced. Furthermore, an increase in the expression of TIMPs caused th MMP-9 activity to be diminished and the MMP-9 and the MMP-2 expressions to be decreased. These results suggest that inhibition of angiogenesis by proton beam irradiation in breast cancer cells is closely related to inhibitions of aromatase activity and transcription and to down-regulation of TGF- β and VEGF transcription.

  17. Anti-angiogenic activity in metastasis of human breast cancer cells irradiated by a proton beam

    International Nuclear Information System (INIS)

    Angiogenesis is an essential process of metastasis in human breast cancer. We investigated the effects of proton beam irradiation on angiogenic enzyme activities and their expressions in MCF-7 human breast cancer cells. The regulation of angiogenic regulating factors, of transforming growth factor-β (TGF-β) and of vesicular endothelial growth factor (VEGF) expression in breast cancer cells irradiated with a proton beam was studied. Aromatase activity and mRNA expression, which is correlated with metastasis, were significantly decreased by irradiation with a proton beam in a dose-dependent manner. TGF-β and VEGF transcriptions were also diminished by proton beam irradiation. In contrast, transcription of tissue inhibitors of matrix metalloproteinases (TIMPs), also known as biological inhibitors of matrix metalloproteinases (MMPs), was dose-dependently enhanced. Furthermore, an increase in the expression of TIMPs caused the MMP-9 activity to be diminished and the MMP-9 and the MMP-2 expressions to be decreased. These results suggest that inhibition of angiogenesis by proton beam irradiation in breast cancer cells is closely related to inhibitions of aromatase activity and transcription and to down-regulation of TGF-β and VEGF transcription.

  18. Setup accuracy for prone and supine whole breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Mulliez, Thomas; Vercauteren, Tom; Greveling, Annick van; Speleers, Bruno; Neve, Wilfried de; Veldeman, Liv [University Hospital Ghent, Department of Radiotherapy, Ghent (Belgium); Gulyban, Akos [University Hospital Ghent, Department of Radiotherapy, Ghent (Belgium); University Hospital Liege, Department of Radiotherapy, Liege (Belgium)

    2016-04-15

    To evaluate cone-beam computed tomography (CBCT) based setup accuracy and margins for prone and supine whole breast irradiation (WBI). Setup accuracy was evaluated on 3559 CBCT scans of 242 patients treated with WBI and uncertainty margins were calculated using the van Herk formula. Uni- and multivariate analysis on individual margins was performed for age, body mass index (BMI) and cup size. The population-based margin in vertical (VE), lateral (LA) and longitudinal (LO) directions was 10.4/9.4/9.4 mm for the 103 supine and 10.5/22.4/13.7 mm for the 139 prone treated patients, being significantly (p < 0.01) different for the LA and LO directions. Multivariate analysis identified a significant (p < 0.05) correlation between BMI and the LO margin in supine position and the VE/LA margin in prone position. In this series, setup accuracy is significantly worse in prone compared to supine position for the LA and LO directions. However, without proper image-guidance, uncertainty margins of about 1 cm are also necessary for supine WBI. For patients with a higher BMI, larger margins are required. (orig.) [German] Ziel der Arbeit war es, die interfraktionelle Repositionierungsgenauigkeit in Bauchlage (BL) versus Rueckenlage (RL) bei Ganzbrustbestrahlung (GBB) mittels Cone-Beam-CT (CBCT) zu bestimmen, um die notwendigen PTV-Sicherheitsabstaende zu definieren. Die Repositionierungsgenauigkeit wurde basierend an 3559 CBCT-Scans von 242 mit GBB behandelten Patienten ausgewertet. Die PTV-Sicherheitsabstaende wurden unter Verwendung der ''van-Herk''-Formel berechnet. Uni- und multivariable Analysen wurden fuer Sicherheitsabstaende in jede Richtung auf Basis von Alter, Body-Mass-Index (BMI) und Koerbchengroesse durchgefuehrt. Die basierend auf den taeglichen CBCT-Verschiebungen berechneten PTV-Sicherheitsabstaende betrugen in anteroposteriorer (AP), lateraler (LT oder links-rechts) und kraniokaudaler (CC) Richtung 10,4/9,4/9,4 mm fuer die RL (103 Patienten) und

  19. Phase II trial of 3D-conformal accelerated partial breast irradiation: Lessons learned from patients and physicians’ evaluation

    International Nuclear Information System (INIS)

    Introduction: The present study prospectively reported both physicians’ and patients’ assessment for toxicities, cosmetic assessment and patients’ satisfaction after 3D-conformal accelerated partial breast irradiation (APBI). Materials and Methods: From October 2007 to September 2009, 30 early breast cancer patients were enrolled in a 3D-conformal APBI Phase II trial (40 Gy/10 fractions/5 days). Treatment related toxicities and cosmetic results were assessed by both patients and physicians at each visit (at 1, 2, 6 months, and then every 6 months). Patient satisfaction was also scored. Results: After a median follow-up of 27.7 months, all patients were satisfied with APBI treatment, regardless of cosmetic results or late adverse events. Good/excellent cosmetic results were noticed by 80% of patients versus 92% of cases by radiation oncologists. Breast pain was systematically underestimated by physicians (8–20% vs. 16.6–26.2%; Kappa coefficient KC = 0.16–0.44). Grade 1 and 2 fibrosis and/or breast retraction occurred in 7–12% of patients and were overestimated by patients (KC = 0.14–0.27). Conclusions: Present results have shown discrepancies between patient and physician assessments. In addition to the assessment of efficacy and toxicity after 3D-conformal APBI, patients’ cosmetic results consideration and satisfaction should be also evaluated.

  20. 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

  1. Irradiation from a phytosanitary treatment perspective

    International Nuclear Information System (INIS)

    Recognizing that with the advent of globalisation and initiatives towards liberalization of trade through the elimination of tariff and non-tariff barriers, the challenge towards gaining international market access will hinge primarily on quality of agricultural commodities. Besides aiming for efficiency in production it is crucial to emphasise on quality so that it not only provide a competitive edge but also enables them to penetrate markets that have stringent phytosanitary requirements. The need for an alternative quarantine treatment against agricultural pests has been pressing as according to the Montreal Protocol, fumigation with methyl bromide, the most widely used fumigant, will be globally phased out due to environment reasons. Irradiation is a relatively new technology and lately it has been accepted as one of the phytosanitary measures by the International Plant Protection Convention (IPPC). It provides one of the alternative technologies available to the food industries to control organisms that cause food borne diseases, to reduce food losses due to spoilage and deterioration, and to overcome barriers in food trade. Taking cognizance that irradiation has potential as a treatment technology for the disinfestation of pests of agricultural commodities, efforts have been stepped up to ensure the pre-requisites are in place for its implementation. (Author)

  2. Pharmacological treatment of depression in women with breast cancer

    DEFF Research Database (Denmark)

    Toftegård Andersen, Lærke; Voigt Hansen, Melissa; Rosenberg, Jacob;

    2013-01-01

    escitalopram and the norepinephrine reuptake inhibitor, reboxetine, significantly improved depression and QOL compared with baseline values. In conclusion, depression is a clinical problem in patients with breast cancer. Pharmacological treatment with antidepressants may improve depression and QOL. However...

  3. For Some Breast Cancers, New Drug May Be Treatment Option

    Science.gov (United States)

    Results from an international clinical trial suggest that women with metastatic, HER2-positive breast cancer that is no longer responding to the targeted therapy trastuzumab (Herceptin) may soon have a new treatment option.

  4. Treatment helps young women preserve fertility during breast cancer chemo

    Science.gov (United States)

    Researchers have found that young women with breast cancer were able to better preserve their fertility during cancer treatments by using hormone-blocking drug injections that put them into temporary menopause. The results announced today at the annual me

  5. Socioeconomic Disparities in Breast Cancer Treatment Among Older Women

    OpenAIRE

    White, Arica; Richardson, Lisa C.; Krontiras, Helen; Pisu, Maria

    2014-01-01

    Background: Racial disparities in breast cancer treatment among Medicare beneficiaries have been documented. This study aimed to determine whether racial disparities exist among white and black female Medicare beneficiaries in Alabama, an economically disadvantaged U.S. state.

  6. Release of monocyte migration signals by breast cancer cell lines after ablative and fractionated γ-irradiation

    International Nuclear Information System (INIS)

    Radiotherapy, administered in fractionated as well as ablative settings, is an essential treatment component for breast cancer. Besides the direct tumor cell death inducing effects, there is growing evidence that immune mechanisms contribute - at least in part - to its therapeutic success. The present study was designed to characterize the type and the extent of cell death induced by fractionated and ablative radiotherapy as well as its impact on the release of monocyte migration stimulating factors by dying breast cancer cells. Cell death and senescence assays were employed to characterize the response of a panel of breast cancer cell lines with different receptor and p53 status towards γ-irradiation applied in a fractionated (daily doses of 2 Gy) or ablative setting (single dose of 20 Gy). Cell-free culture supernatants were examined for their monocyte migration stimulating potential in transwell migration and 2D chemotaxis/chemokinesis assays. Irradiation-induced transcriptional responses were analyzed by qRT-PCR, and CD39 surface expression was measured by flow cytometry. Fast proliferating, hormone receptor negative breast cancer cell lines with defective p53 predominantly underwent primary necrosis in response to γ-irradiation when applied at a single, ablative dose of 20 Gy, whereas hormone receptor positive, p53 wildtype cells revealed a combination of apoptosis, primary, and secondary (post-apoptotic) necrosis. During necrosis the dying tumor cells released apyrase-sensitive nucleotides, which effectively stimulated monocyte migration and chemokinesis. In hormone receptor positive cells with functional p53 this was hampered by irradiation-induced surface expression of the ectonucleotidase CD39. Our study shows that ablative radiotherapy potently induces necrosis in fast proliferating, hormone receptor negative breast cancer cell lines with mutant p53, which in turn release monocyte migration and chemokinesis stimulating nucleotides. Future studies have

  7. Breast conserving therapy with accelerated partial breast versus external beam whole breast irradiation: comparison of imaging sequela and complications in a matched population.

    Science.gov (United States)

    Monticciolo, Debra L; Biggs, Kelly; Gist, Ashley K; Sincleair, Spencer T; Hajdik, Rodney L; Nipper, Michael L; Schnitker, James B

    2011-01-01

    Our purpose was to evaluate and compare the imaging sequela and complications of accelerated partial breast irradiation (APBI) with those occurring in patients treated with standard external beam therapy. Patient selection included those who met the criteria for possible ABPI: age 45 or older; cancer stage T1N0M0 or ductal carcinoma in situ 3 cm or less, and negative surgical margins. One hundred and ninety seven had complete records and films available for review. Ninety-seven (49%) were treated with APBI (MammoSite) and 100(51%) were treated with external beam. Image findings for APBI versus external beam were: distortion 90(93%) versus 83(83%), seroma 67(69%) versus 7(7%), skin edema 52(54%) versus 47(47%), increased stroma 75(77%) versus 66(66%), calcifications 10(10%) versus 6(6%), and fat necrosis 12(12%) versus 6(6%). For APBI, skin and stromal edema was more commonly focal. At imaging, the seroma rate was statistically and significantly different between the two treatment modes (p < 0.0001). For patients treated with APBI, seroma formation was not related to balloon size and only weakly related to lumpectomy cavity size. The complication rate was significantly higher for those treated with APBI (36 versus 20%) and the types and treatment of complications differed. There were three recurrences among the APBI group and none among those treated with external beam radiation. PMID:21306469

  8. Study on irradiation treatment to drunk crab

    International Nuclear Information System (INIS)

    For guaranteeing the quality of irradiated drunk crab, manufacture method of the dosimeter, sample setting and taking position, irradiation time, asymmetry degree of irradiation dose, contrast of the dosimeter are discussed and some reference datum to commercialization of drunk crab's irradiation are provided

  9. Sci—Thur PM: Planning and Delivery — 04: Respiratory margin derivation and verification in partial breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Quirk, S [Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta (Canada); Conroy, L [Department of Physics and Astronomy, University of Calgary, Calgary, Alberta (Canada); Smith, WL [Department of Oncology, University of Calgary, Calgary, Alberta (Canada)

    2014-08-15

    Partial breast irradiation (PBI) following breast-conserving surgery is emerging as an effective means to achieve local control and reduce irradiated breast volume. Patients are planned on a static CT image; however, treatment is delivered while the patient is free-breathing. Respiratory motion can degrade plan quality by reducing target coverage and/or dose homogeneity. A variety of methods can be used to determine the required margin for respiratory motion in PBI. We derive geometric and dosimetric respiratory 1D margin. We also verify the adequacy of the typical 5 mm respiratory margin in 3D by evaluating plan quality for increasing respiratory amplitudes (2–20 mm). Ten PBI plans were used for dosimetric evaluation. A database of volunteer respiratory data, with similar characteristics to breast cancer patients, was used for this study. We derived a geometric 95%-margin of 3 mm from the population respiratory data. We derived a dosimetric 95%-margin of 2 mm by convolving 1D dose profiles with respiratory probability density functions. The 5 mm respiratory margin is possibly too large when 1D coverage is assessed and could lead to unnecessary normal tissue irradiation. Assessing margins only for coverage may be insufficient; 3D dosimetric assessment revealed degradation in dose homogeneity is the limiting factor, not target coverage. Hotspots increased even for the smallest respiratory amplitudes, while target coverage only degraded at amplitudes greater than 10 mm. The 5 mm respiratory margin is adequate for coverage, but due to plan quality degradation, respiratory management is recommended for patients with respiratory amplitudes greater than 10 mm.

  10. An alternative approach for treatment of breast cancer.

    Science.gov (United States)

    Swartzendruber, D E; Retsky, M W; Wardwell, R H; Bame, P D

    1994-01-01

    Since adjuvant chemotherapy and hormonal therapy generally extend disease free survival in breast cancer rather than provide a cure, we have examined the current breast cancer paradigm. Heterogeneity is a fundamental characteristic of breast cancer tissue and a well recognized aspect of the disease. There are variations in natural history, histopathology, biochemistry and endocrinology, and molecular biology of cancer tissues and cells within the tissues. A variety of data indicate that growth kinetics are also variable, not only from tumor to tumor, but also during the natural history of an individual's tumor. To better understand kinetic heterogeneity, a stochastic numeric computer model of the natural history of breast cancer has been developed. To be consistent with inter- and intratumor kinetic heterogeneity and with late relapse, the model predicts that tumors grow in an irregular fashion with alternating periods of growth and periods of dormancy rather than the generally accepted modified exponential, or Gompertzian fasion. The prediction of irregular growth has been compared to data relevant to growth characteristics of human breast cancer. Much data support the concept of irregular kinetics and temporary dormancy rather than steady, Gompertzian growth of human breast cancer. Thus, in addition to drug resistance, kinetic heterogeneity may help explain the limited impact that traditional chemotherpeutic treatment has had on mortality from breast cancer. Although the mechanisms underlying irregular growth need to be better understood, non-Gompertzian growth kinetics indicates that there may be alternative approaches for breast cancer treatment. PMID:7865858

  11. The value of radiotherapy in breast-conserving treatment

    International Nuclear Information System (INIS)

    Breast conserving treatment owes its legitimacy to the ability of radiotherapy (RT), in conjunction with limited surgery, to provide local control equivalent to that associated with total mastectomy. This paper will be concerned exclusively with the treatment of the breast, since indications for RT of lymph node areas are independent of the type of breast surgery employed. Randomized trials have enabled quantitation of the effect of reduction in recurrence risk compared to surgery alone. Even though local recurrence is a predictor of metastatic disease, its prevention by breast RT has not yet been shown to improve survival. Thus the main benefits of breast RT relate to preventing the consequences of local failure, namely breast loss. With modern RT techniques, cosmetic results should be satisfactory in 90% of preserved breast. The main clinical research areas concern the optimal sequencing of surgery, RT and chemotherapy, the improvement of local control in high-risk patients, the extension of breast conservation to more advanced cases by the use of neo-adjuvant chemotherapy and RT, the identification of early-stage patients who could be treated with wide excision alone, and the value of RT in ductal in situ carcinomas. (author)

  12. Potential Reduction of Contralateral Second Breast-Cancer Risks by Prophylactic Mammary Irradiation: Validation in a Breast-Cancer-Prone Mouse Model

    OpenAIRE

    Igor Shuryak; Lubomir B Smilenov; Kleiman, Norman J.; Brenner, David J.

    2013-01-01

    BACKGROUND: Long-term breast-cancer survivors have a highly elevated risk (1 in 6 at 20 years) of contralateral second breast cancer. This high risk is associated with the presence of multiple pre-malignant cell clones in the contralateral breast at the time of primary breast cancer diagnosis. Mechanistic analyses suggest that a moderate dose of X-rays to the contralateral breast can kill these pre-malignant clones such that, at an appropriate Prophylactic Mammary Irradiation (PMI) dose, the ...

  13. Changes of initiation, promotion and metastatic enzyme system in human breast cancer with the proton irradiation

    International Nuclear Information System (INIS)

    Proton irradiations in the cells were significantly decreased cell viability but increased the QR activity in a dose-dependent manner. Cell viability was 92.3%, 88.4%, 81.8%, 72.4%, 68.9% at doses of 0.5, 2, 8, 16, and 32 Gy, respectively. At doses of 2, 8, 16, and 32 Gy, QR activity was increased 1.27-, 1.31-, 1.45- and 2.08-fold. However, negligible GST activity in the cells was detected and the activity was not changed by proton irradiation. Proton irradiation also increased GSH contents by 1.18- and 1.21-fold at doses of 0.5 and 2 Gy. In contrast, the ODC activity, a key enzyme in polyamine biosynthesis and tumor promotion, was decreased in a dose-dependent manner. We also investigated anti-metastatic effects of proton beam irradiation in breast cancer cells. Invasion and wound healing assay showed that metastatic activities in breast cancer cells were significantly decreased in a dose-dependent manner by proton beam irradiation. In zymography of MMP-9, the activity was slightly diminished. These results suggest that breast cancer chemopreventive potential was increased with proton irradiation by increasing the QR activity and the GSH levels and by inhibiting the ODC activity.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    International Nuclear Information System (INIS)

    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 that

  16. Breast cancer. Current approach in the treatment

    International Nuclear Information System (INIS)

    Of 115 women who had surgery for a malignant breast tumor proven by biopsy at the Department of General Surgery, Hospital 'Jose Ramon Lopez Tabrane' of Matanzas during the period January 2007 to May 2008 a study was conducted observational, analytical (study cohort) and using certain variables, with the aim of analyzing the behavior of this disease in our environment. Data were collected from medical records of patients admitted a breast lump in that period and files Statistics and Provincial Hospital Pathology 'Jose Ramon Lopez Tabrane'. The percentage method was applied to the description found in our sample, expressing the results in tabular form, with the objective facilitate their interpretation. The most affected age range between 65 and 74, but followed very near the range between 55 and 64. The most frequent clinical stage II, followed by the III. The left breast has proven to be most affected in outer quadrant exceeded. Veronesi conservative technique was the most used in our study. We recommend promoting breast self-examination and use of media We recommend promoting breast self-examination and use of media such as mammography as a method of early diagnosis of breast cancer and the creation of a file to the technical assessment conservative based on the survival and the immediate and mediate complications of this technique, and the best instruction in family practice clinical diagnosis of breast diseases and specialized inter consultation. (Author)

  17. A case of cerebral and intraocular involvements which responded to irradiation in malignant lymphoma of the breast

    International Nuclear Information System (INIS)

    This paper reports a case of malignant lymphoma which was originated from the breast, followed by multiple involvement in the brain, and finally developed intraocular infiltration. These lesions disappeared by irradiation therapy. A 51 years old housewife was admitted to our hospital for the further evaluation and treatment of decreased bilateral visual acuity on May 1981. On May 1976, she noticed a solid tumor of the left breast, and total mastectomy disclosed malignant lymphoma (non-Hodgkin lymphoma, lymphocytic type). On August 1980, she developed diplopia and amnesia. CT scan revealed multiple involvements in brain and cobalt therapy resulted in good response. The ophthalmologic diagnosis was uveitis, but it was impossible to rule out the ophthalmic infiltration of malignant lymphoma and 60Co irradiation (total 2,976 rad) to the bilateral eyes and systemic CHOP therapy were carried out. Consequently, her visual acuity recovered to 0.6, and she is now following ambulatory course. Although non-Hodgkin lymphomas have been reported to originate frequently from non lymphoid tissues, the breast as the primary site is rare and the intracerebral infiltration as an involvement of central nervous system is quite rare. Furthermore, malignant lymphoma of the eyes, especially intraocular involvement is infrequent in incidence. The diagnosis of uveitis due to malignant lymphoma is considered to be difficult because of lack in specific findings. (author)

  18. Accelerated partial irradiation for breast cancer: Systematic review and meta-analysis of 8653 women in eight randomized trials

    International Nuclear Information System (INIS)

    Background and purpose: Accelerated partial breast irradiation (APBI) is the strategy that allows adjuvant treatment delivery in a shorter period of time in smaller volumes. This study was undertaken to assess the effectiveness and outcomes of APBI in breast cancer compared with whole-breast irradiation (WBI). Material and methods: Systematic review and meta-analysis of randomized controlled trials of WBI versus APBI. Two authors independently selected and assessed the studies regarding eligibility criteria. Results: Eight studies were selected. A total of 8653 patients were randomly assigned for WBI versus APBI. Six studies reported local recurrence outcomes. Two studies were matched in 5 years and only one study for different time of follow-up. Meta-analysis of two trials assessing 1407 participants showed significant difference in the WBI versus APBI group regarding the 5-year local recurrence rate (HR = 4.54, 95% CI: 1.78–11.61, p = 0.002). Significant difference in favor of WBI for different follow-up times was also found. No differences in nodal recurrence, systemic recurrence, overall survival and mortality rates were observed. Conclusions: APBI is associated with higher local recurrence compared to WBI without compromising other clinical outcomes

  19. Dosimetric comparison of three dimensional conformal radiation therapy versus intensity modulated radiation therapy in accelerated partial breast irradiation

    Directory of Open Access Journals (Sweden)

    S Moorthy

    2016-01-01

    Full Text Available Aim of Study: Breast conserving surgery (BCS is the standard treatment for stage I and II breast cancer. Multiple studies have shown that recurrences after lumpectomy occur mainly in or near the tumor bed. Use of accelerated partial breast irradiation (APBI allows for significant reduction in the overall treatment time that results in increasing patient compliance and decreasing healthcare costs. We conducted a treatment planning study to evaluate the role of intensity modulated radiation therapy (IMRT with regards to three-dimensional conformal radiation therapy (3DCRT in APBI. Materials and Methods: Computed tomography planning data sets of 33 patients (20 right sided and 13 left sided with tumor size less than 3 cm and negative axillary lymph nodes were used for our study. Tumor location was upper outer, upper inner, central, lower inner, and lower outer quadrants in 10, 10, 5, 4 and 4 patients, respectively. Multiple 3DCRT and IMRT plans were created for each patient. Total dose of 38.5 Gy in 10 fractions were planned. Dosimetric analysis was done for the best 3DCRT and IMRT plans. Results: The target coverage has been achieved by both the methods but IMRT provided better coverage (P = 0.04 with improved conformity index (P = 0.01. Maximum doses were well controlled in IMRT to below 108% (P < 0.01. Heart V2 Gy (P < 0.01, lung V5 Gy (P = 0.01, lung V10 Gy (P = 0.02, contralateral breast V1 Gy (P < 0.01, contralateral lung V2 Gy (P < 0.01, and ipsilateral uninvolved breast (P < 0.01 doses were higher with 3DCRT compared to IMRT. Conclusion: Dosimetrically, IMRT–APBI provided best target coverage with less dose to normal tissues compared with 3DCRT-APBI.

  20. Breast Cancer Basics and You: Staging and Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Breast Cancer Breast Cancer Basics and You: Staging and Treatment Past Issues / ... Table of Contents Staging The extent (stage) of breast cancer needs to be determined to help choose the ...

  1. New treatment option for women with hormone-sensitive breast cancer

    Science.gov (United States)

    A drug used for treating breast cancer, known as exemestane, is more effective than a common breast cancer prevention drug, tamoxifen, in preventing breast cancer recurrence in young women who also receive post-surgical treatment to suppress ovarian funct

  2. Breast cancer in BRCA mutation carriers: medical treatment.

    Science.gov (United States)

    Milani, Andrea; Geuna, Elena; Zucchini, Giorgia; Aversa, Caterina; Martinello, Rossella; Montemurro, Filippo

    2016-10-01

    About 10% of breast cancers are associated with the inheritance of autosomal dominant breast cancer susceptibility alleles BRCA1 and BRCA2. Until recently, the medical management of BRCA mutation-associated breast cancer has not differed from that of the sporadic breast cancer counterpart. However, there is mounting evidence that this molecular alteration confers sensitivity or resistance to systemic therapies that can be exploited in terms of medical management. For example, studies support the use of platinum salts chemotherapy in BRCA mutated cancers. Moreover, a number of targeted therapies are showing activity in BRCA mutation carriers. Above all, BRCA defective tumor cells are particularly sensitive to Poly(ADP-ribose) polymerase (PARP) inhibitors. This review will summarize the state of the art of the medical treatment of breast cancer in BRCA mutation carriers, with a particular focus on chemotherapies and targeted therapies. PMID:26799758

  3. Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast on Patient Selection for Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kuehr, Marietta, E-mail: marietta.kuehr@ukb.uni-bonn.de [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Wolfgarten, Matthias; Stoelzle, Marco [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Leutner, Claudia [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Hoeller, Tobias [Department of Medical Statistics and Epidemiology, University of Bonn, Bonn (Germany); Schrading, Simone; Kuhl, Christiane; Schild, Hans [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Kuhn, Walther; Braun, Michael [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany)

    2011-11-15

    Purpose: Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI. Methods and Materials: From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size {<=}3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget's disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI. Results: MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally. Conclusions: Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI.

  4. An evaluation of the accuracy of semi-permanent skin marks for breast cancer irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Probst, H. [Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield S10 2BP (United Kingdom)]. E-mail: h.probst@shu.ac.uk; Dodwell, D. [Cookridge Hospital Leeds (United Kingdom); Gray, J.C. [University of Newcastle (United Kingdom); Holmes, M. [Leeds Metropolitan University (United Kingdom)

    2006-08-15

    A randomised trial was designed to investigate the accuracy of semi-permanent ink marks versus permanent tattoos for early stage breast cancer irradiation. No significant difference in random and systematic errors was identified between the two groups. On multivariate analysis no specific patient characteristic had a major influence on the systematic errors identified.

  5. An evaluation of the accuracy of semi-permanent skin marks for breast cancer irradiation

    International Nuclear Information System (INIS)

    A randomised trial was designed to investigate the accuracy of semi-permanent ink marks versus permanent tattoos for early stage breast cancer irradiation. No significant difference in random and systematic errors was identified between the two groups. On multivariate analysis no specific patient characteristic had a major influence on the systematic errors identified

  6. Bi-tangential hybrid IMRT for sparing the shoulder in whole breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Farace, P.; Deidda, M.A.; Iamundo de Curtis, I.; Deiana, E.; Farigu, R.; Lay, G.; Porru, S. [Regional Oncological Hospital, Cagliari (Italy). Dept. of Radio-Oncology

    2013-11-15

    Background and purpose: A bi-tangential technique is proposed to reduce undesired doses to the shoulder produced by standard tangential irradiation. Patients and methods: A total of 6 patients affected by shoulder pain and reduced functional capacity after whole-breast irradiation were retrospectively analysed. The standard tangential plan used for treatment was compared with (1) a single bi-tangential plan where, to spare the shoulder, the lateral open tangent was split into two half-beams at isocentre, with the superior portion rotated by 10-20 medially with respect to the standard lateral beam; (2) a double bi-tangential plan, where both the tangential open beams were split. The planning target volume (PTV) coverage and the dose to the portion of muscles and axilla included in the standard tangential beams were compared. Results: PTV95 % of standard plan (91.9 {+-} 3.8) was not significantly different from single bi-tangential plan (91.8 {+-} 3.4); a small but significant (p < 0.01) decrease was observed with the double bi-tangential plan (90.1 {+-} 3.7). A marked dose reduction to the muscle was produced by the single bi-tangential plan around 30-40 Gy. The application of the double bi-tangential technique further reduced the volume receiving around 20 Gy, but did not markedly affect the higher doses. The dose to the axilla was reduced both in the single and the double bi-tangential plans. Conclusion: The single bi-tangential technique would have been able to reduce the dose to shoulder and axilla, without compromising target coverage. This simple technique is valuable for irradiation after axillary lymph node dissection or in patients without dissection due to negative or low-volume sentinel lymph node disease. (orig.)

  7. Bi-tangential hybrid IMRT for sparing the shoulder in whole breast irradiation

    International Nuclear Information System (INIS)

    Background and purpose: A bi-tangential technique is proposed to reduce undesired doses to the shoulder produced by standard tangential irradiation. Patients and methods: A total of 6 patients affected by shoulder pain and reduced functional capacity after whole-breast irradiation were retrospectively analysed. The standard tangential plan used for treatment was compared with (1) a single bi-tangential plan where, to spare the shoulder, the lateral open tangent was split into two half-beams at isocentre, with the superior portion rotated by 10-20 medially with respect to the standard lateral beam; (2) a double bi-tangential plan, where both the tangential open beams were split. The planning target volume (PTV) coverage and the dose to the portion of muscles and axilla included in the standard tangential beams were compared. Results: PTV95 % of standard plan (91.9 ± 3.8) was not significantly different from single bi-tangential plan (91.8 ± 3.4); a small but significant (p < 0.01) decrease was observed with the double bi-tangential plan (90.1 ± 3.7). A marked dose reduction to the muscle was produced by the single bi-tangential plan around 30-40 Gy. The application of the double bi-tangential technique further reduced the volume receiving around 20 Gy, but did not markedly affect the higher doses. The dose to the axilla was reduced both in the single and the double bi-tangential plans. Conclusion: The single bi-tangential technique would have been able to reduce the dose to shoulder and axilla, without compromising target coverage. This simple technique is valuable for irradiation after axillary lymph node dissection or in patients without dissection due to negative or low-volume sentinel lymph node disease. (orig.)

  8. Treatment Option Overview (Male Breast Cancer)

    Science.gov (United States)

    ... exposure, high levels of estrogen, and a family history of breast cancer can increase a man’s risk ... also show the dimpled appearance called peau d’orange (like the skin of an orange). There may ...

  9. Treatment Options for Male Breast Cancer

    Science.gov (United States)

    ... exposure, high levels of estrogen, and a family history of breast cancer can increase a man’s risk ... also show the dimpled appearance called peau d’orange (like the skin of an orange). There may ...

  10. Targeting single-walled carbon nanotubes for the treatment of breast cancer using photothermal therapy

    Science.gov (United States)

    Neves, Luís F. F.; Krais, John J.; Van Rite, Brent D.; Ramesh, Rajagopal; Resasco, Daniel E.; Harrison, Roger G.

    2013-09-01

    This paper focuses on the targeting of single-walled carbon nanotubes (SWNTs) for the treatment of breast cancer with minimal side effects using photothermal therapy. The human protein annexin V (AV) binds specifically to anionic phospholipids expressed externally on the surface of tumour cells and endothelial cells that line the tumour vasculature. A 2 h incubation of the SWNT-AV conjugate with proliferating endothelial cells followed by washing and near-infrared (NIR) irradiation at a wavelength of 980 nm was enough to induce significant cell death; there was no significant cell death with irradiation or the conjugate alone. Administration of the same conjugate i.v. in BALB/c female mice with implanted 4T1 murine mammary at a dose of 0.8 mg SWNT kg-1 and followed one day later by NIR irradiation of the tumour at a wavelength of 980 nm led to complete disappearance of implanted 4T1 mouse mammary tumours for the majority of the animals by 11 days since the irradiation. The combination of the photothermal therapy with the immunoadjuvant cyclophosphamide resulted in increased survival. The in vivo results suggest the SWNT-AV/NIR treatment is a promising approach to treat breast cancer.

  11. Exercise after breast cancer treatment: current perspectives

    OpenAIRE

    Dieli-Conwright CM; Orozco BZ

    2015-01-01

    Christina M Dieli-Conwright, Breanna Z Orozco Division of Biokinesiology and Physical Therapy, Women's Health and Exercise Laboratory, University of Southern California, Los Angeles, CA, USA Abstract: Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offs...

  12. A Phase II Study of Radiotherapy and Concurrent Paclitaxel Chemotherapy in Breast-Conserving Treatment for Node-Positive Breast Cancer

    International Nuclear Information System (INIS)

    Purpose: Administering adjuvant chemotherapy before breast radiotherapy decreases the risk of systemic recurrence, but delays in radiotherapy could yield higher local failure. We assessed the feasibility and efficacy of placing radiotherapy earlier in the breast-conserving treatment course for lymph node–positive breast cancer. Methods and Materials: Between June 2000 and December 2004, 44 women with node-positive Stage II and III breast cancer were entered into this trial. Breast-conserving surgery and 4 cycles of doxorubicin (60 mg/m2)/cyclophosphamide (600 mg/m2) were followed by 4 cycles of paclitaxel (175 mg/m2) delivered every 3 weeks. Radiotherapy was concurrent with the first 2 cycles of paclitaxel. The breast received 39.6 Gy in 22 fractions with a tumor bed boost of 14 Gy in 7 fractions. Regional lymphatics were included when indicated. Functional lung volume was assessed by use of the diffusing capacity for carbon monoxide as a proxy. Breast cosmesis was evaluated with the Harvard criteria. Results: The 5-year actuarial rate of disease-free survival is 88%, and overall survival is 93%. There have been no local failures. Median follow-up is 75 months. No cases of radiation pneumonitis developed. There was no significant change in the diffusing capacity for carbon monoxide either immediately after radiotherapy (p = 0.51) or with extended follow-up (p = 0.63). Volume of irradiated breast tissue correlated with acute cosmesis, and acute Grade 3 skin toxicity developed in 2 patients. Late cosmesis was not adversely affected. Conclusions: Concurrent paclitaxel chemotherapy and radiotherapy after breast-conserving surgery shortened total treatment time, provided excellent local control, and was well tolerated.

  13. A Phase II Study of Radiotherapy and Concurrent Paclitaxel Chemotherapy in Breast-Conserving Treatment for Node-Positive Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, William C. [Department of Radiation Oncology, University Hospitals Case Medical Center, Cleveland, OH (United States); Kim, Janice [Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States); Kim, Edward [Department of Radiation Oncology, Ohio State University Medical Center, Columbus, OH (United States); Silverman, Paula [Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH (United States); Overmoyer, Beth [Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA (United States); Cooper, Brenda W. [Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH (United States); Anthony, Sue [Department of Radiation Oncology, University Hospitals Case Medical Center, Cleveland, OH (United States); Shenk, Robert; Leeming, Rosemary [Department of Surgery, University Hospitals Case Medical Center, Cleveland, OH (United States); Hanks, Shelli H. [Arizona Institute of Urology, Tucson, AZ (United States); Lyons, Janice A., E-mail: janice.lyons@uhhospitals.org [Department of Radiation Oncology, University Hospitals Case Medical Center, Cleveland, OH (United States)

    2012-01-01

    Purpose: Administering adjuvant chemotherapy before breast radiotherapy decreases the risk of systemic recurrence, but delays in radiotherapy could yield higher local failure. We assessed the feasibility and efficacy of placing radiotherapy earlier in the breast-conserving treatment course for lymph node-positive breast cancer. Methods and Materials: Between June 2000 and December 2004, 44 women with node-positive Stage II and III breast cancer were entered into this trial. Breast-conserving surgery and 4 cycles of doxorubicin (60 mg/m{sup 2})/cyclophosphamide (600 mg/m{sup 2}) were followed by 4 cycles of paclitaxel (175 mg/m{sup 2}) delivered every 3 weeks. Radiotherapy was concurrent with the first 2 cycles of paclitaxel. The breast received 39.6 Gy in 22 fractions with a tumor bed boost of 14 Gy in 7 fractions. Regional lymphatics were included when indicated. Functional lung volume was assessed by use of the diffusing capacity for carbon monoxide as a proxy. Breast cosmesis was evaluated with the Harvard criteria. Results: The 5-year actuarial rate of disease-free survival is 88%, and overall survival is 93%. There have been no local failures. Median follow-up is 75 months. No cases of radiation pneumonitis developed. There was no significant change in the diffusing capacity for carbon monoxide either immediately after radiotherapy (p = 0.51) or with extended follow-up (p = 0.63). Volume of irradiated breast tissue correlated with acute cosmesis, and acute Grade 3 skin toxicity developed in 2 patients. Late cosmesis was not adversely affected. Conclusions: Concurrent paclitaxel chemotherapy and radiotherapy after breast-conserving surgery shortened total treatment time, provided excellent local control, and was well tolerated.

  14. Applicator for optimum cobalt-60 primary breast treatments

    International Nuclear Information System (INIS)

    A breast applicator has been designed to optimize 3 field breast treatments for 60Co. The device has a six half value layer beam splitting block constructed in two sections. The larger permanently mounted section is sufficient for treating 90% of the patients. Slots are available for mounting cerroband blocks, and any of five brass half field wedges. A magnetically attached front and back-pointer assembly readily breaks away in the event of a collision between pointer and patient. With this design the breast applicator with wedges and blocks has in-field surface doses reduced to that of an open field without accessory devices. The 50-90% dose decrement of the radiation penumbra for the half field block is comparable to that for the field edge of a typical 6 MV X ray unit, although the 50-10% decrement is larger. The average out-of-field dose at the surface is 8% and is 5% at the depth of dose maximum. The combination for this applicator of sharp penumbra and low out-of-field dose leads to reduced lung and opposite breast doses. The latter was confirmed with TLD measurements on 10 patients, and yielded an average opposite breast dose of 230 cGy for a 4600 cGy prescription. Thus, half-field blocking devices do not preclude, as has been stated in the literature, acceptable opposite breast doses. In addition, proper design of these devices can significantly improve the radiation characteristics for primary breast treatments

  15. Epidemiologic study on carcinoma of the breast following irradiation for benign conditions in infancy and childhood

    Energy Technology Data Exchange (ETDEWEB)

    Oviedo, M.A.; Chmiel, J.S.; Curb, J.D.; Kautz, J.A.; Haenszel, W.; Scanlon, E.F.

    1983-07-01

    To investigate the relationship of irradiation during infancy and childhood to the subsequent development of carcinoma of the breast, 996 eligible patients were studied at Evanston Hospital, Evanston, Illinois, and Northwestern Memorial Hospital, Chicago. This was a case-control study, with those in the control group being selected from concurrent hospital admissions for nonmalignant surgical conditions. A second group consisting of those with benign biopsy results was also studied. The Mantel-Haenszel method of analysis, controlling for age and race, was used to estimate the approximate relative risk of carcinoma of the breast in the irradiated group compared with that for the nonirradiated group. The type of radiation history included radiotherapy for mastitis or enlarged thymus (nine patients), irradiation of the head and neck (69 patients), diagnostic fluoroscopies (ten patients) and miscellaneous irradiation (52 patients) for bursitis, eczema or keloid. Based upon the data obtained from the results of this study and its analysis, we conclude that there is little evidence of increased risk of carcinoma of the breast after irradiation about the head, neck and chest areas for benign conditions in the population being studied herein. Such a risk, if indeed it exists at all for this population, is estimated to be about 10 per cent.

  16. Epidemiologic study on carcinoma of the breast following irradiation for benign conditions in infancy and childhood

    International Nuclear Information System (INIS)

    To investigate the relationship of irradiation during infancy and childhood to the subsequent development of carcinoma of the breast, 996 eligible patients were studied at Evanston Hospital, Evanston, Illinois, and Northwestern Memorial Hospital, Chicago. This was a case-control study, with those in the control group being selected from concurrent hospital admissions for nonmalignant surgical conditions. A second group consisting of those with benign biopsy results was also studied. The Mantel-Haenszel method of analysis, controlling for age and race, was used to estimate the approximate relative risk of carcinoma of the breast in the irradiated group compared with that for the nonirradiated group. The type of radiation history included radiotherapy for mastitis or enlarged thymus (nine patients), irradiation of the head and neck (69 patients), diagnostic fluoroscopies (ten patients) and miscellaneous irradiation (52 patients) for bursitis, eczema or keloid. Based upon the data obtained from the results of this study and its analysis, we conclude that there is little evidence of increased risk of carcinoma of the breast after irradiation about the head, neck and chest areas for benign conditions in the population being studied herein. Such a risk, if indeed it exists at all for this population, is estimated to be about 10 per cent

  17. Effect of high-dose irradiation on quality characteristics of ready-to-eat chicken breast

    Science.gov (United States)

    Yun, Hyejeong; Haeng Lee, Kyung; Jung Lee, Hyun; Woon Lee, Ju; Uk Ahn, Dong; Jo, Cheorun

    2012-08-01

    High-dose (higher than 30 kGy) irradiation has been used to sterilize specific-purposed foods for safe and long-term storage. The objective of this study was to investigate the effect of high-dose irradiation on the quality characteristics of ready-to-eat chicken breast in comparison with those of the low-dose irradiation. Ready-to-eat chicken breast was manufactured, vacuum-packaged, and irradiated at 0, 5, and 40 kGy. The populations of total aerobic bacteria were 4.75 and 2.26 Log CFU/g in the samples irradiated at 0 and 5 kGy, respectively. However, no viable cells were detected in the samples irradiated at 40 kGy. On day 10, bacteria were not detected in the samples irradiated at 40 kGy but the number of bacteria in the samples irradiated at 5 kGy was increased. The pH at day 0 was higher in the samples irradiated at 40 kGy than those at 0 and 5 kGy. The 2-thiobarbituric acid reactive substance (TBARS) values of the samples were not significantly different on day 0. However, on day 10, the TBARS value was significantly higher in the samples irradiated at 40 kGy than those at 0 and 5 kGy. There was no difference in the sensory scores of the samples, except for off-flavor, which was stronger in samples irradiated at 5 and 40 kGy than control. However, no difference in off-flavor between the irradiated ones was observed. After 10 days of storage, only the samples irradiated at 40 kGy showed higher off-flavor score. SPME-GC-MS analysis revealed that 5 kGy of irradiation produced 2-methylbutanal and 3-methylbutanal, which were not present in the control, whereas 40 kGy of irradiation produced hexane, heptane, pentanal, dimethly disulfide, heptanal, and nonanal, which were not detected in the control or the samples irradiated at 5 kGy. However, the amount of compounds such as allyl sulfide and diallyl disulfide decreased significantly in the samples irradiated at 5 kGy and 40 kGy.

  18. Surgical treatment of early breast cancer in day surgery.

    Science.gov (United States)

    Marrazzo, Antonio; Taormina, Pietra; David, Massimo; Riili, Ignazio; Lo Gerfo, Domenico; Casà, Luigi; Noto, Antonio; Mercadante, Sebastiano

    2007-01-01

    Quadrantectomy and associated sentinel lymph node biopsy (SLNB) is currently employed in most breast surgery centres as the gold standard in the treatment of early breast cancer. This approach has a modest morbidity and can usually be performed in a day-surgery regimen, leading to best acceptance by the patients. This reports outlines the experience of our Breast Unit with quadrantectomy and SLNB in day surgery for early breast cancer. One hundred patients presenting to our institution with primary invasive breast cancer measuring less than 3 cm and clinically negative axillary nodes underwent quadrantectomy and SLNB in day surgery. For 60 women with breast cancer the sentinel node was negative, so the only definitive surgical treatment was performed in the day-surgery regimen; 40 patients with positive sentinel nodes were hospitalised a second time for axillary dissection. In these patients that needed clearance of the axilla, SLNB was performed on the only positive node in 22 cases (55%). None of the patients admitted for quadrantectomy and SLNB in day surgery required re-hospitalisation after discharge. All patients proved to be fully satisfied with early discharge from hospital when questioned on the occasion of subsequent monitoring. Short-stay surgical programs in early invasive breast cancer treatment are feasible today owing to the availability of less invasive approaches such as quadrantectomy and SLNB. There are two main pointers to a distinct advantage for this kind of approach, i.e. recovery and psychological adjustment. Recovery from surgery is faster and the patient tends to play down the seriousness of the operation and to have a better mental attitude to neoplastic disease. Moreover, when performing quadrantectomy with SLNB in day surgery fewer than 50% of breast cancer patients (40% in our experience) require another surgical treatment, concluding the surgery in a single session. PMID:18019641

  19. Insomnia and its Treatment in Women with Breast Cancer

    OpenAIRE

    Fiorentino, Lavinia; Ancoli-Israel, Sonia

    2006-01-01

    Insomnia is a common complaint in breast cancer patients and has been shown to have a host of psychological and medical correlates and consequences. Typically insomnia is treated pharmacologically, however more recent findings from randomized controlled clinical trials support the use of cognitive behavioral therapies. The aim of this article is to review the empirically supported breast cancer literature on insomnia, briefly present and explain the insomnia treatment options available, and e...

  20. Profile of palbociclib in the treatment of metastatic breast cancer

    OpenAIRE

    Ehab M; Elbaz M

    2016-01-01

    Moataz Ehab,1 Mohamad Elbaz2,31Department of Pharmacy Practice, 2Department of Pharmacology, Pharmacy School, Helwan University, Egypt; 3Department of Pathology, The Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, USAAbstract: Breast cancer is the most common cancer diagnosed in women. Each year, thousands die either because of disease progression or failure of treatment. Breast cancer is classified into different subtypes based on the molecula...

  1. Profile of palbociclib in the treatment of metastatic breast cancer

    OpenAIRE

    Elbaz, Mohamad

    2016-01-01

    Moataz Ehab,1 Mohamad Elbaz2,31Department of Pharmacy Practice, 2Department of Pharmacology, Pharmacy School, Helwan University, Egypt; 3Department of Pathology, The Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, USAAbstract: Breast cancer is the most common cancer diagnosed in women. Each year, thousands die either because of disease progression or failure of treatment. Breast cancer is classified into different subtypes based on the mole...

  2. [Acute hemorrhagic necrosis of the breast following treatment with Cumarin].

    Science.gov (United States)

    Lüchtrath, H; Walkowsky, A

    1983-08-01

    A case of hemorrhagic necrosis of the breast is reported in a thirty-four year old woman who received Cumarin treatment for deep leg vein thrombosis and pulmonary embolism. It was necessary to remove the breast. The microscopic examination showed complete blockage of the vessels by fibrin thrombi in almost all veins. The cause of this venous thrombosis was explained as a Shwartzman-Sanarelli-Phenomenon. PMID:6555120

  3. A study of irradiation in the treatment of wastewater

    Science.gov (United States)

    Bao, Huaying; Liu, Yuanxia; Jia, Haishun

    2002-03-01

    A grafting copolymer of starch and acrylamide was prepared by 60Co- γ pre-irradiation. After purification, the copolymer was modified by a cationic reaction to form a cationic copolymer. The structure of the cationic copolymer was identified by IR and NMR spectroscopy. Using the industrial and sanitary municipal wastewater from the Factory of Wastewater Treatment of Gaobeidian in Beijing as the study sample, three-treatment methods: flocculation deposition, flocculation deposition combined with γ irradiation and the direct irradiation were carried out. COD was applied to evaluate the treatment effect. The preliminary results show that the method of flocculation deposition combined with γ irradiation was effective than the other two.

  4. Evaluation of dose to cardiac structures during breast irradiation

    DEFF Research Database (Denmark)

    Aznar, M C; Korreman, S-S; Pedersen, A N;

    2011-01-01

    OBJECTIVE: Adjuvant radiotherapy for breast cancer can lead to late cardiac complications. The highest radiation doses are likely to be to the anterior portion of the heart, including the left anterior descending coronary artery (LAD). The purpose of this work was to assess the radiation doses de...

  5. Measuring irradiated lung and heart area in breast tangential fields using a simulator-based computerized tomography device

    International Nuclear Information System (INIS)

    Purpose: To illustrate the use of a simulator based computerized tomography system (SIMCT) in the simulation and planning of tangential breast fields. Methods and Materials: Forty-five consecutive patients underwent treatment planning using a radiotherapy simulator with computerized tomography attachment. One to three scans were obtained for each patient, calculations were made on the central axis scan. Due to the wide aperture of this system all patients were able to be scanned in the desired treatment position with arm abducted 90 deg. . Using available software tools the area of lung and/or heart included within the tangential fields was calculated. The greatest perpendicular distance (GPD) from the chest wall to posterior field edge was also measured. Results: The mean GPD for the group was 25.40 mm with 71% of patients having GPDs of ≤ 30 mm. The mean area of irradiated lung was 1780 sq mm which represented 18.0% of the total ipsilateral lung area seen in the central axis. Seven of the patients with left sided tumors had an average 1314 sq mm heart irradiated in the central axis. This represented 11.9% of total heart area in these patients. Conclusion: Measurements of irradiated lung and heart area can be easily and accurately made using a SIMCT device. Such measurements may help identify those patients potentially at risk for lung or heart toxicity as a consequence of their treatment. A major advantage of this device is the ability to scan patients in the actual treatment position

  6. Soft tissue sarcomas after radiation treatment for breast cancer. Three case studies and review of literature

    International Nuclear Information System (INIS)

    Aims: By means of 3 cases with infield soft tissue carcinomas after radiotherapy for breast cancer, symptoms and therapy are described. Consequences for treatment planning and patient's information before radiotherapy for breast cancer are discussed. Patients: Three of 1,025 patients with breast cancer irradiated from 1984 to 1997 suffered from infield secondary soft tissue sarcomas. The latency periods were 61, 49 and 59 months. Two patients had been treated with breast-conserving therapy (computerized planning, 50 Gy to reference point, 5 times 2 Gy/week, 5-MV photons), 1 patient received a local boost dose of 15 Gy (10-MeV electrons), patient 3 radiotherapy of the thoracic wall and regional lymph nodes after mastectomy using 12-MeV electrons (thoracic wall) and 5-MV photons (lymph node areas) to 50 Gy, 5 times 2 Gy/week. No adjuvant chemotherapy was given. All sarcomas were very extensive, all patients died from local progression and/or distant failure after 17, 13 and 12 months. Results: The incidence of spontaneous sarcomas of the breast in about 0.06%, after operation and radiotherapy 0.09 to 0.45%. No correlations to radiotherapy technique and no risk factors were found. Radiation dose could play a role, but there are very sparse data about this. (orig.)

  7. Late effects of breast cancer treatment and potentials for rehabilitation

    Energy Technology Data Exchange (ETDEWEB)

    Ewertz, Marianne (Dept. of Oncology, Odense Univ. Hospital, Odense (Denmark)); Bonde Jensen, Anders (Inst. of Clinical Research, Univ. of Southern Denmark (Denmark))

    2011-02-15

    Background. Breast cancer is the most frequent malignant disease among women world wide. Survival has been improving leading to an increasing number of breast cancer survivors, in the US estimated to about 2.6 million. Material and methods. The literature was reviewed with focus on data from the Nordic countries. Results. Local therapies such as breast cancer surgery and radiotherapy may cause persistent pain in the breast area, arm, and shoulder reported by 30-50% of patients after three to five years, lymphedema in 15-25% of patients, and restrictions of arm and shoulder movement in 35%. Physiotherapy is the standard treatment for the latter while no pain intervention trials have been published. Chemotherapy may cause infertility and premature menopause, resulting in vasomotor symptoms, sexual dysfunction, and osteoporosis, which are similar to the side effects of endocrine treatment in postmenopausal women. Awareness of cardiotoxicity is needed since anthracyclines, trastuzumab, and radiotherapy can damage the heart. Breast cancer survivors have an increased risk of a major depression and far from all receive adequate anti-depressive treatment. Other psychological symptoms include fear of recurrence, sleep disturbances, cognitive problems, fatigue, and sexual problems. Discussion. To improve rehabilitation, specific goals have to be formulated into national guidelines and high priority directed towards research into developing and testing new interventions for alleviating symptoms and side effects experienced by breast cancer survivors

  8. Late effects of breast cancer treatment and potentials for rehabilitation

    International Nuclear Information System (INIS)

    Background. Breast cancer is the most frequent malignant disease among women world wide. Survival has been improving leading to an increasing number of breast cancer survivors, in the US estimated to about 2.6 million. Material and methods. The literature was reviewed with focus on data from the Nordic countries. Results. Local therapies such as breast cancer surgery and radiotherapy may cause persistent pain in the breast area, arm, and shoulder reported by 30-50% of patients after three to five years, lymphedema in 15-25% of patients, and restrictions of arm and shoulder movement in 35%. Physiotherapy is the standard treatment for the latter while no pain intervention trials have been published. Chemotherapy may cause infertility and premature menopause, resulting in vasomotor symptoms, sexual dysfunction, and osteoporosis, which are similar to the side effects of endocrine treatment in postmenopausal women. Awareness of cardiotoxicity is needed since anthracyclines, trastuzumab, and radiotherapy can damage the heart. Breast cancer survivors have an increased risk of a major depression and far from all receive adequate anti-depressive treatment. Other psychological symptoms include fear of recurrence, sleep disturbances, cognitive problems, fatigue, and sexual problems. Discussion. To improve rehabilitation, specific goals have to be formulated into national guidelines and high priority directed towards research into developing and testing new interventions for alleviating symptoms and side effects experienced by breast cancer survivors

  9. Effect of high-dose irradiation on quality characteristics of ready-to-eat chicken breast

    International Nuclear Information System (INIS)

    High-dose (higher than 30 kGy) irradiation has been used to sterilize specific-purposed foods for safe and long-term storage. The objective of this study was to investigate the effect of high-dose irradiation on the quality characteristics of ready-to-eat chicken breast in comparison with those of the low-dose irradiation. Ready-to-eat chicken breast was manufactured, vacuum-packaged, and irradiated at 0, 5, and 40 kGy. The populations of total aerobic bacteria were 4.75 and 2.26 Log CFU/g in the samples irradiated at 0 and 5 kGy, respectively. However, no viable cells were detected in the samples irradiated at 40 kGy. On day 10, bacteria were not detected in the samples irradiated at 40 kGy but the number of bacteria in the samples irradiated at 5 kGy was increased. The pH at day 0 was higher in the samples irradiated at 40 kGy than those at 0 and 5 kGy. The 2-thiobarbituric acid reactive substance (TBARS) values of the samples were not significantly different on day 0. However, on day 10, the TBARS value was significantly higher in the samples irradiated at 40 kGy than those at 0 and 5 kGy. There was no difference in the sensory scores of the samples, except for off-flavor, which was stronger in samples irradiated at 5 and 40 kGy than control. However, no difference in off-flavor between the irradiated ones was observed. After 10 days of storage, only the samples irradiated at 40 kGy showed higher off-flavor score. SPME-GC–MS analysis revealed that 5 kGy of irradiation produced 2-methylbutanal and 3-methylbutanal, which were not present in the control, whereas 40 kGy of irradiation produced hexane, heptane, pentanal, dimethly disulfide, heptanal, and nonanal, which were not detected in the control or the samples irradiated at 5 kGy. However, the amount of compounds such as allyl sulfide and diallyl disulfide decreased significantly in the samples irradiated at 5 kGy and 40 kGy. - Highlights: ► Comparison of high (40 kGy) and low-dose irradiation (5 kGy) on

  10. Potential of using cerium oxide nanoparticles for protecting healthy tissue during accelerated partial breast irradiation (APBI).

    Science.gov (United States)

    Ouyang, Zi; Mainali, Madan Kumar; Sinha, Neeharika; Strack, Guinevere; Altundal, Yucel; Hao, Yao; Winningham, Thomas Andrew; Sajo, Erno; Celli, Jonathan; Ngwa, Wilfred

    2016-04-01

    The purpose of this study is to investigate the feasibility of using cerium oxide nanoparticles (CONPs) as radical scavengers during accelerated partial breast irradiation (APBI) to protect normal tissue. We hypothesize that CONPs can be slowly released from the routinely used APBI balloon applicators-via a degradable coating-and protect the normal tissue on the border of the lumpectomy cavity over the duration of APBI. To assess the feasibility of this approach, we analytically calculated the initial concentration of CONPs required to protect normal breast tissue from reactive oxygen species (ROS) and the time required for the particles to diffuse to various distances from the lumpectomy wall. Given that cerium has a high atomic number, we took into account the possible inadvertent dose enhancement that could occur due to the photoelectric interactions with radiotherapy photons. To protect against a typical MammoSite treatment fraction of 3.4Gy, 5ng·g(-1) of CONPs is required to scavenge hydroxyl radicals and hydrogen peroxide. Using 2nm sized NPs, with an initial concentration of 1mg·g(-1), we found that 2-10days of diffusion is required to obtain desired concentrations of CONPs in regions 1-2cm away from the lumpectomy wall. The resultant dose enhancement factor (DEF) is less than 1.01 under such conditions. Our results predict that CONPs can be employed for radioprotection during APBI using a new design in which balloon applicators are coated with the NPs for sustained/controlled in-situ release from within the lumpectomy cavity. PMID:27053452

  11. RISK FACTORS FOR DEVELOPMENT OF LYMPHEDEMA FOLLOWING BREAST CANCER TREATMENT : A RETROSPECTIVE STUDY

    OpenAIRE

    Mr. Madhusudan; Ashwin Hebbar; Sunil; Mohammed

    2015-01-01

    OBJECTIVES: The aim and objective of this study is to identify the factors associated with secondary lymphedema after breast cancer treatment. BACKGROUND : Lymphedema of the arm is a complication of breast cancer treatment that affects 2 - 40% of breast cancer survivors. The pathophysiology of lymphedema following breast cancer treatment is poorly understood, probably suggesting a multifactor nature. As the breast cancer survival rate increases, lymphedema wil...

  12. Profile of palbociclib in the treatment of metastatic breast cancer

    Science.gov (United States)

    Ehab, Moataz; Elbaz, Mohamad

    2016-01-01

    Breast cancer is the most common cancer diagnosed in women. Each year, thousands die either because of disease progression or failure of treatment. Breast cancer is classified into different subtypes based on the molecular expression of estrogen receptor (ER), progesterone receptor, and/or human epidermal growth factor receptor 2 (HER2). These receptors represent important therapeutic targets either through monoclonal antibodies or through small-molecule inhibitors directed toward them. However, up to 40% of patients develop either a primary or a secondary resistance to the current treatments. Therefore, there is an urgent need for investigating new targets in order to overcome the resistance and/or enhance the current therapies. Cell cycle is altered in many human cancers, especially in breast cancer. Cyclin-dependent kinases (CDKs), especially CDK4 and CDK6, play a pivotal role in cell cycle progression that makes them potential targets for new promising therapies. CDK inhibition has shown strong antitumor activities, ranging from cytostatic antiproliferative effects to synergistic effects in combination with other antitumor drugs. In order to overcome the drawbacks of the first-generation CDK inhibitors, recently, new CDK inhibitors have emerged that are more selective to CDK4 and CDK6 such as palbociclib, which is the most advanced CDK4/6 inhibitor in trials. In preclinical studies, palbociclib has shown a very promising antitumor activity, especially against ERα+ breast cancer subtype. Palbociclib has gained world attention, and US the Food and Drug Administration has accelerated its approval for first-line treatment in combination with letrozole for the first-line systematic treatment of postmenopausal women with ERα+/HER2− locally advanced or metastatic breast cancer. In this review, we discuss the potential role of CDK inhibition in breast cancer treatment, and focus on palbociclib progress from preclinical studies to clinical trials with mentioning the

  13. Interim Cosmetic Results and Toxicity Using 3D Conformal External Beam Radiotherapy to Deliver Accelerated Partial Breast Irradiation in Patients With Early-Stage Breast Cancer Treated With Breast-Conserving Therapy

    International Nuclear Information System (INIS)

    Purpose: We present our ongoing clinical experience utilizing three-dimensional (3D)-conformal radiation therapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer treated with breast-conserving therapy. Methods and Materials: Ninety-one consecutive patients were treated with APBI using our previously reported 3D-CRT technique. The clinical target volume consisted of the lumpectomy cavity plus a 10- to 15 -mm margin. The prescribed dose was 34 or 38.5 Gy in 10 fractions given over 5 consecutive days. The median follow-up was 24 months. Twelve patients have been followed for ≥4 years, 20 for ≥3.5 years, 29 for >3.0 years, 33 for ≥2.5 years, and 46 for ≥2.0 years. Results: No local recurrences developed. Cosmetic results were rated as good/excellent in 100% of evaluable patients at ≥ 6 months (n = 47), 93% at 1 year (n = 43), 91% at 2 years (n = 21), and in 90% at ≥3 years (n = 10). Erythema, hyperpigmentation, breast edema, breast pain, telangiectasias, fibrosis, and fat necrosis were evaluated at 6, 24, and 36 months after treatment. All factors stabilized by 3 years posttreatment with grade I or II rates of 0%, 0%, 0%, 0%, 9%, 18%, and 9%, respectively. Only 2 patients (3%) developed grade III toxicity (breast pain), which resolved with time. Conclusions: Delivery of APBI with 3D-CRT resulted in minimal chronic (≥6 months) toxicity to date with good/excellent cosmetic results. Additional follow-up is needed to assess the long-term efficacy of this form of APBI

  14. Cosmetic Outcomes and Complications Reported by Patients Having Undergone Breast-Conserving Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Hill-Kayser, Christine E., E-mail: hill@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vachani, Carolyn; Hampshire, Margaret K.; Di Lullo, Gloria A. [Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Metz, James M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2012-07-01

    Purpose: Over the past 30 years, much work in treatment of breast cancer has contributed to improvement of cosmetic and functional outcomes. The goal of breast-conservation treatment (BCT) is avoidance of mastectomy through use of lumpectomy and adjuvant radiation. Modern data demonstrate 'excellent' or 'good' cosmesis in >90% of patients treated with BCT. Methods and Materials: Patient-reported data were gathered via a convenience sample frame from breast cancer survivors using a publically available, free, Internet-based tool for creation of survivorship care plans. During use of the tool, breast cancer survivors are queried as to the cosmetic appearance of the treated breast, as well as perceived late effects. All data have been maintained anonymously with internal review board approval. Results: Three hundred fifty-four breast cancer survivors having undergone BCT and voluntarily using this tool were queried with regard to breast cosmesis and perceived late effects. Median diagnosis age was 48 years, and median current age 52 years. 'Excellent' cosmesis was reported by 27% (n = 88), 'Good' by 44% (n = 144), 'Fair' by 24% (n = 81), and 'Poor' by 5% (n = 18). Of the queries posted to survivors after BCT, late effects most commonly reported were cognitive changes (62%); sexual concerns (52%); changes in texture and color of irradiated skin (48%); chronic pain, numbness, or tingling (35%); and loss of flexibility in the irradiated area (30%). Survivors also described osteopenia/osteoporosis (35%), cardiopulmonary problems (12%), and lymphedema (19%). Conclusions: This anonymous tool uses a convenience sample frame to gather patient reported assessments of cosmesis and complications after breast cancer. Among the BCT population, cosmetic assessment by survivors appears less likely to be 'excellent' or 'good' than would be expected, with 30% of BCT survivors reporting 'fair' or

  15. Identification of treatments targeting PMLexpressing breast cancers

    OpenAIRE

    Insausti Urkia, Naroa

    2016-01-01

    The main aim of this project is to find a suitable ATO concentration to combine with already approved chemotherapeutic agents to find that synergistic effect in triple negative breast cancer MDA-MB 231 cell line, as a new strategy to treat the disease.

  16. Irradiation as Quarantine Treatment of Rambutan

    International Nuclear Information System (INIS)

    Eggs and larvae of Bactrocera dorsalis and Bactrocera correcta were investigated for their tolerant dose of irradiation. Artificially in feasted rambutans were irradiated at target doses of 0, 10, 20, 30, 40, 50 and 60 Gy. The results showed that the lowest dose that could inhibit adult emergence was 102.89 Gy for B. dorsalis and 97.61 Gy for B. correcta (P=0.999968, Probit 9). Larvae of B. dorsalis were irradiated at the dose

  17. Breast cancer treatment and sexual dysfunction: Moroccan women's perception

    Directory of Open Access Journals (Sweden)

    Ismaili Nabil

    2011-06-01

    Full Text Available Abstract Background This exploratory prospective study evaluated women's responses to questions that asked them to describe how their body image and sexual functioning had changed since their breast cancer diagnosis to treatment. Methods A questionnaire concerning body image scale and various sexual problems experienced after diagnosis and treatment was anonymously completed by 120 women in the outpatient clinic of our hospital's Division of medical Oncology. To be eligible, subjects had to be sexually active and had histology proven breast cancer. They also had to have received treatment for breast cancer. Results 100% of participants have never spoken with their doctor about this subject. 84% of the participants continued sexual activity after treatment, but there was an increase in the incidence of sexual functioning problems which resulted in a slight reduction in the quality of their sex lives. 65% of the women experienced dyspareunia followed by lubrication difficulties (54% and the absence or reduction of sexual desire (48% and 64%, respectively while, 37% had lack of satisfaction (37%. Female orgasmic disorder and brief intercourse and arousal were reported respectively by 40% and 38% of the subjects. The sexual dysfunctions were absent before diagnosis and management of breast cancer in 91.5% subjects and of these 100% subjects complained of a deterioration of the symptomatology after the various treatments. 90% of the dysfunctions were observed after chemotherapy, 9% after surgery and 3% after radiotherapy; none of the subjects indicated the onset of dysfunctions to have been associated with hormonotherapy. 100% expressed not having received sufficient information about how the disease and treatment (including surgery might affect their sexual life. Conclusion Breast cancer and its treatment may result in significant difficulties with sexual functioning and sexual life. Addressing these problems is essential to improve the quality of

  18. Cost of treatment for breast cancer in central Vietnam

    Directory of Open Access Journals (Sweden)

    Nguyen Hoang Lan

    2013-02-01

    Full Text Available Background: In recent years, cases of breast cancer have been on the rise in Vietnam. To date, there has been no study on the financial burden of the disease. This study estimates the direct medical cost of a 5-year treatment course for women with primary breast cancer in central Vietnam. Methods: Retrospective patient-level data from medical records at the Hue Central Hospital between 2001 and 2006 were analyzed. Cost analysis was conducted from the health care payers’ perspective. Various direct medical cost categories were computed for a 5-year treatment course for patients with breast cancer. Costs, in US dollars, discounted at a 3% rate, were converted to 2010 after adjusting for inflation. For each cost category, the mean, standard deviation, median, and cost range were estimated. Median regression was used to investigate the relationship between costs and the stage, age at diagnosis, and the health insurance coverage of the patients. Results: The total direct medical cost for a 5-year treatment course for breast cancer in central Vietnam was estimated at $975 per patient (range: $11.7–$3,955. The initial treatment cost, particularly the cost of chemotherapy, was found to account for the greatest proportion of total costs (64.9%. Among the patient characteristics studied, stage at diagnosis was significantly associated with total treatment costs. Patients at later stages of breast cancer did not differ significantly in their total costs from those at earlier stages however, but their survival time was much shorter. The absence of health insurance was the main factor limiting service uptake. Conclusion: From the health care payers’ perspective, the Government subsidization of public hospital charges lowered the direct medical costs of a 5-year treatment course for primary breast cancer in central Vietnam. However, the long treatment course was significantly influenced by out-of-pocket payments for patients without health insurance.

  19. A case of organizing pneumonia with a reversed halo sign following postoperative irradiation for breast cancer

    International Nuclear Information System (INIS)

    A 69-year-old woman received radiation therapy of 50 Gy following surgery for left breast cancer. Eleven months later, chest computed tomography revealed infiltrative shadows with air bronchograms in both lower lung fields and a reversed halo sign in the right lower lobe. Transbronchial lung biopsy revealed polypoid granulation tissue in the terminal air spaces, which was consistent with organizing pneumonia (OP). Prednisolone therapy resolved the radiographic abnormalities. The reversed halo sign was believed to be specific to cryptogenic organizing pneumonia. We reported a case of OP with a reversed halo sign following postoperative irradiation for breast cancer. (author)

  20. Clinicopathological classification and individualized treatment of breast cancer

    Institute of Scientific and Technical Information of China (English)

    HU Hui; LIU Yin-hua; XU Ling; ZHAO Jian-xin; DUAN Xue-ning; YE Jing-ming; LI Ting

    2013-01-01

    Background The clinicopathological classification was proposed in the St.Gallen Consensus Report 2011.We conducted a retrospective analysis of breast cancer subtypes,tumor-nodal-metastatic (TNM) staging,and histopathological grade to investigate the value of these parameters in the treatment strategies of invasive breast cancer.Methods A retrospective analysis of breast cancer subtypes,TNM staging,and histopathological grading of 213 cases has been performed by the methods recommended in the St.Gallen International Expert Consensus Report 2011.The estrogen receptor (ER),progesterone receptor (PR),human epidermal growth factor receptor-2 (HER2),and Ki-67 of 213 tumor samples have been investigated by immunohistochemistry according to methods for classifying breast cancer subtypes proposed in the St.Gallen Consensus Report 2011.Results The luminal A subtype was found in 53 patients (24.9%),the luminal B subtype was found in 112 patients (52.6%),the HER2-positive subtype was found in 22 patients (10.3%),and the triple-negative subtype was found in 26 patients (12%).Histopathological grade and TNM staging differed significantly among the four subtypes of breast cancer (P<0.001).Conclusion It is important to consider TNM staging and histopathological grading in the treatment strategies of breast cancer based on the current clinicopathological classification methods.

  1. Feasibility, efficacy and cosmetic effect of three-dimensional conformal external bean partial breast irradiation for the selected early stage breast cancer patients after breast-conserving surgery

    International Nuclear Information System (INIS)

    Objective: To explore the feasibility, efficacy and cosmetic effect of three-dimensional conformal external beam partial breast irradiation (EB-PBI) after breast-conserving surgery for the selected Chinese early stage breast cancer patients. Methods: From June 2003 to December 2010, Forty-four early stage breast cancer patients underwent underwent EB-PBI after breast-conserving surgery. Twenty patients had CT simulation scan in moderate deep inspiration breathing hold, and twenty-four patients in free breathing. EB-PBI was planned and delivered by three-dimensional conformal radiotherapy (3DCRT) with four non-coplanar beams. The prescribed dose was 3.40 Gy per fraction in thirty-nine patients and 3.85 Gy per fraction in five patients, twice per day at an interval of at least six hours, in five consecutive days. Results: The number of patients with follow up time of 2, 3 and 5 years were 39, 31 and 16, Grade 1 acute radiation-induced dermatitis was observed in 17 patients (39%) at three months. Cosmesis was good or excellent in all cases at six months after radiotherapy and in 95% cases at two years after radiotherapy. The 2-, 3- and 5- year local control rates were 100%, 99% and 94%, respectively. The 2-, 3-, and 5-year survival rates were all 100% and no metastases occurred. Conclusions: EB-PBI delivered by 3DCRT is feasible for selected Chinese early stage breast cancer patients after breast-conserving surgery. The cosmetic effect, local control rate and long-term survival rate are satisfactory, and acute radiation toxicity is very low. (authors)

  2. Breast cancer treatment and ethnicity in British Columbia, Canada

    Directory of Open Access Journals (Sweden)

    Barroetavena Maria

    2010-04-01

    Full Text Available Abstract Background Racial and ethnic disparities in breast cancer incidence, stage at diagnosis, survival and mortality are well documented; but few studies have reported on disparities in breast cancer treatment. This paper compares the treatment received by breast cancer patients in British Columbia (BC for three ethnic groups and three time periods. Values for breast cancer treatments received in the BC general population are provided for reference. Methods Information on patients, tumour characteristics and treatment was obtained from BC Cancer Registry (BCCR and BC Cancer Agency (BCCA records. Treatment among ethnic groups was analyzed by stage at diagnosis and time period at diagnosis. Differences among the three ethnic groups were tested using chi-square tests, Fisher exact tests and a multivariate logistic model. Results There was no significant difference in overall surgery use for stage I and II disease between the ethnic groups, however there were significant differences when surgery with and without radiation were considered separately. These differences did not change significantly with time. Treatment with chemotherapy and hormone therapy did not differ among the minority groups. Conclusion The description of treatment differences is the first step to guiding interventions that reduce ethnic disparities. Specific studies need to examine reasons for the observed differences and the influence of culture and beliefs.

  3. Combined modulated electron and photon beams planned by a Monte-Carlo-based optimization procedure for accelerated partial breast irradiation

    Science.gov (United States)

    Atriana Palma, Bianey; Ureba Sánchez, Ana; Salguero, Francisco Javier; Arráns, Rafael; Míguez Sánchez, Carlos; Walls Zurita, Amadeo; Romero Hermida, María Isabel; Leal, Antonio

    2012-03-01

    The purpose of this study was to present a Monte-Carlo (MC)-based optimization procedure to improve conventional treatment plans for accelerated partial breast irradiation (APBI) using modulated electron beams alone or combined with modulated photon beams, to be delivered by a single collimation device, i.e. a photon multi-leaf collimator (xMLC) already installed in a standard hospital. Five left-sided breast cases were retrospectively planned using modulated photon and/or electron beams with an in-house treatment planning system (TPS), called CARMEN, and based on MC simulations. For comparison, the same cases were also planned by a PINNACLE TPS using conventional inverse intensity modulated radiation therapy (IMRT). Normal tissue complication probability for pericarditis, pneumonitis and breast fibrosis was calculated. CARMEN plans showed similar acceptable planning target volume (PTV) coverage as conventional IMRT plans with 90% of PTV volume covered by the prescribed dose (Dp). Heart and ipsilateral lung receiving 5% Dp and 15% Dp, respectively, was 3.2-3.6 times lower for CARMEN plans. Ipsilateral breast receiving 50% Dp and 100% Dp was an average of 1.4-1.7 times lower for CARMEN plans. Skin and whole body low-dose volume was also reduced. Modulated photon and/or electron beams planned by the CARMEN TPS improve APBI treatments by increasing normal tissue sparing maintaining the same PTV coverage achieved by other techniques. The use of the xMLC, already installed in the linac, to collimate photon and electron beams favors the clinical implementation of APBI with the highest efficiency.

  4. Treatment of wound sepsis in irradiated mice

    International Nuclear Information System (INIS)

    The local and systemic effect of penicillin therapy, supplemented by immunoglobulins, and pentoxifylline on wounds infected by Staphylococcus aureus was evaluated in mice irradiated with 6.5 Gy 60Co γ-rays. Treatment with 62.5 mg/kg penicillin-G was administered for 10 days. Numbers of bacteria were significantly reduced from 7.3 (± 0.3) to 5.3 (± 0.4) log10 CFU/mg ± muscle in treated animals. Administration of immunoglobulin G i.v. or pentoxifylline i.p. alone, or in addition to penicillin-G, did not further reduce the number of bacteria. Increase in the dose of penicillin to 250 mg/kg decreased the number of bacteria more than 62.5 mg/kg. Bacteria were recovered from spleens and/or livers of all 13 untreated mice, and only in six of the 13 penicillin-treated mice (P<0.05). Penicillin therapy reduced the systemic spread of S. aureus. (author)

  5. A multipurpose irradiation plant for simultaneous treatment of different foods

    International Nuclear Information System (INIS)

    An industrial multipurpose irradiation plant with a particularly high effectiveness of radiation utilization is presented. The originality of this conceptual design consists of the simultaneous treatment of two products, which are separately irradiated to either high or low absorbed doses. A pneumatical transport system into appropriate channels with air mixing during irradiation has been proposed for the radappertization of granular animal feed, meanwhile a conventional truck-conveyor system has been suggested for the sprout inhibition treatment of potatoes. Moreover, potatoes pass through the irradiation cell twice at high and low level respectively. (author)

  6. Waste treatment by microwave and electron beam irradiation

    International Nuclear Information System (INIS)

    Comparative results obtained by applying separate and combined (successive and simultaneous) electron beam (EB) and microwave (MW) irradiation to waste treatment, such as food residuals (minced beef, wheat bran and wheat flour) and sewage sludge performed from a food industry wastewater treatment station (vegetable oil plant), are presented. The research results demonstrated that the simultaneous EB and MW irradiation produces the biggest reduction of microorganisms. The tests also demonstrated that the irradiation time and the upper limit of required EB absorbed dose, which ensures a complete sterilization effect, could be reduced by a factor of two by an additional use of MW energy to EB irradiation

  7. The national survey of breast cancer treatment pattern in Korea (1998): the use of breast-conserving treatment

    International Nuclear Information System (INIS)

    In order to improve the proper use of radiotherapy and breast-conserving treatment (BCT) in the management of breast cancer, current status of breast cancer treatment in Korea was surveyed nationwide and the use of BCT were evaluated. Patients characteristics and treatment pattern of 1048 breast cancer patients from 27 institutions diagnosed between January, 1998 and June, 1998 were analyzed. The incidence of receiving BCT was analyzed according to the stage, age, geography, type of hospital, and the availability of radiotherapy facility. Radical mastectomy was performed in 64.8% of total patients and 26% of patients received breast-conserving surgery (BCS). The proportions of patients receiving BCT were 47.5% in stage 0, 54.4% in stage I and 20.3% in stage II. Some of the patients (6.6% of stage I, 10.1% of stage II and 66.7% of stage III) not received radiotherapy after BCS. Only 45% of stage III patients received post-operative radiotherapy after radical mastectomy. The proportion of patients receiving BCT was different according to the geography and availability of radiotherapy facilities. Radiotherapy was not fully used in the management of breast cancer, even in the patients received breast-conserving surgery. The proportion of the patients who received BCT was lower than the report of western countries. To improve the application of proper management of breast cancer, every efforts such as a training of physicians, public education, and improving accessibility of radiotherapy facilities should be done. The factors predicting receipt of BCT were accessibility of radiotherapy facility and geography. Also, periodic survey like current research is warranted

  8. Integration of an irradiator at a wastewater treatment plant

    International Nuclear Information System (INIS)

    Gamma ray irradiation, as a Process to Further Reduce Pathogens (PFRP), can be easily integrated into a number of different sludge treatment process schemes where a Process to Significantly Reduce Pathogens (PSRP) is also provided. It is expected, however, that most applications of the irradiation process will be in conjunction with anaerobic digestion as the PSRP. Sludges dewatered by filter pressing or sand bed drying can be directly irradiated, while sludges dewatered by belt press, vacuum filter, and centrifugation will require further drying prior to irradiation. Operation and maintenance requirements for sludge irradiation appear relatively simple compared to a number of process units commonly found in wastewater treatment facilities. Specialized services required to monitor and maintain the irradiation source material will be provided by an outside contractor, eliminating contact by treatment plant personnel. In general, sludge irradiation presents a substantially lower risk to the health and safety of treatment plant personnel than do several other units and process operations normally found in wastewater treatment facilities. It is concluded that integration of the gamma ray sludge irradiator into a wastewater treatment facility poses no unusual difficulty

  9. Long-Term Efficacy and Patterns of Failure After Accelerated Partial Breast Irradiation: A Molecular Assay-Based Clonality Evaluation

    International Nuclear Information System (INIS)

    Purpose: To determine the long-term efficacy and cosmetic results of accelerated partial breast irradiation (APBI) by reviewing our institution's experience. Methods and Materials: A total of 199 patients with early-stage breast cancer were treated prospectively with adjuvant APBI after lumpectomy using interstitial brachytherapy. All patients had negative margins, 82% had Stage I disease, median tumor size was 1.1 cm, and 12% had positive lymph nodes. The median follow-up for surviving patients was 8.6 years. Fifty-three patients (27%) have been followed for ≥10 years. Results: Six ipsilateral breast tumor recurrences (IBTRs) were observed, for a 5-year and 10-year actuarial rate of 1.6% and 3.8%, respectively. A total of three regional nodal failures were observed, for a 10-year actuarial rate of 1.6%. Five contralateral breast cancers developed, for a 5- and 10-year actuarial rate of 2.2% and 5.2%, respectively. The type of IBTR (clonally related vs. clonally distinct) was analyzed using a polymerase chain reaction-based loss of heterozygosity assay. Eighty-three percent of IBTRs (n = 5) were classified as clonally related. Multiple clinical, pathologic, and treatment-related factors were analyzed for an association with the development of an IBTR, regional nodal failure, or contralateral breast cancer. On multivariate analysis, no variable was associated with any of these events. Cosmetic results were rated as excellent/good in 99% of patients. Conclusions: Long-term results with APBI using interstitial brachytherapy continue to demonstrate excellent long-term local and regional control rates and cosmetic results. According to a polymerase chain reaction-based loss of heterozygosity assay, 83% of recurrences were classified as clonally related

  10. Cosmetic evaluation of breast conserving treatment for mammary cancer. 2

    International Nuclear Information System (INIS)

    The effects on surgical treatment techniques, radiation doses and fraction sizes on cosmetic outcome were analysed in patients with stage I and II breast cancer treated with breast conserving surgery and a wide range of radiotherapy doses. The individual impact of different treatment parameters and patient-related factors was assessed by using both qualitative scoring and quantitative measurements. The validity of the system was tested by correlating the measurements with the subjective scoring, for each of the different factors assessed. (author). 23 refs; 9 figs.; 2 tabs

  11. Breast radiotherapy: an Australasian survey of current treatment techniques

    International Nuclear Information System (INIS)

    Prior to the dissemination of evidence-based quality assurance guidelines, the Australian National Breast Cancer Centre Radiation Oncology Group conducted a process survey of breast radiotherapy treatment delivery throughout Australia. A process survey was conducted in August/September 1998. This survey comprised questions enquiring about treatment positioning, immobilization devices used, planning strategies, simulation and dose computation methods, treatment prescribing and quality assurance. The survey was sent to 123 Australian fellows of the Royal Australian and New Zealand College of Radiologists (RANZCR) and to the six directors of New Zealand radiation oncology departments. Fifty-eight questionnaires were returned of which 38 were received from individuals and 20 represented a reply from a department with a routine breast radiotherapy protocol (representing an average of 4.5 radiation oncologists per reply). The study identified great consistency between departments with respect to dose and fractionation for breast tangents. The study also identified some areas of treatment planning and delivery that varied between individuals or departments. These mainly reflected a lack of evidence in some areas of radiotherapy treatment delivery. The circulation of quality assurance guidelines will perhaps improve consistency of radiotherapy techniques in which studies have identified that technique changes improve outcome. This study identified that these areas include the taking of simulation and port films and the use of off-axis dosimetry. Further studies are required for areas of radiotherapy treatment delivery that have little evidence for or against their implementation. Copyright (2001) Blackwell Science Pty Ltd

  12. Bevacizumab in the treatment of HER2-negative breast cancer

    Directory of Open Access Journals (Sweden)

    Vito Lorusso

    2008-11-01

    Full Text Available Vito LorussoOncologic Institute, Vito Fazzi Hospital, Lecce, ItalyAbstract: Angiogenesis has a clear and definite role in the breast cancer progression process, making antivascular endothelial growth factor (VEGF therapies an attractive option for the treatment of metastatic breast cancer (MBC. Bevacizumab is a potent humanized monoclonal antibody to VEGF, which has shown regression of breast cancer in preclinical and clinical setting, either alone or in combination with cytotoxic treatment. Additionally, bevacizumab potentially increases the effectiveness of other anticancer therapies through the normalization of tumor vasculature, reduction of intratumoral pressure and improved tumor oxygenation. Phase 1/2 trials showed significant antitumor effects of bevacizumab in MBC, in particular in tumors not expressing HER2 receptor. A first phase 3 trial in pre-treated MBC patients showed better response rates but no survival benefit from the addition of bevacizumab to capecitabine. However, in two phase 2 trial in first-line setting in patients with MBC, bevacizumab improved progression-free survival in combination with weekly paclitaxel in comparison to paclitaxel alone or in combination with 3-weekly docetaxel in comparison with docetaxel alone, respectively. Bevacizumab in combination with taxanes seems to be a highly effective first-line treatment for MBC patients. Future research will investigate bevacizumab in the neoadjuvant or adjuvant setting, where even more potential may exist for these patients.Keywords: bevacizumab, breast cancer, HER2, HER2-negative breast cancer

  13. Blood hemoglobin level and treatment outcome of early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Henke, M.; Sindlinger, F. [Dept. of Radiotherapy, Radiological Univ. Clinic, Freiburg (Germany); Ikenberg, H. [Dept. of Gynecology and Obstretics, Gynecological Univ. Clinic, Freiburg (Germany); Gerds, T.; Schumacher, M. [Inst. for Medical Biometry and Medical Informatics, Univ. Freiburg (Germany)

    2004-01-01

    Background and purpose: to determine whether the blood hemoglobin concentration correlates with the prognosis of patients with early breast cancer and, if so, whether this is restricted to treatment modality. Patients and methods: data were collected retrospectively from patients with early breast cancer (T1,2 NO-2 MO) who underwent either breast-conserving surgery followed by adjuvant radiotherapy (BCS-RT; n = 96) or a modified radical mastectomy (MRM; n = 194). The effect of preoperative blood hemoglobin level, nodal status, histological grading and hormone receptor status on disease-free survival was determined for both treatment modalities using a cox regression model and visualized by kaplan-meier plots. Results: the blood hemoglobin concentration significantly correlated with disease-free survival of patients receiving BCS-RT (relative risk [RR]: 0.67 per g/dl; p = 0.007). This was independent of other known risk factors for breast cancer patients, as determined by multivariate analysis. By contrast, the blood hemoglobin level had no prognostic significance when patients were treated with MRM. Conclusion: blood hemoglobin concentration seems to affect the prognosis of patients with early breast cancer when a treatment schedule that includes radiotherapy is applied. Reduced radiosensitivity due to diminished tumor oxygenation may be the underlying cause. Confirmative trials and studies intended to elucidate the underlying mechanism are warranted. (orig.)

  14. The role of neoadjuvant chemotherapy for breast cancer treatment.

    Science.gov (United States)

    Ikeda, Tadashi; Jinno, Hiromitsu; Matsu, Akira; Masamura, Shigeru; Kitajima, Masaki

    2002-01-01

    Neoadjuvant chemotherapy has become popular, especially for patients with advanced breast cancer. The pros and cons of neoadjuvant chemotherapy for treating breast cancer patients are reviewed. The advantages of neoadjuvant chemotherapy are 1) overall survival and recurrence-free survival rate are the same as post-operative chemotherapy, 2) serves as an in vivo sensitivity test, 3) increases the rate of breast conserving therapy, 4) facilitates the study of cancer biology. On the other hand, the disadvantages of neoadjuvant chemotherapy are 1) it modifies the stage, 2) treatment delay of PD cases, 3) residual intraductal component may be left behind after breast conserving surgery, 4) there are some cases of over-treatment. Combination chemotherapy is one possible way to increase the pathological CR rate, although the optimal order and cycles have not been determined. To avoid residual cancer cells after breast conserving surgery, the shrinkage pattern should be evaluated by MRI. Core needle biopsy should be performed before neoadjuvant chemotherapy to avoid over-treatment. It is essential to develop more effective regimens and stratify patients based on predictive factors. PMID:12196715

  15. Which techniques for an additional irradiation of the tumour bed in a breast cancer?

    International Nuclear Information System (INIS)

    The authors report a comparison of different techniques for an additional irradiation of the tumour bed, in terms of local control and aesthetic result in the case of a breast cancer. This additional irradiation has been delivered by electron beam in five fractions, high dose rate curie-therapy in two fractions, photon beam in five or six fractions, and low dose rate curie-therapy. The dose increase in the tumour bed allows the local control rate to be increased without compromising aesthetic results. However, the comparison of the different boost techniques does not reveal significant differences. Short communication

  16. Recent international developments regarding standardization of food irradiation treatment

    International Nuclear Information System (INIS)

    The recommendations of the Joint Expert Committee on Food Irradiation at its 1976 and 1979 meetings, published by WHO/FAO/IAEA in 1977 and 1980 are discussed in relation to the Recommended Codex International General Standard for Irradiated Food and the Recommended International Code of Practice for the Operation of Radiation Facilities Used for the Treatment of Foods, which are based on them. The texts of these documents are appended. The problem of labelling irradiated foods is discussed

  17. Accelerated partial breast irradiation using intensity-modulated radiotherapy technique compared to whole breast irradiation for patients aged 70 years or older: subgroup analysis from a randomized phase 3 trial

    OpenAIRE

    Meattini, Icro; Saieva, Calogero; Marrazzo, Livia; Di Brina, Lucia; Pallotta, Stefania; Mangoni, Monica; Meacci, Fiammetta; Bendinelli, Benedetta; Francolini, Giulio; Desideri, Isacco; De Luca Cardillo, Carla; Scotti, Vieri; Furfaro, Ilaria Francesca; Rossi, Francesca; Greto, Daniela

    2015-01-01

    The purpose of this study was to report the efficacy and the safety profile on the subset of selected early breast cancer (BC) patients aged 70 years or older from a single-center phase 3 trial comparing whole breast irradiation (WBI) to accelerated partial breast irradiation (APBI) using intensity-modulated radiation therapy technique. Between 2005 and 2013, 520 patients aged more than 40 years old were enrolled and randomly assigned to receive either WBI or APBI in a 1:1 ratio. Eligible pat...

  18. Cosmesis with bilateral mammoreduction for conservative breast cancer treatment.

    Science.gov (United States)

    Goffman, Thomas E; Schneider, Heather; Hay, Karen; Elkins, David E; Schnarrs, Robert A; Carman, Claire

    2005-01-01

    Over 7 years, 57 women with breast cancer underwent lumpectomy and bilateral mammoreduction. Physical complaints about large or lax breast shape were the predominate rationale. Two patients were immediately lost to follow-up, 55 patients remained and were followed every 3 months for an average of 1.6 years. This is the largest series traceable by computer and literature search. Chart review and patient examination in this retrospective review were utilized as the basis for data within the article. Collated notes from patients' doctors were assessed, as well as documented patient responses to the procedure. Pictures without head/face for identifiers were taken of the patients. Chart data were collected by clinicians, but were reviewed blindly by a statistician. The overall control and cosmesis rates as well as alleviation of heavy breast problems were noted. Only 6% of women had fair to poor cosmetic results; the majority (82%) had excellent to good results. Women with very large breasts or markedly relaxed breast tissue of concern to the patients proved optimal candidates for lumpectomy of cancer and bilateral mammoreduction in the conservative treatment of these cancers. There was a significant reduction in the physical complaints of the patients as well. For women with very pendulous or extremely large breasts, lumpectomy and bilateral mammoreduction may prove to be the optimal course of action. PMID:15871705

  19. Advancements of antisense oligonucleotides in treatment of breast cancer

    Institute of Scientific and Technical Information of China (English)

    YANGShuan-Ping; SONGSan-Tai; 等

    2003-01-01

    Breast cancer is one kind of multi-gene related malignancy.Overexpression of some oncogenes such as HER-2(c-erbB-2,Neu),bcl-2/bcl-xL,protein kinase A(PKA),and transferrin receptor gene(TfR gene),etc significantly affect the prognosis of breast cancer.It was shown that specific suppression of the overexpressed genes above resulted in the improvement of the therapy of breast cancer.Antisense interference.one of useful tools for inhibiting the overexpression of specific oncogenes,was involved in the therapy of breast cancer in recent years. Data indicated that antisense oligonucleotides(ON)could inhibit specially the expression of the target genes on mRNA or protein levels in most of cases;some ON candidates showed encouraging therapeutic effects in vitro and in vivo on breast cancer cell lines or xenografts.Furthermore,the combination use of the antisense ON and normal chemotherapeutic agents indicated synergistic antitumor effects,which was probably the best utilization of antisense ON in the treatment of breast cancer.

  20. The Role of Methylation in Breast Cancer Susceptibility and Treatment.

    Science.gov (United States)

    Pouliot, Marie-Christine; Labrie, Yvan; Diorio, Caroline; Durocher, Francine

    2015-09-01

    DNA methylation is a critical mechanism of epigenetic modification involved in gene expression programming, that can promote the development of several cancers, including breast cancer. The methylation of CpG islands by DNA methyltransferases is reversible and has been shown to modify the transcriptional activity of key proliferation genes or transcription factors involved in suppression or promotion of cell growth. Indeed, aberrant methylation found in gene promoters is a hallmark of cancer that could be used as non-intrusive biomarker in body fluids such as blood and plasma for early detection of breast cancer. Many biomarker genes have been evaluated for breast cancer detection. However, in the absence of a unique biomarker having the sufficient specificity and sensitivity, a panel of multiple genes should be used. Treatments targeting aberrant methylation by DNA methyltransferase inhibitors, which trigger re-expression of silenced genes, are now available and allow for better treatment efficiency. PMID:26254344

  1. Carboplatin treatment of antiestrogen-resistant breast cancer cells

    DEFF Research Database (Denmark)

    Larsen, Mathilde S; Yde, Christina Westmose; Christensen, Ib J;

    2012-01-01

    sensitivity to carboplatin, as it was previously shown with cisplatin, and whether low Bcl-2 expression levels have a potential value as marker for increased carboplatin sensitivity. Breast cancer cells resistant to the pure antiestrogen fulvestrant, and two out of four cell lines resistant to the...... antiestrogen tamoxifen, were more sensitive to carboplatin treatment compared to the parental MCF-7 cell line. This indicates that carboplatin may be an advantageous treatment in antiestrogen‑resistant breast cancer; however, a marker for increased sensitivity would be needed. Low Bcl-2 expression was...... combination with Bcl-xL and Bax, could explain the observed responses to carboplatin in all tamoxifen‑resistant cell lines, indicating that more markers are needed to predict the response to carboplatin in tamoxifen‑resistant breast cancer....

  2. The Treatment of Breast Cancer Using Liposome Technology

    Directory of Open Access Journals (Sweden)

    Sarah Brown

    2012-01-01

    Full Text Available Liposome-based chemotherapeutics used in the treatment of breast cancer can in principle enhance the therapeutic index of otherwise unencapsulated anticancer drugs. This is partially attributed to the fact that encapsulation of cytotoxic agents within liposomes allows for increased concentrations of the drug to be delivered to the tumor site. In addition, the presence of the phospholipid bilayer prevents the encapsulated active form of the drug from being broken down in the body prior to reaching tumor tissue and also serves to minimize exposure of the drug to healthy sensitive tissue. While clinically approved liposome-based chemotherapeutics such as Doxil have proven to be quite effective in the treatment of breast cancer, significant challenges remain involving poor drug transfer between the liposome and cancerous cells. In this review, we discuss the recent advancements made in the development of liposome-based chemotherapeutics with respect to improved drug transfer for use in breast cancer therapy.

  3. A planning comparison of 7 irradiation options allowed in RTOG 1005 for early-stage breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Guang-Pei, E-mail: gpchen@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Liu, Feng [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); White, Julia [Department of Radiation Oncology, The Ohio State University, Columbus, OH (United States); Vicini, Frank A. [Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, MI (United States); Freedman, Gary M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Arthur, Douglas W. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA (United States); Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States)

    2015-04-01

    This study compared the 7 treatment plan options in achieving the dose-volume criteria required by the Radiation Therapy Oncology Group (RTOG) 1005 protocol. Dosimetry plans were generated for 15 representative patients with early-stage breast cancer (ESBC) based on the protocol-required dose-volume criteria for each of the following 7 treatment options: 3D conformal radiotherapy (3DCRT), whole-breast irradiation (WBI) plus 3DCRT lumpectomy boost, 3DCRT WBI plus electron boost, 3DCRT WBI plus intensity-modulated radiation therapy (IMRT) boost, IMRT WBI plus 3DCRT boost, IMRT WBI plus electron boost, IMRT WBI plus IMRT boost, and simultaneous integrated boost (SIB) with IMRT. A variety of dose-volume parameters, including target dose conformity and uniformity and normal tissue sparing, were compared for these plans. For the patients studied, all plans met the required acceptable dose-volume criteria, with most of them meeting the ideal criteria. When averaged over patients, most dose-volume goals for all plan options can be achieved with a positive gap of at least a few tenths of standard deviations. The plans for all 7 options are generally comparable. The dose-volume goals required by the protocol can in general be easily achieved. IMRT WBI provides better whole-breast dose uniformity than 3DCRT WBI does, but it causes no significant difference for the dose conformity. All plan options are comparable for lumpectomy dose uniformity and conformity. Patient anatomy is always an important factor when whole-breast dose uniformity and conformity and lumpectomy dose conformity are considered.

  4. A new instrument for estimation of survival in elderly patients irradiated for metastatic spinal cord compression from breast cancer

    International Nuclear Information System (INIS)

    Elderly patients become more important in oncology. In this group, personalized treatment approaches taking into account survival prognoses and comorbidities play a major role. Predictive instruments are necessary to estimate the survival of elderly cancer patients. The importance of separate instruments for different tumor entities has been recognized. In this study, an instrument was generated to estimate the survival of elderly patients developing metastatic spinal cord compression (MSCC) from breast cancer. In 218 elderly patients (age ≥65 years) irradiated for MSCC from breast cancer, nine factors were evaluated for survival: fractionation regimen, age, time from breast cancer diagnosis to RT of MSCC, visceral metastases, other bone metastases, time developing motor deficits, pre-radiotherapy ambulatory status, number of involved vertebrae, and Eastern Cooperative Oncology Group (ECOG) performance score. Factors significantly associated with survival in the Cox regression analysis were included in the prognostic instrument. Scores for each factor were calculated by dividing the 6-months survival rates by 10. The sums of these scores represented the patients’ scores. On multivariate analyses, visceral metastases (p < 0.001), time developing motor deficits (p < 0.001), ambulatory status (p < 0.001), number of involved vertebrae (p = 0.032), and ECOG performance score (p < 0.001) were significant and included in the prognostic instrument. Based on the patients’ scores, three groups were designed: 18–27 points, 28–39 points and 40–42 points. Six-months survival rates were 4, 62 and 100 %, respectively (p < 0.001). This new instrument contributes to personalized treatment in elderly patients with MSCC from breast cancer by predicting an individual patient’s survival prognosis

  5. Image Enhancement by Microwave Double Irradiation for Early Diagnosis of Breast Carcinoma

    OpenAIRE

    T. V. PADMAVATHY; S. Muttan; Punal M. Arabi

    2011-01-01

    Cancer is the uncontrolled growth of abnormal cells; if not detected and treated at the early stage cancer would become fatal. Early detection of the disease increases the survival rate. Though there are several diagnostic methods, each method is having its own merits and demerits. In this study, a method of obtaining an active thermo gram by irradiating the patients breast twice using a microwave source of 2450 MHz and allowing them to cool naturally after every radiation is proposed. Result...

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  7. Late effects and cosmetic results of conventional versus hypofractionated irradiation in breast-conserving therapy

    International Nuclear Information System (INIS)

    Background and purpose: breast irradiation after lumpectomy is an integral component of breast-conserving therapy (BCT). As the prognosis is general good following BCT, late morbidity and cosmesis are important. The present study compares two different radiation schedules with respect to these two endpoints. Patients and methods: 129 breast cancer patients (pT1-2 pN0-1 cM0) were irradiated between 09/1992 and 08/1994 with either a 22-day fractionation schedule (2.5 Gy to 55 Gy, 4 x /week, n = 65) or with a conventional fractionation schedule (28 days, 2.0 Gy to 55 Gy, 5 x /week, n = 64), both without additional boost. The equivalent dose of 2-Gy fractions (EQD2) was 55 Gy and 62 Gy, respectively. Late toxicity, assessed according to the LENT-SOMA criteria, and cosmetic outcome, graded on a 5-point scale, were evaluated after a median of 86 months (range 72-94 months) in tumor-free breast cancer patients. Results: LENT-SOMA grade 2/3 toxicity (2.5 Gy vs. 2.0 Gy): breast pain (18% vs. 11%; p = 0.3), fibrosis (57% vs. 16%; p < 0.001), telangiectasia (22% vs. 3%; p = 0.002), atrophy (31% vs. 3%; p < 0.001). Medication to breast pain was taken by 8% versus 9% of patients. Cosmesis was very good/good/acceptable in 75% versus 93% (2.5 Gy vs. 2.0 Gy; p = 0.006). Conclusion: late morbidity was significantly frequent and cosmesis was significantly worse after hypofractionated radiotherapy (2.5 Gy to 55 Gy). However, morbidity was not associated with major implications on daily life. (orig.)

  8. Late effects and cosmetic results of conventional versus hypofractionated irradiation in breast-conserving therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fehlauer, F.; Tribius, S.; Alberti, W.; Rades, D. [Dept. of Radiation Oncology, Univ. Medical Clinic Hamburg-Eppendorf, Hamburg (Germany)

    2005-10-01

    Background and purpose: breast irradiation after lumpectomy is an integral component of breast-conserving therapy (BCT). As the prognosis is general good following BCT, late morbidity and cosmesis are important. The present study compares two different radiation schedules with respect to these two endpoints. Patients and methods: 129 breast cancer patients (pT1-2 pN0-1 cM0) were irradiated between 09/1992 and 08/1994 with either a 22-day fractionation schedule (2.5 Gy to 55 Gy, 4 x /week, n = 65) or with a conventional fractionation schedule (28 days, 2.0 Gy to 55 Gy, 5 x /week, n = 64), both without additional boost. The equivalent dose of 2-Gy fractions (EQD2) was 55 Gy and 62 Gy, respectively. Late toxicity, assessed according to the LENT-SOMA criteria, and cosmetic outcome, graded on a 5-point scale, were evaluated after a median of 86 months (range 72-94 months) in tumor-free breast cancer patients. Results: LENT-SOMA grade 2/3 toxicity (2.5 Gy vs. 2.0 Gy): breast pain (18% vs. 11%; p = 0.3), fibrosis (57% vs. 16%; p < 0.001), telangiectasia (22% vs. 3%; p = 0.002), atrophy (31% vs. 3%; p < 0.001). Medication to breast pain was taken by 8% versus 9% of patients. Cosmesis was very good/good/acceptable in 75% versus 93% (2.5 Gy vs. 2.0 Gy; p = 0.006). Conclusion: late morbidity was significantly frequent and cosmesis was significantly worse after hypofractionated radiotherapy (2.5 Gy to 55 Gy). However, morbidity was not associated with major implications on daily life. (orig.)

  9. Irradiation in combination of heat treatment of mango puree

    International Nuclear Information System (INIS)

    The effect of irradiation with heat combination treatment on the shelf life and quality of mango puree was studied. Thermal inactivation of polyphenol oxidase enzyme at 80 degree C and 15 min. was used as a measure of adequacy of pre-heat treatment. Irradiation of mango puree after heat treatment at dosage of 0, 2, 4, 6 and 8 kGy showed no change in mc, pH, acidity, and TSS but during storage, growth of microorganisms brought changes in these values. Irradiation in combination with low temperature (5 degree C) reduced discoloration and darkening rate during storage. Irradiation dose from 0 to 8 kGy resulted in log linear reductions in microorganism levels but at 6 and 8 kGy, there was no growth of microorganisms. Products irradiated at 8 kGy showed no microorganism growth at both temperatures

  10. Sludge disinfection by combined treatment of bleaching powder and irradiation

    International Nuclear Information System (INIS)

    Sludge disinfection by combined treatment of bleaching powder and irradiation. Disinfection of sludge by combined treatment of bleaching powder and irradiation has been investigated. Sludge were obtained from water and waste sanitation department (Dinas Kebersihan) DKI located at Kebon Nanas, Jakarta. Sludge were mixed with bleaching powder at the concentration of 0, 10 and 20 mg/l and then irradiated in multipurpose panoramic batch irradiator (PANBIT) with doses of 2, 4, 6, 8, and 10 kGy and a dose rate 9 kGy/h. The reducing colony form unit caused by the combined treatment depend on type bacteria observed in sludge. Pathogenic bacteria as Clostridium still survive at a dose of 10 kGy on sludge containing 20 mg/l bleaching powder, but Salmonella, Shigella, and Vibrio were not detected in this experiment, neither in the control nor in the irradiated samples. (author). 14 refs.; 4 figs

  11. Can loco-regional irradiation be a routine supplement to high dose chemotherapy with autologous bone marrow transplant in women with poor prognosis breast cancer

    International Nuclear Information System (INIS)

    Purpose: High dose chemotherapy followed by bone marrow transplantation (BMT) is currently being performed in many women with localized, poor prognosis breast cancer. The purpose of this study was to examine patterns of care in radiation treatment as well as acute side effects in women who received breast or chest wall and regional nodal irradiation (XRT) post BMT. Methods: The records of 126 consecutive women with localized, poor prognosis breast cancer who received an autologous BMT at Emory University between (3(90)) and (7(96)) were retrospectively reviewed. Results: All 126 women underwent high dose chemotherapy with cyclophosphamide, carboplatinum and thiotepa followed by BMT. Loco - regional XRT after BMT was routinely recommended for patients with 10 or more positive axillary lymph nodes or inflammatory carcinoma. Overall, 90 patients received local +/- regional XRT; 11 patients prior to BMT and 79 patients post BMT. Three of these patients had a local relapse prior to beginning XRT post BMT. Thirty six patients did not receive XRT for the following reasons: major post BMT morbidity or insufficient hematological recovery (15 patients), less than 10 positive axillary lymph nodes (12 patients), or refusal/not referred (9 patients). Therefore, of the 103 patients (excludes those with less than 10 positive nodes) intended to receive post BMT irradiation, 14.5 % (15 patients- 2 with inflammatory carcinoma) were unable to receive it secondary to post BMT morbidity and 9% (9 patients) refused or were not referred. Of these 79 patients irradiated post BMT, 16 had stage IIA, 20 stage IIB, 27 stage IIIA and 16 inflammatory carcinoma (IIIB). The median time from transplant to irradiation was 82 days (range 44 - 641). Average dose to breast or chest wall was 49.5 Gy (range 42-55.8 Gy). Boost dose (mean 12 Gy, range 10-22 Gy) was given in 62% of patients. The median tumor bed/mastectomy scar dose was 60 Gy (range 42-72 Gy). Supraclavicular, posterior axillary and

  12. Decrease of the lumpectomy cavity volume after whole-breast irradiation affects small field boost planning

    International Nuclear Information System (INIS)

    To determine whether small field boost (SFB) replanning is necessary when the lumpectomy cavity (LPC) decreases during whole-breast irradiation (WBI) and what parameters might predict a change in the SFB plan. Forty patients had computed tomography (CT) simulation (CT1) within 60 days of surgery and were resimulated (CT2) after 37.8–41.4 Gy for SFB planning. A 3-field photon plan and a single en face electron plan were created on both CTs and compared. In the 26 patients who had a ≥5 cm3 and a ≥25% decrease in lumpectomy cavity volume (LCV) between CT scans, the SFB plan using photons was different in terms of normal breast tissue volume irradiated (BTV) (p 3 and a ≥25% decrease in LCV during WBI. Some patients may benefit from electron SFB replanning but no tested characteristics reliably predict those who may benefit the most. The amount of BTV irradiated is less with electrons than in photon plans and this has the potential to improve cosmesis, a clinically important outcome in breast-conserving therapy.

  13. 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.

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

    International Nuclear Information System (INIS)

    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

  15. Postoperative beta irradiation in the treatment of pterygium

    International Nuclear Information System (INIS)

    High recurrence rates are reported after surgical treatment of ptergyia. With the use of beta irradiation, the recurrence rate drops dramatically. This paper describes technic and dosage used in a group of patients receiving postoperative beta irradiation. Two thirds of these patients, however, had at least two surgical procedures. A recurrence rate of 3.5% was observed, with no apparent morbidity

  16. Pregnancy after treatment of breast cancer--a population-based study on behalf of Danish Breast Cancer Cooperative Group

    DEFF Research Database (Denmark)

    Kroman, N.; Jensen, M.B.; Wohlfahrt, J.;

    2008-01-01

    after breast cancer treatment. The present study is a ten-year update. MATERIAL AND METHODS: Danish Breast Cancer Cooperative Group has since 1977 collected population-based data on tumour characteristics, treatment regimes, and follow-up status on Danish women with breast cancer. Pregnancy history was...... added from the Danish Civil Registration System, the National Birth Registry, and the National Induced Abortion registry. Cox regression was used to estimate the risk ratio of dying among women with a pregnancy after breast cancer treatment compared with women without such experience. RESULTS: In all......, 10 236 women with primary breast cancer aged 45 years or less at the time of diagnosis were followed for 95 616 person years. Among these, 371 women experienced pregnancy after treatment of breast cancer. In a multivariate analysis that included age at diagnosis, stage of disease, and pregnancy...

  17. Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution

    International Nuclear Information System (INIS)

    Purpose: To evaluate postradiation regional heart perfusion changes with single photon emission tomography (SPECT) myocardial perfusion imaging in 69 patients treated with tangential photon beams radiation therapy (RT) for left-sided breast cancer. To correlate SPECT changes with percent irradiated left ventricle (LV) volume and risk factors for coronary artery disease (CAD). Methods and Materials: Rest SPECT of the LV was acquired pre-RT and at 6-month intervals post-RT. The extent of defects (%) with a severity > 1.5 standard deviations below the mean was quantitatively analyzed for the distributions of the left anterior descending (LAD) artery, left circumflex (LCX) artery, and right coronary artery (RCA) based on computer assisted polar map reconstruction (i.e., bull's-eye-view). Changes in perfusion were correlated with percent irradiated LV receiving > 25 Gy (range 0-32%). Data on patient- and treatment-related factors were collected prospectively (e.g., cardiac premorbidity, risk factors for CAD, chemotherapy, and hormonal treatment). Results: In the LAD distribution, there were increased perfusion defects at 6 months (median 11%; interquartile range 2-23) compared with baseline (median 5%; interquartile range 1-14) (p<0.001). There were no increases in perfusion defects in the LCX or RCA distributions. In multivariate analysis, the SPECT perfusion changes in the LAD distribution at 6 months were independently associated with percent irradiated LV (p<0.001), hormonal therapy (p=0.005), and pre-RT hypercholesterolemia (p=0.006). The SPECT defects in the LAD distribution at 12 and 18 months were not statistically different from those at 6 months. The perfusion defects in the LAD distribution were limited essentially to the regions of irradiated myocardium. Conclusion: Tangential photon beam RT in patients with left-sided breast cancer was associated with short-term SPECT defects in the vascular distribution corresponding to the radiation portals. Factors

  18. Profile of palbociclib in the treatment of metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    Ehab M

    2016-05-01

    Full Text Available Moataz Ehab,1 Mohamad Elbaz2,31Department of Pharmacy Practice, 2Department of Pharmacology, Pharmacy School, Helwan University, Egypt; 3Department of Pathology, The Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, USAAbstract: Breast cancer is the most common cancer diagnosed in women. Each year, thousands die either because of disease progression or failure of treatment. Breast cancer is classified into different subtypes based on the molecular expression of estrogen receptor (ER, progesterone receptor, and/or human epidermal growth factor receptor 2 (HER2. These receptors represent important therapeutic targets either through monoclonal antibodies or through small-molecule inhibitors directed toward them. However, up to 40% of patients develop either a primary or a secondary resistance to the current treatments. Therefore, there is an urgent need for investigating new targets in order to overcome the resistance and/or enhance the current therapies. Cell cycle is altered in many human cancers, especially in breast cancer. Cyclin-dependent kinases (CDKs, especially CDK4 and CDK6, play a pivotal role in cell cycle progression that makes them potential targets for new promising therapies. CDK inhibition has shown strong antitumor activities, ranging from cytostatic antiproliferative effects to synergistic effects in combination with other antitumor drugs. In order to overcome the drawbacks of the first-generation CDK inhibitors, recently, new CDK inhibitors have emerged that are more selective to CDK4 and CDK6 such as palbociclib, which is the most advanced CDK4/6 inhibitor in trials. In preclinical studies, palbociclib has shown a very promising antitumor activity, especially against ERα+ breast cancer subtype. Palbociclib has gained world attention, and US the Food and Drug Administration has accelerated its approval for first-line treatment in combination with letrozole for the first-line systematic

  19. Three-dimensional scapulothoracic motion following treatment for breast cancer

    OpenAIRE

    2008-01-01

    Abstract Varying levels of shoulder morbidity following treatment for breast cancer have been reported. Patients report pain, weakness, tightness and reduced functional capacity. Normal painfree motion of the arm and shoulder requires mobility in the scapulothoracic, glenohumeral, acromioclavicular and sternoclavicular joints. Under healthy conditions elevation of the arm is accompanied by scapula retraction, lateral rotation and posterior tilt. However, when scapuloth...

  20. Irradiation quarantine treatments for mango seed weevil and Cryptophlebia spp

    International Nuclear Information System (INIS)

    Irradiation was explored as a method to prevent adult emergence in, or to sterilize, mango seed weevil. Mixed-age mango seed weevils in mangoes were irradiated with target doses of 50, 100, or 300 Gy and held for adult emergence. The 300 Gy treatment (dose range 180-310 Gy) did not prevent adult emergence. Emerging adults from the 100 and 300 Gy treatments were lethargic and short-lived, and laid no eggs indicating sterility. An irradiation quarantine treatment (300 Gy) to sterilize mango seed weevil in mangoes has been approved. This treatment opens U.S. mainland markets to mango exports from Hawaii. Cryptophlebia illepida (Butler) and C. ombrodelta (Lower) (Lepidoptera: Tortricidae) are quarantine pests that attack lychee, longan, rambutan, mangoes and other fruits in Hawaii. Studies were undertaken to determine whether irradiation treatment at 250 Gy, an accepted treatment for disinfestation of fruit flies in tropical fruits from Hawaii, would also control the two Cryptophlebia species (Follett and Lower 2000). C. illepida was determined to be more tolerant of irradiation than C. ombrodelta and so C. illepida was used in detailed tests. Using the criterion of success in developing to the adult stage, the pattern of tolerance to irradiation in C. illepida was generally eggs< early instars< late instars< pupae. The most tolerant stage that could potentially occur in harvested fruits is the late (fourth and fifth) instar. No C. illepida larvae receiving an irradiation dose ≥125 Gy and emerging as adults produced viable eggs, indicating sterility can be achieved at doses <250 Gy. Large-scale tests in which 11,256 late instars were irradiated with a target dose of 250 Gy resulted in a pupation rate of only 8.4% and no adult eclosion. Therefore, the irradiation quarantine treatment of a minimum absorbed dose of 250 Gy approved for Hawaii's fruit flies will effectively disinfest fruits of any Cryptophlebia in addition to fruit flies. (author)

  1. First results of the preoperative accelerated partial breast irradiation (PAPBI) trial

    International Nuclear Information System (INIS)

    Background and purpose: The aim of this study is to assess the toxicity and cosmetic outcome of preoperative accelerated partial breast irradiation (PAPBI) for breast cancer patients with low risk on local recurrence. Material and methods: Women aged ⩾60 years with an invasive, unifocal ⩽3 cm on MRI, (non-lobular) adenocarcinoma of the breast and a negative sentinel node received PAPBI (40 Gray in 10 fractions over 2 weeks). Six weeks after radiotherapy a wide local excision was performed. Results: 70 patients with a median follow-up of 23 months (3–44 months) were evaluated. The overall postoperative infection rate was 11%. At 1, 2 and 3 years of follow-up respectively 89%, 98% and 100% of patients had no or mild induration-fibrosis. Fibrosis was only found in a small volume of the breast. The global cosmetic outcome was good to excellent in 77% at 6 months to 100% at 3 years. Two patients developed a local recurrence. Conclusion: Our first results show limited fibrosis in a small volume and good to excellent cosmetic outcome. In selected patients, preoperative radiotherapy appears to be a good option for breast conserving therapy

  2. Papillary endothelial hyperplasia arising in the irradiated breast: A diagnostic dilemma.

    Science.gov (United States)

    Khazai, Laila; Chau, Alec; Hoover, Susan; Rosa, Marilin

    2016-07-01

    Papillary endothelial hyperplasia (PEH) is a benign proliferative lesion that may occur in any site of the body, but most commonly affects the skin and subcutaneous tissues. In the breast, PEH has been documented but is rare. PEH is notorious for being misdiagnosed as angiosarcoma due to its complex growth pattern, papillary processes and interlacing vascular channels. The occurrence of PEH years after breast irradiation constitutes a pathological and clinical diagnostic challenge because angiosarcoma is far more common in this setting. The most important features that differentiate papillary endothelial hyperplasia from angiosarcoma are its presentation as a round nodule without infiltrative borders, its localization inside a vessel or in association with thrombus, and the lack of significant cytologic atypia or areas of solid growth, even in the presence of a complex architecture. Clinical history and site of involvement (cutaneous versus parenchymal) are usually of help to establish a correct diagnosis. Herein, we describe two cases of PEH presenting in patients with history of breast carcinoma and breast radiation therapy. The clinical and morphological features as well as the differential diagnoses are discussed. To our knowledge, no other cases of PEH of the breast occurring in the post-radiation setting have been described in the literature. PMID:27157404

  3. Treatment outcomes of occult breast carcinoma and prognostic analyses

    Institute of Scientific and Technical Information of China (English)

    WANG Jing; ZHANG Ye-fan; WANG Xin; WANG Jian; YANG Xue; GAO Yin-qi; FANG Yi

    2013-01-01

    Background The surgical management of occult breast cancer is controversial.We compared the outcomes of different treatments of occult breast cancer and evaluated the potential prognostic factors for overall survival and recurrence.Methods We retrospectively reviewed 77 patients who presented to our hospital from 1968 to 2011 with a diagnosis of occult breast cancer.Patients were divided into three groups:42 patients (63%) were treated with modified radical mastectomy+axillary lymph node dissection (ALND),16 patients (24%) were treated with ALND+postoperative radiotherapy,and 9 patients (13%) with only ALND.Survival analyses were undertaken to compare the efficacy of these three treatments.Results Of the 77 patients with occult breast cancer,2 patients were lost to follow-up and 8 patients refused surgical treatment:67 patients (90.4%) were included in this analysis.The median follow-up was 62.2 (0.6-328.0)months.Kaplan-Meier analyses showed no significant difference in overall survival and recurrence-free survival between the three groups (P=0.494 and 0.397,respectively).The prevalence of local recurrence was 11.9% for the mastectomy+ALND,18.8% for ALND+radiotherapy,and 11.1% for ALND-only groups,and those for distant recurrence were 2.4%,12.5%,and 11.1%,respectively.Compared with progesterone receptor-negative subjects,progesterone receptor-positive patients had better overall survival and lower recurrence rates (P=0.057 and 0.062,respectively).Conclusions There was no significant difference in outcomes between mastectomy and breast-preserving surgery.Expression of the progesterone receptor should be taken into account when evaluating the prognosis of occult breast cancer.

  4. Loco-regional recurrences after mastectomy in breast cancer: prognostic factors and implications for postoperative irradiation

    International Nuclear Information System (INIS)

    Purpose: Potential risk factors including DNA flow cytometric-derived parameters predicting loco-regional recurrence (LRR) in early breast cancer were investigated.Materials and methods: This study included 608 patients treated by modified radical mastectomy between 1982 and 1987. Recommendations regarding local treatment as well as adjuvant systemic therapy did not change during this period. Patients treated by adjuvant chemotherapy were randomized to receive additional medroxyprogesterone acetate (MPA) treatment. Only 59 (10%) patients received postoperative irradiation (XRT) to the chest wall and/or axillary lymph nodes; another 121 (20%) patients received XRT to the internal mammary nodes because of centromedially located tumours.Results: Patients were followed for a median period of 7.5 years. The event-free survival at 10 years was 50%. The cumulative incidence rate of LRR at 10 years was 18% (n=93), either with (n=30) or without (n=63) concurrent distant metastases. The chest wall, regional lymph nodes or both were involved in 41 (44%), 38 (41%) and 12 (13%) patients, respectively. Multivariate analysis according to the Cox model revealed two factors associated with LRR, i.e. pT (P<0.05) and nodal status (P<0.0510%) and low risk (<10%) group for LRR could be identified.Conclusions: Results indicate that T-stage and nodal status, combined with ECE, may help to identify patients at risk for loco-regional recurrence, whereas DNA flow cytometry does not. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  5. Therapeutic Electromagnetic Field (TEMF and gamma irradiation on human breast cancer xenograft growth, angiogenesis and metastasis

    Directory of Open Access Journals (Sweden)

    Hardman W Elaine

    2005-07-01

    Full Text Available Abstract Background The effects of a rectified semi-sinewave signal (15 mT amplitude, 120 pulses per second, EMF Therapeutics, Inc. (TEMF alone and in combination with gamma irradiation (IR therapy in nude mice bearing a human MDA MB231 breast cancer xenograft were tested. Green fluorescence protein transfected cancer cells were injected into the mammary fat pad of young female mice. Six weeks later, mice were randomly divided into four treatment groups: untreated controls; 10 minute daily TEMF; 200 cGy of IR every other day (total 800 cGy; IR plus daily TEMF. Some mice in each group were euthanized 24 hours after the end of IR. TEMF treatment continued for 3 additional weeks. Tumor sections were stained for: endothelial cells with CD31 and PAS or hypoxia inducible factor 1α (HIF. Results Most tumors 3 were white but tumors >35 mm3 were pink and had a vascularized capsule. The cortex within 100 microns of the capsule had little vascularization. Blood vessels, capillaries, and endothelial pseudopods were found at >100 microns from the capsule (subcortex. Tumors >35 mm3 treated with IR 24 hours previously or with TEMF had decreased blood vessels in the subcortex and more endothelial pseudopods projecting into hypoxic, HIF positive areas than tumors from the control group. Mice that received either IR or TEMF had significantly fewer lung metastatic sites and slower tumor growth than did untreated mice. No harmful side effects were attributed to TEMF. Conclusion TEMF therapy provided a safe means for retarding tumor vascularization, growth and metastasis.

  6. Effect of adjuvant systemic treatment on cosmetic outcome and late normal-tissue reactions after breast conservation

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, Joergen [Dept. of Oncology, Odense Univ. Hospital, Odense (Denmark); Overgaard, Jens [Dept. of Experimental Clinical Oncology, Danish Cancer Society, Aarhus (Denmark); Overgaard, Marie [Dept. of Oncology, Aarhus Univ. Hospital, Aarhus (Denmark)

    2007-05-15

    To investigate whether adjuvant treatment with CMF or tamoxifen predisposes to an unfavorable cosmetic outcome or increased breast morbidity after radiotherapy in breast conservation. Data from 266 patients who entered a randomized breast conservation trial (DBCG-82TM protocol) was analyzed. The patients were treated with lumpectomy and axillary dissection followed by external beam radiotherapy to the residual breast. High-risk patients (n 94), as well as 31 low-risk patients, received additional radiation to the regional lymph nodes. Adjuvant systemic treatment was given to all high-risk patients: premenopausal patients (n = 67) received eight cycles of CMF intravenously (600/40/600 mg/m{sup 2}) every fourth week; postmenopausal patients (n = 27) received 30 mg of tamoxifen daily for one year. Clinical assessments included cosmetic outcome, breast fibrosis, skin telangiectasia, and dyspigmentation which were scored on a 4-point categorical scale after median 6.6 years. The observations were analyzed in multivariate logistic regression analysis which included potential risk factors on outcome related to systemic treatment, surgery, radiation technique, tumor, and patient characteristics. In premenopausal patients, systemic treatment with CMF independently predicted a fair/poor cosmetic outcome, RR = 2.2 (95% CI 1.2-4.2), as well as increased skin telangiectasia, RR = 3.3 (1.4-8.2). There was no impact of tamoxifen treatment on cosmetic outcome in postmenopausal patients (p 0.32). However, univariate analysis showed that tamoxifen was significantly associated with breast fibrosis (p <0.004), as was radiation to the regional lymph nodes (p <0.0001). A strong interaction between axillary irradiation and tamoxifen treatment occurred since 26 of 27 high-risk postmenopausal patients had received both tamoxifen and axillary irradiation. In multivariate regression analysis, axillary irradiation independently predicted moderate/severe breast fibrosis with a relative risk of

  7. Effect of adjuvant systemic treatment on cosmetic outcome and late normal-tissue reactions after breast conservation

    International Nuclear Information System (INIS)

    To investigate whether adjuvant treatment with CMF or tamoxifen predisposes to an unfavorable cosmetic outcome or increased breast morbidity after radiotherapy in breast conservation. Data from 266 patients who entered a randomized breast conservation trial (DBCG-82TM protocol) was analyzed. The patients were treated with lumpectomy and axillary dissection followed by external beam radiotherapy to the residual breast. High-risk patients (n 94), as well as 31 low-risk patients, received additional radiation to the regional lymph nodes. Adjuvant systemic treatment was given to all high-risk patients: premenopausal patients (n = 67) received eight cycles of CMF intravenously (600/40/600 mg/m2) every fourth week; postmenopausal patients (n = 27) received 30 mg of tamoxifen daily for one year. Clinical assessments included cosmetic outcome, breast fibrosis, skin telangiectasia, and dyspigmentation which were scored on a 4-point categorical scale after median 6.6 years. The observations were analyzed in multivariate logistic regression analysis which included potential risk factors on outcome related to systemic treatment, surgery, radiation technique, tumor, and patient characteristics. In premenopausal patients, systemic treatment with CMF independently predicted a fair/poor cosmetic outcome, RR = 2.2 (95% CI 1.2-4.2), as well as increased skin telangiectasia, RR = 3.3 (1.4-8.2). There was no impact of tamoxifen treatment on cosmetic outcome in postmenopausal patients (p 0.32). However, univariate analysis showed that tamoxifen was significantly associated with breast fibrosis (p <0.004), as was radiation to the regional lymph nodes (p <0.0001). A strong interaction between axillary irradiation and tamoxifen treatment occurred since 26 of 27 high-risk postmenopausal patients had received both tamoxifen and axillary irradiation. In multivariate regression analysis, axillary irradiation independently predicted moderate/severe breast fibrosis with a relative risk of 5

  8. 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.

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

    International Nuclear Information System (INIS)

    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 (P75% 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 conventional WBI

  10. The in vitro immunogenic potential of caspase-3 proficient breast cancer cells with basal low immunogenicity is increased by hypofractionated irradiation

    International Nuclear Information System (INIS)

    Radiotherapy is an integral part of breast cancer treatment. Immune activating properties of especially hypofractionated irradiation are in the spotlight of clinicians, besides the well-known effects of radiotherapy on cell cycle and the reduction of the clonogenic potential of tumor cells. Especially combination of radiotherapy with further immune stimulation induces immune-mediated anti-tumor responses. We therefore examined whether hypofractionated irradiation alone or in combination with hyperthermia as immune stimulants is capable of inducing breast cancer cells with immunogenic potential. Clonogenic assay, AnnexinA5-FITC/Propidium iodide assay and ELISA analyses of heat shock protein 70 and high mobility group box 1 protein were applied to characterize colony forming capability, cell death induction, cell death forms and release of danger signals by breast cancer cells in response to hypofractionated radiation (4x4Gy, 6x3Gy) alone and in combination with hyperthermia (41.5 °C for 1 h). Caspase-3 deficient, hormone receptor positive, p53 wild type MCF-7 and caspase-3 intact, hormone receptor negative, p53 mutated MDA-MB231 breast cancer cells, the latter in absence or presence of the pan-caspase inhibitor zVAD-fmk, were used. Supernatants of the treated tumor cells were analyzed for their potential to alter the surface expression of activation markers on human-monocyte-derived dendritic cells. Irradiation reduced the clonogenicity of caspase deficient MCF-7 cells more than of MDA-B231 cells. In contrast, higher amounts of apoptotic and necrotic cells were induced in MDA-B231 cells after single irradiation with 4Gy, 10Gy, or 20Gy or after hypofractionated irradiation with 4x4Gy or 6x3Gy. MDA-B231 cells consecutively released higher amounts of Hsp70 and HMGB1 after hypofractionated irradiation. However, only the release of Hsp70 was further increased by hyperthermia. Both, apoptosis induction and release of the danger signals, was dependent on caspase-3. Only

  11. The impact of dose calculation algorithms on partial and whole breast radiation treatment plans

    Directory of Open Access Journals (Sweden)

    Berrang Tanya

    2010-12-01

    Full Text Available Abstract Background This paper compares the calculated dose to target and normal tissues when using pencil beam (PBC, superposition/convolution (AAA and Monte Carlo (MC algorithms for whole breast (WBI and accelerated partial breast irradiation (APBI treatment plans. Methods Plans for 10 patients who met all dosimetry constraints on a prospective APBI protocol when using PBC calculations were recomputed with AAA and MC, keeping the monitor units and beam angles fixed. Similar calculations were performed for WBI plans on the same patients. Doses to target and normal tissue volumes were tested for significance using the paired Student's t-test. Results For WBI plans the average dose to target volumes when using PBC calculations was not significantly different than AAA calculations, the average PBC dose to the ipsilateral breast was 10.5% higher than the AAA calculations and the average MC dose to the ipsilateral breast was 11.8% lower than the PBC calculations. For ABPI plans there were no differences in dose to the planning target volume, ipsilateral breast, heart, ipsilateral lung, or contra-lateral lung. Although not significant, the maximum PBC dose to the contra-lateral breast was 1.9% higher than AAA and the PBC dose to the clinical target volume was 2.1% higher than AAA. When WBI technique is switched to APBI, there was significant reduction in dose to the ipsilateral breast when using PBC, a significant reduction in dose to the ipsilateral lung when using AAA, and a significant reduction in dose to the ipsilateral breast and lung and contra-lateral lung when using MC. Conclusions There is very good agreement between PBC, AAA and MC for all target and most normal tissues when treating with APBI and WBI and most of the differences in doses to target and normal tissues are not clinically significant. However, a commonly used dosimetry constraint, as recommended by the ASTRO consensus document for APBI, that no point in the contra

  12. Irradiation doses on thyroid gland during the postoperative irradiation for breast cancer

    Directory of Open Access Journals (Sweden)

    Mustafa Akın

    2014-01-01

    Conclusions: In majority of the node-positive breast cancer patients treated with 3D CRT, the thyroid gland was exposed to considerable doses. On the other hand, for 44% of the patients are at risk for developing thyroid function abnormalities which should be considered during the routine follow-up.

  13. Results of combination treatment for triple-negative breast cancer

    OpenAIRE

    M. A. Sekundova; V.I. Borisov; A. M. Sdvizhkov

    2014-01-01

    The authors give the results of treatment in 128 patients with operable triple-negative breast cancer (BC). All the patients underwent surgical intervention, the volume of which depended on the stage of the disease. The efficiency of adjuvant and neoadjuvant chemotherapy, as well as pre- and postoperative radiotherapy was evaluated. The side effects of different treatment options were analyzed. Five-year relapse-free and overall survival rates were traced in this patient group. It is conclude...

  14. Imaging Surveillance of Patients with Breast Cancer after Primary Treatment: Current Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jung Hyun; Kim, Min Jung; Kim, Eun-Kyung; Moon, Hee Jung [Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of)

    2015-11-01

    Women who have been treated for breast cancer are at risk for second breast cancers, such as ipsilateral recurrence or contralateral metachronous breast cancer. As the number of breast cancer survivors increases, interest in patient management and surveillance after treatment has also increased. However, post-treatment surveillance programs for patients with breast cancer have not been firmly established. In this review, we focus on the imaging modalities that have been used in post-treatment surveillance for patients with breast cancer, such as mammography, ultrasonography, magnetic resonance imaging, and positron emission tomography, the effectiveness of each modality for detecting recurrence, and how they can be applied to manage patients.

  15. Sewage Water Treatment by Gamma Irradiation

    International Nuclear Information System (INIS)

    This study indicates that Gamma irradiation could be the solution for raising the standards of disinfection in waste water of Damascus city up to the international standards, when samples of the inlet of the planet was irradiated with Gamma radiation at dose rate of 3.4 KGy./hr The radiation sensitivity of total micro-organisms, fungi, and pathogenic bacteria was 0.316, 0.318 , 0.306 KGy respectively Also the results showed the absence of Ascaris Lumbricoides ova which permit reusing the recycled waste water in irrigation safely. (authors)

  16. [The fertility-associated treatment of young breast cancer patients].

    Science.gov (United States)

    Lu, Y S; Wu, K J

    2016-01-01

    There is no treatment norm on the fertility issue of breast cancer patients. The clinical studies show that the effects of chemotherapy and endocrine treatment on menstrual cycle and ovarian function have connection with patients' age, therapeutic regimen and drug dose. The time to be pregnant should be decided according to the stage of tumor and the therapeutic regimen. The trimester of pregnancy and tumor stage should be considered when making the therapeutic regimen for the breast cancer patients during pregnancy. And it is not recommended to choose the induced abortion for the therapeutic aim. Theoretically, ovarian function inhibition drugs have great application prospects, while, of which the long-term affect on human body and the relation with tumor development need more researches to study. The available evidence-based practices consider that the pregnancy after breast cancer treatment has no adverse affects on the prognosis of early and middle stage breast cancer patients. More study results are needed to normalize and detail the therapeutic regimen and fertility guidance. PMID:26792357

  17. Improved survival with combined modality treatment for Stage IV breast cancer

    International Nuclear Information System (INIS)

    Between 1974 and 1977, 85 patients with breast cancer at first postmastectomy relapse were irradiated (Radiation 3500 to 6000 rad--3/5 weeks) to all clinically evident lesions. Radiation fields were properly shaped to include a maximum 40% active bone marrow. After 3 to 4 weeks rest, chemotherapy was started as adjuvant therapy for residual or subclinical disease (ADR 30 mg/M2 Day 1 and 8, 5-FU 400 mg/M2 Day 1 and 8, CY 100 mg/M2 Day 1 through 14: repeated after 14 days). ADR was discontinued at 500/M2 and substituted by MTX 30 mg/M2 Day 1 and 8 for a total of 2 years. Irradiated sites were chest wall in 35, supraclavicular and internal mammary nodes in 22, bone in 56, single lung lesions in 12, brain in 24. Controls were 52 comparable but non-randomized patients treated with chemotherapy only. Forty days after x-irradiation 68 patients (80%) were free of disease (NED) while in 17 cases (20%) some residual was still present (RED). In 28 of 68 cases (41%) NED after x-irradiation and 13 of 17 (76%) in RED group developed second relapse after a median interval of 26 and 20 mos., respectively. Four of 52 patients (8%) in the control group had complete regression with a median interval to second relapse of 7 mos. Median survival was 30 mos., 24 mos., and 13 mos., respectively, for NED, RED and chemotherapy only. Eighteen patients (26%) are free of disease after 36 to 48 mos. in the combined modality group; none in the chemotherapy group. Combined treatment cases did not show untolerable myelodepression. In 10 long-surviving patients a marked subcutaneous and skin fibrosis developed because of drug additive effect. Stage IV breast cancers rendered clinically free of disease with x-irradiation and subsequently treated with chemotherapy survive significantly longer than with chemotherapy alone

  18. Cognitive function after adjuvant treatment for early breast cancer

    DEFF Research Database (Denmark)

    Debess, Jeanne; Riis, Jens Østergaard; Engebjerg, Malene Cramer;

    2010-01-01

    start of adjuvant treatment and after 6 months by neuropsychological tests and questionnaires to evaluate cognitive function, quality of life and psychological distress. Neuropsychological tests did not reveal any differences in cognitive function between breast cancer patients after chemotherapy and......The purpose of this study was to examine cognitive function in patients with early breast cancer before and after adjuvant chemotherapy or 6 months of tamoxifen. We performed a population-based study in the county of North Jutland, Denmark, including 120 women aged <60 years who received adjuvant...... chemotherapy with seven cycles of cyclophosphamide, epirubicin and fluoruracil or adjuvant tamoxifen for 6 months for early breast cancer from 2004 to 2006. They were compared with an aged-matched group of 208 women without previous cancer selected randomly from the same population. Data were collected before...

  19. The importance of rehabilitation in the treatment of breast cancer

    Directory of Open Access Journals (Sweden)

    Elżbieta Kamusińska

    2014-09-01

    Full Text Available Mastectomy due to breast cancer results in many problems and physical dysfunctions related with the constant necessity to protect the upper extremity at the site of the operated breast, and application of a specialist physiotherapeutic procedure. Rehabilitation is an integral part of the process of breast cancer treatment, and its primary goal is the limitation of selected physical, psychological, and social consequences of this cancerous disease. The achievement of rehabilitation goals requires teamwork – the simultaneous solving of problems in various spheres of the patient’s life. This work should be considered as overall care activity concerning a human being according to a holistic approach. A very important element of rehabilitation after mastectomy is to reassure the patient that with the help of specialists she can overcome difficulties, solve her problems, and return to normal daily life.

  20. Variation in Post-Surgical Lumpectomy Cavity Volume With Delay in Initiation of Breast Irradiation Because of Chemotherapy

    International Nuclear Information System (INIS)

    Purpose: The addition of a radiotherapy boost has been shown to improve local control in breast conservation therapy. Three dimensional planning provides more accurate targeting of the operative bed than clinical setup using the lumpectomy scar. However, contraction of the lumpectomy cavity over time may have implications for the volume of tissue included in the boost field. Methods and Materials: The clinical variables and treatment planning volumes for patients receiving whole-breast radiotherapy at a single institution between July 1, 2006, and December 31, 2007 were analyzed retrospectively. Results: Of the 93 patients identified, 29 received chemotherapy (CTX) and 64 did not; CTX was sequenced before radiotherapy in all patients. Patients receiving CTX were more likely to have higher T and N stage and a longer interval between definitive breast surgery and radiation. The lumpectomy specimens of women receiving CTX trended toward being larger than those of women not receiving CTX (113.4cm3 vs. 74.6cm3, p = 0.08). Despite this, the volume of the lumpectomy cavity measured on computed tomography was smaller in patients receiving CTX (9.1cm3 vs. 16.8cm3, p = 0.02), as was the volume of the planning target volume (56.6cm3 vs. 79.9cm3, p = 0.02). Conclusions: Patients receiving CTX were at higher risk for local recurrence. However, as a result of lumpectomy bed contraction, these patients received a boost to a smaller volume than patients not receiving CTX. This finding is counterintuitive and supports re-evaluation of the optimal size of the boost field. In addition, these results may have implications for patients treated with partial breast irradiation.

  1. Aichi Cancer Center 10-year experience with conservative breast treatment of early breast cancer: retrospective analysis regarding failure patterns and factors influencing local control

    International Nuclear Information System (INIS)

    Purpose: We analyzed the clinical results of conservative breast therapy in our institute to determine the risk factors influencing local and distant disease recurrence. Methods and Materials: From 1989 to 1997, 301 breasts of 295 women with early breast cancer were treated with conservative surgery and adjuvant radiotherapy. There were 212 incidences of Stage I breast cancer, and 89 of Stage II. Patients were routinely treated with local resection, axillar dissection, and 46-50 Gy irradiation given in 23-25 fractions. Some also received a radiation boost to the tumor bed. Results: The 5-/8-year overall survival, disease-free survival, and local control rates were 93.2/91.5%, 86.0/80.6%, and 95.1/92.5%, respectively. Using both univariate and multivariate analyses, tumor volume, estrogen receptor status, and age <40 years were significant prognostic factors for disease-free survival. Both age <40 years and surgical method had a strong effect on local control by uni- and multivariate analysis. Surgical margin status was a significant prognostic factor for local control at the univariate level (p<0.0001), though it had only borderline significance at the multivariate level (p 0.08). No patient experienced severe morbidity due to radiotherapy. Conclusion: The results obtained are comparable to previously reported data. Although the follow-up period was too short to draw definite conclusions about long-term outcomes, the outcome from conservative breast treatment was acceptable

  2. Natural cures for breast cancer treatment.

    Science.gov (United States)

    Shareef, Munazza; Ashraf, Muhammad Aqeel; Sarfraz, Maliha

    2016-05-01

    For centuries, herbs and plants have been used for medicinal purposes and as food as well. This review concerns about different types of plants that retain the immune stimulating and anti-tumor properties. Large variety of active phytochemicals such as carotenoids, flavonoids, ligands, polyphenolics, terpenoids, sulfides, lignans and plant sterols has been identified in different types of herbs. These phytochemicals have different mechanisms of action. They either stimulate the protective enzyme like glutathione transferase or prevent the cell proliferation. This review has centered on the biochemical properties of Allium sativum, Echinacea, Curcuma longa, Arctium lappa, Camellia sinensis, Panax ginseng and Flax seed. Extracts and juices of Withania somnifera, Amoora rohituka, Dysoxylum binectariferum and Vaccinium macrocarpon, respectively also used as anti-breast cancer. The volatile oils and extracts of these herbs and plants inhibit the synthesis of mevalonate that lessen the tumor growth and cholesterol synthesis. PMID:27275107

  3. Natural cures for breast cancer treatment

    Directory of Open Access Journals (Sweden)

    Munazza Shareef

    2016-05-01

    Full Text Available For centuries, herbs and plants have been used for medicinal purposes and as food as well. This review concerns about different types of plants that retain the immune stimulating and anti-tumor properties. Large variety of active phytochemicals such as carotenoids, flavonoids, ligands, polyphenolics, terpenoids, sulfides, lignans and plant sterols has been identified in different types of herbs. These phytochemicals have different mechanisms of action. They either stimulate the protective enzyme like glutathione transferase or prevent the cell proliferation. This review has centered on the biochemical properties of Allium sativum, Echinacea, Curcuma longa, Arctium lappa, Camellia sinensis, Panax ginseng and Flax seed. Extracts and juices of Withania somnifera, Amoora rohituka, Dysoxylum binectariferum and Vaccinium macrocarpon, respectively also used as anti-breast cancer. The volatile oils and extracts of these herbs and plants inhibit the synthesis of mevalonate that lessen the tumor growth and cholesterol synthesis.

  4. Pain in Breast Cancer Treatment: Aggravating Factors and Coping Mechanisms

    Directory of Open Access Journals (Sweden)

    Maria de Fatima Guerreiro Godoy

    2014-01-01

    Full Text Available The objective of this study was to evaluate pain in women with breast cancer-related lymphedema and the characteristics of aggravating factors and coping mechanisms. The study was conducted in the Clinica Godoy, São Jose do Rio Preto, with a group of 46 women who had undergone surgery for the treatment of breast cancer. The following variables were evaluated: type and length of surgery; number of radiotherapy and chemotherapy sessions; continued feeling of the removed breast (phantom limb, infection, intensity of pain, and factors that improve and worsen the pain. The percentage of events was used for statistical analysis. About half the participants (52.1% performed modified radical surgery, with 91.3% removing only one breast; 82.6% of the participants did not perform breast reconstruction surgery. Insignificant pain was reported by 32.60% of the women and 67.3% said they suffered pain; it was mild in 28.8% of the cases (scale 1–5, moderate in 34.8% (scale 6–9, and severe in 4.3%. The main mechanisms used to cope with pain were painkillers in 41.30% of participants, rest in 21.73%, religious ceremonies in 17.39%, and chatting with friends in 8.69%. In conclusion, many mastectomized patients with lymphedema complain of pain, but pain is often underrecognized and undertreated.

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

    International Nuclear Information System (INIS)

    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.

  6. 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.

  7. The effect of thoracic irradiation for cancer of the breast on ventilation, perfusion and pulmonary permeability

    International Nuclear Information System (INIS)

    Regional and overall lung function was studied in 14 women during a one-year follow-up after postmastectomy irradiation for cancer of the breast. The dose was 40 Gy in the chest wall and 20-40 Gy in the apex of the lung. Immediately after irradiation there was a slight increase in pulmonary clearance of 99TCm-DTPA compared to baseline values. This increase, however, was not restricted to the field of irradiation. Three months after irradiation there were regional defects in the ventilation and perfusion scintigrams in 11 of the patients. At the same time there was a greater decrease in total lung capacity, vital capacity and diffusion capacity for CO than in ventilation and perfusion. One year after irradiation the lung function impairment had only insignificantly regressed. It is concluded that local lung irradiation may cause persistent regional and generalized lung function impairment. The early increase in pulmonary clearance of 99Tcm-DTPA could not be used as a predictor of subsequent lung function impairment. (orig.)

  8. Microbiological and other characteristics of chicken breast meat following electron-beam and sous-vide treatments

    International Nuclear Information System (INIS)

    The combined effects of radiation and sous-vide treatment of chicken breast meat were investigated with respect to survival and growth of Listeria monocytogenes, shelf life, thiamine content, and sensory qualities. Chicken breasts were inoculated with L. monocytogenes 81-861 (10(5) CFU/G), vacuum-packed, irradiated with electron beam (EB) up to 2.9 kGy, and cooked to an internal temperature of 65.6 degrees C. Sous-vide treatment alone had marginal lethal effect on the L. monocytogenes; the residual inoculum reached 10(7) CFU/g after 8 weeks at 2 degrees C. However, after the combined treatments of sous-vide and EB at 2.9 kGy, the organism remained undetectable during the 8-week storage period. Parallel studies on uninoculated breast meat revealed that sous-vide samples had a shelf life of less than 6 weeks without EB treatment, whereas samples that were irradiated and then received sous-vide treatment had a shelf life of at least 8 weeks. There was a slight reduction in thiamine levels as a result of the EB treatment, but there was essentially no additional loss of thiamine due to the subsequent sous-vide treatment and storage at 2 degrees C. Electron-beam treatment had very little effect on the odor and flavor of the reheated samples. It was concluded that EB treatment combined with, sous-vide treatment can greatly enhance the microbial safety and shelf life of chicken breast meat

  9. Hypo-fractionated whole breast irradiation: Pro and cons; Irradiation hypofractionnee dans le cancer du sein: pour ou contre?

    Energy Technology Data Exchange (ETDEWEB)

    Cutuli, B. [Institut du cancer Courlancy, 38, rue de Courlancy, 51100 Reims (France); Fourquet, A. [Institut Curie, 26, rue d' Ulm, 75005 Paris (France)

    2011-10-15

    The continuous increase of breast cancer (BC) incidence, the logistic constraints of the protracted standard 5-week radiations regimen have led to test short hypo-fractionated whole breast radiation therapy schemes. Three prospective randomized trials and a pilot trial have been published. Large numbers of patients were included, with follow-up duration ranging from 5 to 12 years. The conclusions of these trials were similar, showing local control and toxicity equivalent to those of the standard regimen, and supporting the use of three schemes: 42.5 Gy/16 fractions/3 weeks, 40 Gy/15 fractions/3 weeks or 41.6 Gy/13 fractions/5 weeks. However, the patients in these trials had favourable prognostic factors, were treated to the breast only and the boost dose, when indicated, was delivered with a standard fractionation. Hypo-fractionated treatment can only be recommended in patients treated to the breast only, without nodal involvement, with grade < 3 tumours and who are not candidate to chemotherapy. If a boost is to be given, a standard fractionation should be used. Particular care should be taken to avoid heterogeneities leading to high fractional doses to organs at risk (lung and heart). (authors)

  10. Irradiation as a quarantine treatment for ornamentals

    International Nuclear Information System (INIS)

    The orchid weevil, Orchidophilus aterrimus (Waterhouse), was the most damaging and most difficult to control among the insect pests surveyed. The duration of development of the different stages of orchid weevil were as follows: egg incubation was 7.20 ± 1.47 days, larval period was 58.70 ± 11.24, and the pupal period was 10.83 ± 1.54 days. The total developmental period from egg to adult was 70.15 ± 12.04 days. The pre-oviposition period of the adult female was 44.27 ± 12.18 days and the mean number of eggs laid by a female per week was 3.95 ± 1.36 eggs. Radiosensitivity, in general, decreased with the age of the orchid weevil; the adult was the least sensitive and the eggs the most sensitive to radiation. However, radiosensitivity also varied within a developmental stage. Pairing studies on orchid weevils showed that older adults (11-to-30-days-old) irradiated with 150 Gy and paired as I x U and U x I laid eggs, but surviving larvae died 6 days after egg hatch. The melanization test for irradiated orchid weevil larvae produced inconsistent results. A shorter vase-life was found on Dendrobium cut-flowers irradiated with 100 to 450 Gy. Among the different varieties of Heliconia, the variety Parrot was the most tolerant to radiation. Irradiation affected the growth of the seedlings and ready-to-bloom Dendrobium plants. It also affected the formation of spikes on the latter. The percentage of dropped/wilted flowers in flowering Dendrobium plants was higher on irradiated plants as compared with the control. (author)

  11. Uncaria tomentosa—Adjuvant Treatment for Breast Cancer: Clinical Trial

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Santos Araújo

    2012-01-01

    Full Text Available Breast cancer is the most frequent neoplasm affecting women worldwide. Some of the recommended treatments involve chemotherapy whose toxic effects include leukopenia and neutropenia. This study assessed the effectiveness of Uncaria tomentosa (Ut in reducing the adverse effects of chemotherapy through a randomized clinical trial. Patients with Invasive Ductal Carcinoma—Stage II, who underwent a treatment regimen known as FAC (Fluorouracil, Doxorubicin, Cyclophosphamide, were divided into two groups: the UtCa received chemotherapy plus 300 mg dry Ut extract per day and the Ca group that only received chemotherapy and served as the control experiment. Blood samples were collected before each one of the six chemotherapy cycles and blood counts, immunological parameters, antioxidant enzymes, and oxidative stress were analyzed. Uncaria tomentosa reduced the neutropenia caused by chemotherapy and was also able to restore cellular DNA damage. We concluded that Ut is an effective adjuvant treatment for breast cancer.

  12. Radiotherapy in the management of early breast cancer

    OpenAIRE

    Wang, Wei

    2013-01-01

    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 tha...

  13. Evaluation of two intracavitary high-dose-rate brachytherapy devices for irradiating additional and irregularly shaped volumes of breast tissue

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Sharon M., E-mail: sharonlu@ucsd.edu [Department of Radiation Oncology and Center for Advanced Radiotherapy Technologies (CART), University of California, San Diego, La Jolla, CA (United States); Scanderbeg, Daniel J.; Barna, Patrick; Yashar, William; Yashar, Catheryn [Department of Radiation Oncology and Center for Advanced Radiotherapy Technologies (CART), University of California, San Diego, La Jolla, CA (United States)

    2012-04-01

    The SAVI and Contura breast brachytherapy applicators represent 2 recent advancements in brachytherapy technology that have expanded the number of women eligible for accelerated partial breast irradiation in the treatment of early-stage breast cancer. Early clinical experience with these 2 single-entry, multichannel high-dose-rate brachytherapy devices confirms their ease of use and dosimetric versatility. However, current clinical guidelines for SAVI and Contura brachytherapy may result in a smaller or less optimal volume of treated tissue compared with traditional interstitial brachytherapy. This study evaluates the feasibility of using the SAVI and Contura to irradiate larger and irregularly shaped target volumes, approaching what is treatable with the interstitial technique. To investigate whether additional tissue can be treated, 17 patients treated with the SAVI and 3 with the Contura were selected. For each patient, the planning target volume (PTV) was modified to extend 1.1 cm, 1.3 cm, and 1.5 cm beyond the tumor bed cavity. To evaluate dose conformance to an irregularly shaped target volume, 9 patients treated with the SAVI and 3 with the Contura were selected from the original 20 patients. The following asymmetric PTV margin combinations were assessed for each patient: 1.5/0.3, 1.3/0.3, and 1.1/0.3 cm. For all patients, treatment planning was performed, adopting the National Surgical Adjuvant Breast and Bowel Project guidelines, and dosimetric comparisons were made. The 6-1 and 8-1 SAVI devices can theoretically treat a maximal tissue margin of 1.5 cm and an asymmetric PTV with margins ranging from 0.3 to 1.5 cm. The 10-1 SAVI and Contura can treat a maximal margin of 1.3 cm and 1.1 cm, respectively, and asymmetric PTV with margins ranging from 0.3-1.3 cm. Compared with the Contura, the SAVI demonstrated greater dosimetric flexibility. Risk of developing excessive hot spots increased with the size of the SAVI device. Both the SAVI and Contura appear

  14. Persistent seroma after intraoperative placement of MammoSite for accelerated partial breast irradiation: Incidence, pathologic anatomy, and contributing factors

    International Nuclear Information System (INIS)

    Purpose: To investigate the incidence of, and possible factors associated with, seroma formation after intraoperative placement of the MammoSite catheter for accelerated partial breast irradiation. Methods and Materials: This study evaluated 38 patients who had undergone intraoperative MammoSite catheter placement at lumpectomy or reexcision followed by accelerated partial breast irradiation with 34 Gy in 10 fractions. Data were collected regarding dosimetric parameters, including the volume of tissue enclosed by the 100%, 150%, and 200% isodose shells, dose homogeneity index, and maximal dose at the surface of the applicator. Clinical and treatment-related factors were analyzed, including patient age, patient weight, history of diabetes and smoking, use of reexcision, interval between surgery and radiotherapy, total duration of catheter placement, total excised specimen volume, and presence or absence of postprocedural infection. Seroma was verified by clinical examination, mammography, and/or ultrasonography. Persistent seroma was defined as seroma that was clinically detectable >6 months after radiotherapy completion. Results: After a median follow-up of 17 months, the overall rate of any detectable seroma was 76.3%. Persistent seroma (>6 months) occurred in 26 (68.4%) of 38 patients, of whom 46% experienced at least modest discomfort at some point during follow-up. Of these symptomatic patients, 3 required biopsy or complete cavity excision, revealing squamous metaplasia, foreign body giant cell reaction, fibroblasts, and active collagen deposition. Of the analyzed dosimetric, clinical, and treatment-related variables, only body weight correlated positively with the risk of seroma formation (p = 0.04). Postprocedural infection correlated significantly (p = 0.05) with a reduced risk of seroma formation. Seroma was associated with a suboptimal cosmetic outcome, because excellent scores were achieved in 61.5% of women with seroma compared with 83% without seroma

  15. A RETROSPECTIVE ANALYSIS OF SURGICAL TREATMENT FOR BREAST MALIGNANT TUMORS

    Institute of Scientific and Technical Information of China (English)

    范志民; 刘国津; 盖学良; 王晓军; 辛志泳

    2002-01-01

    Objective: To review the evolution of the current surgical treatment for breast malignant tumors over the past twenty years in the First Hospital of Jilin University (the former Bethune University of Medical Sciences). Methods: 1195 eligible patients with primary breast malignant tumor diagnosed and surgically treated at the First Teaching Hospital from January 1980 and December 2000 were retrospectively analyzed. Results: The peak frequency was in 40-49 years of age (40.00%), the age of the patients with breast malignant tumors trends to become young. The most common pTNM classification was Stage Ⅱ. The most common histological type was infiltrating ductal carcinoma (398 patients, 33.31%), and simple carcinoma (279 patients, 23.53%). Modified radical mastectomy was the most common operation procedure performed (779 patients, 65.19%), and was increasingly used while radical mastectomy was adopted decreasingly in recent decade. Conclusion: The variation of operation procedures performed on patients with breast malignant tumors reflected the advance of our understanding of the biology of cancer and the progression of new treatment principles.

  16. Extracorporeal High-Intensity Focused Ultrasound Treatment for Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    HuiZhu; FengWu; WenzhiChen; YoudeCao; JinBai; ZhibiaoWang

    2004-01-01

    OBJECTIVE To evaluate the clinical safety and efficacy of using highintensity focused ultrasound (HIFU) therapy, for breast cancer, and to select the appropriate methods in evaluating the therapeutic effects.METHODS A total of 24 patients with breast cancer underwent HIFU treatment 1-2 weeks before receiving modified radical mastectomy. During and after HIFU therapy, changes in blood pressure, breath, pulse and peripheral blood oxygen saturation were monitored. At the same time, the damage of the skin and tissue produced by HIFU at the target region was evaluated as well. Surgically excised samples were used for pathological examinations to evaluate the HIFU-induced destruction of the targeted tissue. Three patients received Tc-ECT and 1 MRI examinations before and after HIFU.RESULTS HIFU treatment had no apparent influence on either the tissue nearby the target or on vital signs of the patients. Pathological, tc-ECT and MRI examinations demonstrated that targeted tissue showed complete coagulative necrosis.CONCLUSION Under the guidance of real-time ultrasonic imaging, HIFU can effectively and safely destroy the breast cancer mass and 99MTc-ECT and MRI examination can be utilized to evaluate the therapeutic effects.HIFU may become one of the options for breast cancer therapy in the future.

  17. Late effects of radiotherapy in the treatment of breast cancer

    International Nuclear Information System (INIS)

    Late effects after radiotherapy for breast cancer include radiation induced malignancy and changes in irradiated tissues leading to e.g. edema of the arm, decreased mobility of the shoulder joint, brachial plexus neuropathy, pulmonary fibrosis, telangiectasia or atrophic ulceration of the skin. While radiation-induced malignancy depends on the volume of tissue irradiated and the total dose, other late effects are also fractionation dependent. Several reports have shown increased rates of such late effects after changes of the fractionation schedule which should be isoeffective according to the mathematical models commonly used to predict early effects. Although knowledge of the relation between total dose, number of fractions and radiation effects in late responding tissues has increased, extrapolations from the models should be used cautiously. The dose-response curve seems to be steeper for late effects than for tumour control. The possibility of late effects should be included in the decision as to when and how to treat breast cancer with radiotherapy. (orig.)

  18. Irradiation of the tumor bed alone after lumpectomy in selected patients with early stage breast cancer treated with breast conserving therapy

    International Nuclear Information System (INIS)

    Purpose: We present the initial findings of our in-house protocol treating the tumor bed alone after lumpectomy with low dose rate (LDR) interstitial brachytherapy in selected patients with early stage breast cancer treated with breast conserving therapy (BCT). Materials and Methods: Since 1/1/93, 50 women with early stage breast cancer were entered into a protocol of tumor bed irradiation alone using an interstitial LDR implant. Patients were eligible if their tumor was an infiltrating ductal carcinoma ≤ 3 cm in maximum diameter, pathologic margins were clear by at least 2 mm, the tumor did not contain an extensive intraductal component, the axilla was surgically staged with ≤ 3 nodes involved with cancer, and a postoperative mammogram was performed. Implants were positioned using a template guide delivering 50 Gy over 96 hours to the lumpectomy bed plus a 1-2 cm margin. Local control, cosmetic outcome, and complications were assessed. Results: Patients ranged in age from 40 to 84 years (median 65). The median tumor size was 10 mm (range, 1-25). Seventeen patients (34%) had well differentiated tumors, 22 (4%) had moderately differentiated tumors, and in 11 (22%) the tumor was poorly differentiated. Forty-five patients (90%) were node negative while 5 (10%) had 1-3 positive nodes. A total of 23 (46%) patients were placed on tamoxifen and 3 (6%) received adjuvant systemic chemotherapy. No patient was lost to follow-up. The median follow-up is 40 months (range 29-50). No patient has experienced a local, regional, or distant failure. One patient died from colorectal carcinoma with no evidence of recurrent breast cancer. Good-to-excellent cosmetic results have been observed in all 50 patients (median cosmetic follow-up 36 months). No patient has experienced significant sequelae related to their implant. Conclusions: Early results with treatment of the tumor bed alone with a LDR interstitial implant appear promising. Long-term follow-up of these patients will be

  19. Adoption of Hypofractionated Whole-Breast Irradiation for Early-Stage Breast Cancer: A National Cancer Data Base Analysis

    International Nuclear Information System (INIS)

    Purpose: To evaluate the relationship of patient, hospital, and cancer characteristics with the adoption of hypofractionation in a national sample of patients diagnosed with early-stage breast cancer. Methods and Materials: We performed a retrospective study of breast cancer patients in the National Cancer Data Base from 2004-2011 who were treated with radiation therapy and met eligibility criteria for hypofractionation. We used logistic regression to identify factors associated with receipt of hypofractionation (vs conventional fractionation). Results: We identified 13,271 women (11.7%) and 99,996 women (88.3%) with early-stage breast cancer who were treated with hypofractionation and conventional fractionation, respectively. The use of hypofractionation increased significantly, with 5.4% of patients receiving it in 2004 compared with 22.8% in 2011 (P<.001 for trend). Patients living ≥50 miles from the cancer reporting facility had increased odds of receiving hypofractionation (odds ratio 1.57 [95% confidence interval 1.44-1.72], P<.001). Adoption of hypofractionation was associated with treatment at an academic center (P<.001) and living in an area with high median income (P<.001). Hypofractionation was less likely to be used in patients with high-risk disease, such as increased tumor size (P<.001) or poorly differentiated histologic grade (P<.001). Conclusions: The use of hypofractionation is rising and is associated with increased travel distance and treatment at an academic center. Further adoption of hypofractionation may be tempered by both clinical and nonclinical concerns

  20. Adoption of Hypofractionated Whole-Breast Irradiation for Early-Stage Breast Cancer: A National Cancer Data Base Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Elyn H. [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Mougalian, Sarah S. [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Department of Medical Oncology, Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Soulos, Pamela R. [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Rutter, Charles E.; Evans, Suzanne B. [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States); Haffty, Bruce G. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Gross, Cary P. [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Yu, James B., E-mail: james.b.yu@yale.edu [Yale School of Medicine, Yale School of Medicine, New Haven, Connecticut (United States); Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale, New Haven, Connecticut (United States); Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States)

    2014-12-01

    Purpose: To evaluate the relationship of patient, hospital, and cancer characteristics with the adoption of hypofractionation in a national sample of patients diagnosed with early-stage breast cancer. Methods and Materials: We performed a retrospective study of breast cancer patients in the National Cancer Data Base from 2004-2011 who were treated with radiation therapy and met eligibility criteria for hypofractionation. We used logistic regression to identify factors associated with receipt of hypofractionation (vs conventional fractionation). Results: We identified 13,271 women (11.7%) and 99,996 women (88.3%) with early-stage breast cancer who were treated with hypofractionation and conventional fractionation, respectively. The use of hypofractionation increased significantly, with 5.4% of patients receiving it in 2004 compared with 22.8% in 2011 (P<.001 for trend). Patients living ≥50 miles from the cancer reporting facility had increased odds of receiving hypofractionation (odds ratio 1.57 [95% confidence interval 1.44-1.72], P<.001). Adoption of hypofractionation was associated with treatment at an academic center (P<.001) and living in an area with high median income (P<.001). Hypofractionation was less likely to be used in patients with high-risk disease, such as increased tumor size (P<.001) or poorly differentiated histologic grade (P<.001). Conclusions: The use of hypofractionation is rising and is associated with increased travel distance and treatment at an academic center. Further adoption of hypofractionation may be tempered by both clinical and nonclinical concerns.

  1. A prone technique for treatment of the breast, supraclavicular and axillary nodes

    International Nuclear Information System (INIS)

    Radiation therapy to women with large pendulous breasts presents dosimetric challenges when the whole breast (WB) and supraclavicular and axillary (SCF + AX) nodes need to be encompassed. The aim of this case study was to demonstrate the feasibility of planning and treating a pendulous breasted patient in the prone position. Computerised tomography (CT) images were acquired of the patient in both the prone and supine positions. A Perspex plate was added to the CDR Systems Inc. (Calgary, Canada) prone breastboard to minimize SCF + AX contour variations. Dosimetry was performed on both CT scans and the resultant treatment plans were evaluated for conformity, homogeneity, dose to the lung and maximum doses to the spinal cord (SC) and irradiated volume. The daily set-up in the prone position was monitored for stability and reproducibility. The patient completed her treatment course in the prone position. Minimal daily interventions were required to ensure the position was reproduced. Grade 3 skin toxicity was recorded in the SCF + AX region where the Perspex plate was added to the prone positioning device. There was minimal difference in dosimetry between prone and supine plans in the SCF + AX region. The prone WB plan showed improved homogeneity (prone 0.15; supine 0.22) and conformity (prone 0.90; supine 0.77). A simple addition to the breastboard has enabled a pendulous breasted woman with SC + AX involvement to be treated in the prone position. Set-up of this technique is achievable on a daily basis with minimal impact on workflow. It is a feasible alternative to supine treatment for this patient group.

  2. Incidental dose to coronary arteries is higher in prone than in supine whole breast irradiation. A dosimetric comparison in adjuvant radiotherapy of early stage breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wuerschmidt, Florian; Stoltenberg, Solveigh; Kretschmer, Matthias; Petersen, Cordula

    2014-06-15

    Sparing of normal lung is best achieved in prone whole breast irradiation (WBI). However, exposure of the heart and coronary arteries might increase due to anterior movement of the heart in prone WBI. Treatment plans of 46 patients with large breasts irradiated for mammary cancer after breast-conserving surgery were retrospectively analyzed. The average treated breast volume of right-sided breasts (n = 33) was 1,804 ccm and 1,500 ccm for left-sided breasts (n = 13). The majority had invasive cancer (96 %) of which 61 % were pT1 and 39 % pT2 tumors. All patients received radiation therapy to the breast only. For three-dimensional (3D) treatment planning, all patients underwent a noncontrast-enhanced CT in the supine position with a wingboard and a second CT in the prone position using a prone breastboard. Nontarget volumes of the lung, heart, and coronary arteries were contoured. A total dose of 50.4 Gy was prescribed to the breast only. Differences were calculated for each patient and compared using the Wilcoxon signed-rank test. Treatment of left-sided breasts resulted in similar average mean heart doses in prone versus supine WBI (4.16 vs. 4.01 Gy; p = 0.70). The left anterior descending artery (LAD) had significantly higher dose exposure in left versus right WBI independent of position. Prone WBI always resulted in significantly higher exposures of the right circumflex artery (RCA) and LAD as compared to supine WBI. In left WBI, the mean LADprone was 33.5 Gy vs. LADsupine of 25.6 Gy (p = 0.0051). The V20prone of the LAD was 73.6 % vs. V20supine 50.4 % (p = 0.0006). The heart dose is not different between supine and prone WBI. However, in left WBI the incidental dose to the LAD with clinically relevant doses can be significantly higher in prone WBI. This is discussed controversially in the literature as it might depend on contouring and treatment techniques. We recommend contouring of LAD if patients are treated in prone WBI and evaluation of alternative

  3. Outcomes in Women Treated With MammoSite Brachytherapy or Whole Breast Irradiation Stratified by ASTRO Accelerated Partial Breast Irradiation Consensus Statement Groups

    Energy Technology Data Exchange (ETDEWEB)

    Zauls, A. Jason, E-mail: zauls@musc.edu [Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC (United States); Watkins, John M. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC (United States); Wahlquist, Amy E. [Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, SC (United States); Brackett, N. Craig [Coastal Carolina Breast Center, Georgetown, SC (United States); Aguero, Eric G. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC (United States); Baker, Megan K. [Department of Surgery, Medical University of South Carolina, Charleston, SC (United States); Jenrette, Joseph M. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC (United States); Garrett-Mayer, Elizabeth [Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, SC (United States); Harper, Jennifer L. [Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC (United States)

    2012-01-01

    Purpose: The American Society for Radiation Oncology published a Consensus Statement for accelerated partial breast irradiation identifying three groups: Suitable, Cautionary, and Unsuitable. The objective of this study was to compare oncologic outcomes in women treated with MammoSite brachytherapy (MB) vs. whole breast irradiation (WBI) after stratification into Statement groups. Methods: Eligible women had invasive carcinoma or ductal carcinoma in situ (DCIS) {<=}3 cm, and {<=}3 lymph nodes positive. Women were stratified by radiation modality and Statement groups. Survival analysis methods including Kaplan-Meier estimation, Cox regression, and competing risks analysis were used to assess overall survival (OS), disease-free survival (DFS), time to local failure (TTLF), and tumor bed failure (TBF). Results: A total of 459 (183 MB and 276 WBI) patients were treated from 2002 to 2009. After a median follow-up of 45 months, we found no statistical differences by stratification group or radiation modality with regard to OS and DFS. At 4 years TTLF or TBF were not statistically different between the cohorts. Univariate analysis in the MB cohort revealed that nodal positivity (pN1 vs. pN0) was related to TTLF (hazard ratio 6.39, p = 0.02). There was a suggestion that DCIS histology had an increased risk of failure when compared with invasive ductal carcinoma (hazard ratio 3.57, p = 0.06). Conclusions: MB and WBI patients stratified by Statement groups seem to combine women who will have similar outcomes regardless of radiation modality. Although outcomes were similar, we remain guarded in overinterpretation of these preliminary results until further analysis and long-term follow-up data become available. Caution should be used in treating women with DCIS or pN1 disease with MB.

  4. Outcomes in Women Treated With MammoSite Brachytherapy or Whole Breast Irradiation Stratified by ASTRO Accelerated Partial Breast Irradiation Consensus Statement Groups

    International Nuclear Information System (INIS)

    Purpose: The American Society for Radiation Oncology published a Consensus Statement for accelerated partial breast irradiation identifying three groups: Suitable, Cautionary, and Unsuitable. The objective of this study was to compare oncologic outcomes in women treated with MammoSite brachytherapy (MB) vs. whole breast irradiation (WBI) after stratification into Statement groups. Methods: Eligible women had invasive carcinoma or ductal carcinoma in situ (DCIS) ≤3 cm, and ≤3 lymph nodes positive. Women were stratified by radiation modality and Statement groups. Survival analysis methods including Kaplan-Meier estimation, Cox regression, and competing risks analysis were used to assess overall survival (OS), disease-free survival (DFS), time to local failure (TTLF), and tumor bed failure (TBF). Results: A total of 459 (183 MB and 276 WBI) patients were treated from 2002 to 2009. After a median follow-up of 45 months, we found no statistical differences by stratification group or radiation modality with regard to OS and DFS. At 4 years TTLF or TBF were not statistically different between the cohorts. Univariate analysis in the MB cohort revealed that nodal positivity (pN1 vs. pN0) was related to TTLF (hazard ratio 6.39, p = 0.02). There was a suggestion that DCIS histology had an increased risk of failure when compared with invasive ductal carcinoma (hazard ratio 3.57, p = 0.06). Conclusions: MB and WBI patients stratified by Statement groups seem to combine women who will have similar outcomes regardless of radiation modality. Although outcomes were similar, we remain guarded in overinterpretation of these preliminary results until further analysis and long-term follow-up data become available. Caution should be used in treating women with DCIS or pN1 disease with MB.

  5. Treatment of Lymphedema with Saam Acupuncture in Patients with Breast Cancer: A Pilot Study

    OpenAIRE

    Jeong, Young Ju; Kwon, Hyo Jung; Park, Young Sun; Kwon, Oh Chang; Shin, Im Hee; Park, Sung Hwan

    2015-01-01

    Background: Lymphedema is a troublesome complication affecting quality of life (QoL) in many women after breast-cancer treatment. Recent studies have suggested that acupuncture can reduce symptoms of lymphedema in breast-cancer survivors.

  6. New Treatment Option for Young Women with Hormone-Sensitive Breast Cancer

    Science.gov (United States)

    ... treatment option for young women with hormone-sensitive breast cancer Posted: June 1, 2014 Contact: NCI Press Office 301-496-6641 A drug used for treating breast cancer, known as exemestane, is more effective than a ...

  7. Breast Cancer: Staging and Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Screening For Breast Cancer Staging and Treatment Past Issues / Summer 2014 Table of Contents Staging The extent (stage) of breast cancer needs to be determined to help choose the ...

  8. Prevention and Treatment of Bone Metastases in Breast Cancer

    Directory of Open Access Journals (Sweden)

    Ripamonti Carla

    2013-09-01

    Full Text Available In breast cancer patients, bone is the most common site of metastases. Medical therapies are the basic therapy to prevent distant metastases and recurrence and to cure them. Radiotherapy has a primary role in pain relief, recalcification and stabilization of the bone, as well as the reduction of the risk of complications (e.g., bone fractures, spinal cord compression. Bisphosphonates, as potent inhibitors of osteoclastic-mediated bone resorption are a well-established, standard-of-care treatment option to reduce the frequency, severity and time of onset of the skeletal related events in breast cancer patients with bone metastases. Moreover bisphosphonates prevent cancer treatment-induced bone loss. Recent data shows the anti-tumor activity of bisphosphonates, in particular, in postmenopausal women and in older premenopausal women with hormone-sensitive disease treated with ovarian suppression. Pain is the most frequent symptom reported in patients with bone metastases, and its prevention and treatment must be considered at any stage of the disease. The prevention and treatment of bone metastases in breast cancer must consider an integrated multidisciplinary approach.

  9. Investigation of variability in image acquisition and contouring during 3D ultrasound guidance for partial breast irradiation

    International Nuclear Information System (INIS)

    Three-dimensional ultrasound (3DUS) at simulation compared to 3DUS at treatment is an image guidance option for partial breast irradiation (PBI). This study assessed if user dependence in acquiring and contouring 3DUS (operator variability) contributed to variation in seroma shifts calculated for breast IGRT. Eligible patients met breast criteria for current randomized PBI studies. 5 Operators participated in this study. For each patient, 3 operators were involved in scan acquisitions and 5 were involved in contouring. At CT simulation (CT1), a 3DUS (US1) was performed by a single radiation therapist (RT). 7 to 14 days after CT1 a second CT (CT2) and 3 sequential 3DUS scans (US2a,b,c) were acquired by each of 3 RTs. Seroma shifts, between US1 and US2 scans were calculated by comparing geometric centers of the seromas (centroids). Operator contouring variability was determined by comparing 5 RT’s contours for a single image set. Scanning variability was assessed by comparing shifts between multiple scans acquired at the same time point (US1-US2a,b,c). Shifts in seromas contoured on CT (CT1-CT2) were compared to US data. From an initial 28 patients, 15 had CT visible seromas, met PBI dosimetric constraints, had complete US data, and were analyzed. Operator variability contributed more to the overall variability in seroma localization than the variability associated with multiple scan acquisitions (95% confidence mean uncertainty of 6.2 mm vs. 1.1 mm). The mean standard deviation in seroma shift was user dependent and ranged from 1.7 to 2.9 mm. Mean seroma shifts from simulation to treatment were comparable to CT. Variability in shifts due to different users acquiring and contouring 3DUS for PBI guidance were comparable to CT shifts. Substantial inter-observer effect needs to be considered during clinical implementation of 3DUS IGRT

  10. Locally advanced non inflammatory breast cancer treated by combined chemotherapy and preoperative irradiation: updated results in a series of 120 patients

    International Nuclear Information System (INIS)

    Purpose. - To evaluate our updated data concerning survival and locoregional control in a study of locally advanced non inflammatory breast cancer after primary chemotherapy followed by external preoperative irradiation. Patients and methods. - Between 1982 and 1998, 120 patients (75 stage IIIA, 41 stage IIIB, and 4 stage IIIC according to AJCC staging system 2002) were consecutively treated by four courses of induction chemotherapy with anthracycline-containing combinations followed by preoperative irradiation (45 Gy to the breast and nodal areas) and a fifth course of chemotherapy. Three different locoregional approaches were proposed, depending on tumour characteristics and tumour response. After completion of local therapy, all patients received a sixth course of chemotherapy and a maintenance adjuvant chemotherapy regimen without anthracycline. The median follow-up from the beginning of treatment was 140 months. Results. - Mastectomy and axillary dissection were performed in 49 patients (with residual tumour larger than 3 cm in diameter or located behind the nipple or with bifocal tumour), and conservative treatment in 71 patients (39 achieved clinical complete response or partial response >90% and received additional radiation boost to initial tumour bed; 32 had residual mass ≤3 cm in diameter and were treated by wide excision and axillary dissection followed by a boost to the excision site). Ten-year actuarial local failure rate was 13% after irradiation alone, 23% after wide excision and irradiation, and 4% after mastectomy (p =0.1). After multivariate analysis, possibility of breast-conserving therapy was related to initial tumour size (<6 vs. ≥6 cm in diameter, p =0.002). Ten-year overall metastatic disease-free survival rate was 61%. After multivariate analysis, metastatic disease-free survival rates were significantly influenced by clinical stage (stage IIIA-B vs. IIIC, p =0.0003), N-stage (N0 vs. N1-2a, and 3c, p = 0.017), initial tumour size (<6

  11. Fat necrosis in women with early-stage breast cancer treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To report the incidence of clinical, pathological and radiological fat necrosis (FN) in women treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy (BRT) for early-stage breast cancer and to study certain variables associated with it. Methods and materials: Between May 2000 and August 2008, 171 women were treated with APBI using high dose rate (HDR) BRT. Patients were treated to a dose of 34 Gy/10 fractions/1 week with two fractions/day after intraoperative/postoperative placement of catheters. Results: At a median follow up of 48 months (SD: 28) 20 women developed FN with median time to detection being 24 months (range: 4–62 months, SD: 20). Actuarial 5 and 7 year FN rate was 18% and 23%, respectively. Grade 1 FN was seen in 4, grade 2 in 8 and grade 4 in 8 women. Additional investigations such as aspiration/biopsy were done in 9 patients. Volume of excision was the only significant factor affecting FN (p = 0.04). Conclusions: Actuarial FN rate of 18% at 5 years in our study was comparable to other reported series of FN. Median time of detection of FN was 24 months. Higher volume of excision resulted in an increased incidence of fat necrosis.

  12. Is there an Ideal Breast Conservation Rate for the Treatment of Breast Cancer?

    Science.gov (United States)

    Tan, M P

    2016-09-01

    Since the results of randomised controlled trials in the last quarter of the twentieth century were reported, it has been conventionally accepted that breast conservation treatment (BCT) provides equivalent survival to mastectomy for early breast cancer. As expected, there was an initial fall in the use of mastectomy. The first decade of the twenty-first century, however, witnessed a trend of increasing mastectomy rates in some regions. This perplexing circumstance served as an impetus for a relook at survival outcomes with each surgical modality. Recent studies have demonstrated higher survival rates and improved local control associated with BCT. Such findings warrant a re-evaluation of treatment strategies, beginning with whether there is an optimum BCT rate. PMID:27177489

  13. Irradiation of left breast and cardiac risk: fundamentals for a prospective study; Irradiation du sein gauche et risque cardiaque: bases pour une etude prospective

    Energy Technology Data Exchange (ETDEWEB)

    Untereiner, M.; Frederick, B.; Burie, D.; Philippi, S.; Joseph, S.; Harzee, L.; Hoziel, D.; Eschenbrenner, A.; Meyer, P. [Centre Francois-Baclesse, Esch-sur-Alzette (Luxembourg); Gibeau, L.; Laurent-Daniel, F.; Libert, S.; Fressancourt, C. [Centre Gray, 59 - Maubeuge (France)

    2010-10-15

    As the delineation of the anterior interventricular artery and of the heart is to be taken into account during irradiations of the left beast, in order to limit cardiotoxicity, the authors discuss the results of previous studies which highlighted this risk, and notably in a retrospective assessment of dose-volume histograms of the anterior interventricular artery and of the heart which concerned 162 left breast irradiations. This last study allowed cardiac tolerance thresholds to be defined. Short communication

  14. Breast

    International Nuclear Information System (INIS)

    Ultrasound is not an efficacious screening modality to detect early-stage breast malignancy in a clinically unremarkable population of women. Computed body tomography is similarly not practical for screening because of slice thickness and partial volume averaging, a higher radiation dose than modern mammography, and the lack of availability of such units for such a high throughput requirement. Nevertheless, these two imaging modalities can be very useful in management to guide the least invasive and efficacious treatment of the patient. X-ray mammography remains the principal imaging modality in the search for breast malignancy, but ultrasound is the single most important second study in the diagnostic evaluation of the breast. The combined use of these techniques and the ability to perform guided aspiration and localization procedures can result in a reduction in the surgical removal of benign cysts and reduction in the amount of tissue volume required if excision becomes necessary

  15. Nearly Complete Response of Brain Metastases from HER2 Overexpressing Breast Cancer with Lapatinib and Capecitabine after Whole Brain Irradiation

    Directory of Open Access Journals (Sweden)

    Esin Oktay

    2013-01-01

    Full Text Available Trastuzumab treatment does not prevent intracranial seeding and is largely ineffective for established central nervous system metastasis in HER2 overexpressing breast cancer patients. Combination therapy of lapatinib and capecitabine may be an effective treatment option for brain metastasis of HER2-positive breast cancer. We report a patient with breast cancer overexpressing HER-2 where brain metastases were successfully treated with radiation and a combination of lapatinib and capecitabine.

  16. Significance of ipsilateral breast tumor recurrence after breast conserving treatment: role of surgical removal

    Institute of Scientific and Technical Information of China (English)

    Romano Demicheli; Ilaria Ardoino; Federico Ambrogi; Roberto Agresti; Elia Biganzoli

    2013-01-01

    To analyze the pattern over time (dynamics) of further recurrence and death after ipsilateral breast tumor recurrence (IBTR) in breast cancer patients undergoing breast conserving treatment (BCT).Methods:A total of 338 evaluable patients experiencing IBTR were extracted from a database of 3,293 patients undergoing BCT.The hazard rates for recurrence and mortality throughout 10 years of follow-up after IBTR were assessed and were compared to the analogous estimates associated to the primary treatment.Results:In a time frame with the time origin at the surgical treatment for IBTR,the hazard rate for further recurrence displays a bimodal pattern (peaks at the second and at the sixth year).Patients receiving mastectomy for IBTR reveal recurrence and mortality dynamics similar to that of node positive (N+) patients receiving mastectomy as primary surgery,apart from the first two-three years,when IBTR patients do worse.If the patients with time to IBTR longer than 2.5 years are considered,differences disappear.Conclusions:The recurrence and mortality dynamics following IBTR surgical removal is similar to the corresponding dynamics following primary tumor removal.In particular,patients with time to IBTR in excess of 2.5 years behave like N+ patients following primary tumor removal.Findings may be suitably explained by assuming that the surgical manoeuvre required by IBTR treatment is able to activate a sudden growing phase for tumor foci most of which,as suggested by the systemic model of breast cancer,would have reached the clinical level according to their own dynamics.

  17. Concurrent chemoradiotherapy in adjuvant treatment of breast cancer

    International Nuclear Information System (INIS)

    The optimal sequencing of chemotherapy and radiotherapy after breast surgery was largely studied but remains controversial. Concurrent chemo-radiotherapy is a valuable method for adjuvant treatment of breast cancer which is under ongoing research program in our hospital. We are evaluating the feasibility of the concomitant use of chemotherapy retrospectively. Two hundred forty four women having breast cancer were investigated in a retrospective study. All patients were either treated by radical surgery or breast conservative surgery. The study compares two adjuvant treatments associating concomitant chemotherapy and radiotherapy. In the first group (group A) the patients were treated by chemotherapy and radiotherapy in concomitant way using anthracycline (n = 110). In the second group (group B) the patients were treated by chemotherapy and radiotherapy in concomitant way using CMF treatment (n = 134). Chemotherapy was administered in six cycles, one each 3 weeks. Radiotherapy delivered a radiation dose of 50 Gy on the whole breast (or on the external wall) and/or on the lymphatic region. The Kaplan-Meier method was used to estimate the rates of disease free survival, loco-regional recurrence-free survival and overall survival. The Pearson Khi2 test was used to analyse the homogeneity between the two groups. The log-rank test was used to evaluate the differences between the two groups A and B. After 76.4 months median follow-up (65.3 months mean follow up), only one patient relapsed to loco-regional breast cancer when the treatment was based on anthracycline. However, 8 patients relapsed to loco-regional breast cancer when the treatment was based on CMF. In the anthracycline group, the disease free survival after 5 years, was 80.4% compared to 76.4% in the CMF group (Log-rank test: p = 0.136). The overall survival after 5 years was 82.5% and 81.1% in the anthracycline and CMF groups respectively (Log-rank test: p = 0.428). The loco-regional free survival at 5 years

  18. Breast carcinoma conservative treatment. Stages I and II

    International Nuclear Information System (INIS)

    From 1981 to 1988, 265 patients with breast cancer stages I and II (UICC-1987), were evaluated after conservative treatment with quadrantectomy plus axillectomy, radiotherapy and chemotherapy. After surgical treatment, the patients were submitted to radiation therapy in the breast. One hundred and fifty six (58,8%) patients were submitted to adjuvant chemotherapy. The median clinical follow-up period was 42.8 months with a minimum of 24 and a maximum of 99 months. Six (2,3%) patients presented local recurrence and 48 (18,1%) presented distant metastasis. After five years the total survival rate was 89,7% and the disease free survival rate was 75% in the same period. The study did not show significant differences among the clinical stages classified after surgery and the use of adjuvant chemotherapy did not influence the results of the many stages. (author). 194 refs, 33 figs, 6 tabs

  19. Wastewater treatment using gamma irradiation: Tetouan pilot station, Morocco

    International Nuclear Information System (INIS)

    The increasing demand on limited water supplies has accelerated the wastewater reuse and reclamation. We investigated gamma irradiation effects on wastewater by measuring differences in the legislated parameters, aiming to reuse the wastewater. Effluents samples were collected at the urban wastewater treatment station of Tetouan and were irradiated at different doses ranging from 0 to 14 kGy using a Co60 gamma source. The results showed an elimination of bacterial flora, a decrease of biochemical and chemical oxygen demand, and higher conservation of nutritious elements. The results of this study indicated that gamma irradiation might be a good choice for the reuse of wastewater for agricultural activities.

  20. Evaluation of the Flash effect in breast irradiation using TomoDirect. An investigational study

    International Nuclear Information System (INIS)

    Flash is a specified function in TomoDirect that enables beam expansion by opening additional leaves to the target. This study assessed the theoretical dose distribution resulting from Flash in breast irradiation using TomoDirect. A cylindrical phantom that enabled dose distribution of the breast was used for verifying the effect of planning target volume (PTV) contouring and Flash. A total of 18 Gy in 10 fractions were prescribed to the PTV. Five PTVs were then created by Contracting this contour by 0, 1, 2, 3, 4 and 5 mm, giving PTV-x. Flash ±x is defined by opening x (number) of the leaves. The Flash effect in the air was compared with each set-up error of 5, 10 and 15 mm, respectively. The minimum PTV dose from PTV-1 to PTV-3 increased from 13.88 Gy to 15.86 Gy. In contrast, Dmin in PTV-4 and PTV-5 was 17.80 Gy in 98.88% of the prescription dose. Without Flash, when 5-, 10- and 15-mm set-up errors applied in the PTV, relative doses of 87.88, 23.73 and 7.94% were observed, respectively. However, in Flash 3, which was equal to the usual air margin of 1.875 cm, a relative dose of 104.24% ± 0.30% was observed, irrespective of set-up errors (5 mm to 15 mm). Flash opening is useful for countervailing set-up errors in breast cancer patients who receive breast irradiation with TomoDirect. (author)

  1. Treatment results and prognostic factors of early breast cancer treated with a breast conserving operation and radiotherapy

    International Nuclear Information System (INIS)

    The purpose of this study was to analyze the prognostic factors affecting local control and survival rates for patients with early breast cancer who received breast conserving treatment (BCT) and to find out the optimal treatment according to their risk factors. From October 1994 to December 2001, 605 patients with 611 stage I and II breast cancers received BCT, and the results were analyzed retrospectively. BCT consists of breast conserving surgery and whole breast irradiation. All the patients underwent lumpectomy or quad-rantectomy. Axillary lymph node dissection or sentinel lymph node biopsy was performed in 608 cases (99.5%). The radiation dose to the whole breast was 50.4 Gy over 5 weeks with a 1.8 Gy daily fraction and with boost doses of 9-14.4 Gy administered to the tumor bed. Adjuvant chemotherapy was performed in most of the patients with axillary lymph node metastasis or tumors larger than 1 cm. The median follow-up period was 47 months. Local relapse, regional relapse and distant metastasis occurred in 15 (2.5%), 16 (2.6%) and 43 patients (7.1%), respectively. The 5-year overall survival, local-relapse-free survival, distant-metastasis-free survival and disease-free survival rates were 95.3%, 97.2%, 91.3% and 88.5%, respectively. On multivariate analysis, age (P=0.02), number of involved axillary lymph nodes (P=0.01) and nuclear grade (P=0.01) affected the local-relapse-free survival. The factors associated with disease-free survival were the T stage (P=0.05), number of involved axillary lymph nodes (P=0.01) and nuclear grade (P=0.001). Overall survival was associated with the T stage (P=0.02), number of involved axillary lymph nodes (P=0.01) and c-erb B2 overexpression (P=0.05). Patients with more than two factors among age≤35 years, positive lymph node metastasis and high nuclear grade showed a poor 5-year local-relapse-free survival rate compared with others (P=0.001). Also, patients with more than two factors among tumor size >1 cm, positive

  2. [Changes in the surgical treatment of breast cancer].

    Science.gov (United States)

    Taguchi, T

    1988-01-01

    The principle in surgery for breast cancer is to clean out and remove en masse the primary lesion within the breast as well as the lymph nodes (metastases) in the vicinity. This fundamental approach to surgical intervention was established by Halsted and Meyer at the close of the nineteenth century. This has been termed typical mastectomy to this day and standard radical mastectomy has been the method used. Later, a more expanded type of radical surgery was performed on somewhat more advanced cases, but a less radical approach then came about. Since 1960, the excision of nodes in the cerebrum and cerebellum was not used for early cancer, and in some cases a more conservative approach in which only part of the breasts was removed resulted, as Europe and the United States were heavily toward reduced operations. Thus, it was considered that axillary expurgation was needed, but that excision of nodes in the cerebrum and cerebellum was not essential in every case. One approach is less aggressive, whether as to the expurgation or excision of the surrounding area of the breast; in certain cases, treatment may be combined with radiation and the surgery minimized. The above-mentioned operative procedure which leaves brain nodes intact has been called modified radical mastectomy. This is subdivided into the Auchincloss method, in which modes in the cerebellum are extirpated, and the Patey method, in which the cerebral nodes are preserved. In Japan this approach has been used for breast cancer in Stage I and Stage II, with surgery gradually becoming the mainstream. Conservative breast operation procedures such as tumor extirpation, partial breast removal or segmental resection are still rare in Japan but very common in Europe and the United States. Since remote metastases frequently occur through the circulation in breast cancer, in recent years it has generally been regarded as a whole-body disease and, in terms of the advance of the cancer in each case, the method of

  3. 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.

  4. Technique of radiotherapeutic treatment of breast cancer with scarcity means

    International Nuclear Information System (INIS)

    The objective of this work is to show the particularities in the treatment simulation localization, in the volume selection and in the main planning strategies motive by our scarcity means during the first year of performance. It was utilized a computerized tomograph, an X-ray equipment with tele commanded table. Also it was utilized a radio opaque lattice of marked center and knowing space and also a magnetic pointer for indicating 80 cm length between focus-skin. Putting the patient on an inclined plane of self design and manufacture, it was realized three cuts at different levels over what are limited the clinical target volume (CTV) and it is optimized the isocenter through its determined localization by equations. It was employed equations for the radiobiological prediction about fibrosis and dermatitis. It was utilized another techniques or procedures for planning such as personnel wedges or the dose equilibrium in three points of the breast. It was evaluated toxicities (EORTC-RTOG). The results were as follow: Acute dermatitis (grade 1: 23 %; grade 2: 59 %; grade 3: 18 %). Acute pneumonitis (grade 1: 4.3 %); acute pharyngitis (grade 1: 11 %; grade 2: 3.7 %. In conservator treatment of breast it was obtained excellent aesthetic results in 15 %; good 72 %; moderate 11 %; and bad 3 %. The good aesthetic results by the combined use of the optimization techniques in clinical dosimetry, personnel wedges, isocenter therapy and computerized planning in the radiotherapeutic treatment of the breast cancer. (Author)

  5. Left-Sided Whole Breast Irradiation with Hybrid-IMRT and Helical Tomotherapy Dosimetric Comparison

    OpenAIRE

    An-Cheng Shiau; Chen-Hsi Hsieh; Hui-Ju Tien; Hsin-Pei Yeh; Chi-Ta Lin; Pei-Wei Shueng; Le-Jung Wu

    2014-01-01

    Purpose. Limited-tomotherapy and hybrid-IMRT treatment techniques were compared for reductions in ipsilateral and contralateral lung, heart, and contralateral breast radiation doses. Methods and Materials. Thirty consecutively treated left-sided early-stage breast cancer patients were scheduled for lTomo and hIMRT. For the hIMRT plan conventional tangential-field and four-field IMRT plans were combined with different weightings in the prescribed dose. For the lTomo plan a geometrically limite...

  6. Left-sided breast cancer irradiation using rotational and fixed-field radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Qi, X. Sharon, E-mail: xqi@mednet.ucla.edu [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA (United States); Liu, Tian X. [Department of Radiology, Baylor College of Medicine, Houston, TX (United States); Liu, Arthur K.; Newman, Francis; Rabinovitch, Rachel; Kavanagh, Brian [Department of Radiation Oncology, University of Colorado, Denver, CO (United States); Hu, Y. Angie [Department of Radiation Oncology, Duke University, Durham, NC (United States)

    2014-10-01

    The 3-dimensional conformal radiotherapy (3DCRT) technique is the standard for breast cancer radiotherapy. During treatment planning, not only the coverage of the planning target volume (PTV) but also the minimization of the dose to critical structures, such as the lung, heart, and contralateral breast tissue, need to be considered. Because of the complexity and variations of patient anatomy, more advanced radiotherapy techniques are sometimes desired to better meet the planning goals. In this study, we evaluated external-beam radiation treatment techniques for left breast cancer using various delivery platforms: fixed-field including TomoDirect (TD), static intensity-modulated radiotherapy (sIMRT), and rotational radiotherapy including Elekta volumetric-modulated arc therapy (VMAT) and tomotherapy helical (TH). A total of 10 patients with left-sided breast cancer who did or did not have positive lymph nodes and were previously treated with 3DCRT/sIMRT to the entire breast were selected, their treatment was planned with Monaco VMAT, TD, and TH. Dosimetric parameters including PTV coverage, organ-at-risk (OAR) sparing, dose-volume histograms, and target minimum/maximum/mean doses were evaluated. It is found that for plans providing comparable PTV coverage, the Elekta VMAT plans were generally more inhomogeneous than the TH and TD plans. For the cases with regional node involvement, the average mean doses administered to the heart were 9.2 (± 5.2) and 8.8 (± 3.0) Gy in the VMAT and TH plans compared with 11.9 (± 6.4) and 11.8 (± 9.2) Gy for the 3DCRT and TD plans, respectively, with slightly higher doses given to the contralateral lung or breast or both. On average, the total monitor units for VMAT plans are 11.6% of those TH plans. Our studies have shown that VMAT and TH plans offer certain dosimetric advantages over fixed-field IMRT plans for advanced breast cancer requiring regional nodal treatment. However, for early-stage breast cancer fixed

  7. Dietary omega-3 fatty acids and ionizing irradiation on human breast cancer xenograft growth and angiogenesis

    OpenAIRE

    Cameron Ivan L; Short Nicholas; Sun LuZhe; Hardman W Elaine

    2005-01-01

    Abstract Background The effects of an omega-3 (n-3) fatty acid enriched diet alone and in combination with gamma irradiation (IR) therapy in nude mice bearing a human MDA-MB231 breast cancer xenograft were tested. The cancer cells were injected into the mammary fat pad of young female mice. Six weeks later, mice were randomly divided into two diet groups: 1) mice with 10% corn oil (rich in omega 6 fatty acids) in their food, 2) mice consuming a 10% fat diet that was enriched in n-3 fatty acid...

  8. Cosmetic Outcomes for Accelerated Partial Breast Irradiation Before Surgical Excision of Early-Stage Breast Cancer Using Single-Dose Intraoperative Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: Determine cosmetic outcome and toxicity profile of intraoperative radiation delivered before tumor excision for patients with early-stage breast cancer. Methods and Materials: Patients age 48 or older with ultrasound-visible invasive ductal cancers <3 cm and clinically negative lymph nodes were eligible for treatment on this institutional review board-approved Phase II clinical trial. Treatment planning ultrasound was used to select an electron energy and cone size sufficient to cover the tumor plus a 1.5- to 2.0-cm circumferential margin laterally and a 1-cm-deep margin with the 90% isodose line. The dose was prescribed to a nominal 15 Gy and delivered using a Mobetron electron irradiator before tumor excision by segmental mastectomy. Physician- and patient-assessed cosmetic outcome and patient satisfaction were determined by questionnaire. Results: From March 2003 to July 2007, 71 patients were treated with intraoperative radiation therapy. Of those, 56 patients were evaluable, with a median follow-up of 3.1 years (minimum 1 year). Physician and patient assessment of cosmesis was 'good or excellent' (Radiation Therapy Oncology Group cosmesis scale) in 45/56 (80%) and 32/42 (76%) of all patients, respectively. Eleven patients who received additional whole breast radiation had similar rates of good or excellent cosmesis: 40/48 (83%) and 29/36 (81%), respectively). Grade 1 or 2 acute toxicities were seen in 4/71 (6%) patients. No Grade 3 or 4 toxicities or serious adverse events have been seen. Conclusion: Intraoperative radiotherapy delivered to an in situ tumor is feasible with acceptable acute tolerance. Patient and physician assessment of the cosmetic outcome is good to excellent.

  9. Focal adhesion signaling in breast cancer treatment

    NARCIS (Netherlands)

    Ma, Yafeng

    2009-01-01

    Understanding the molecular mechanisms of survival and migratory pathways in cancer cells is essential to better comprehending cancer progression, metastasis formation and drug resistance, thereby benefiting the development of novel anticancer treatments. The overall goal of the work is to better un

  10. Prevalence and risk factors for development of lymphedema following breast cancer treatment

    International Nuclear Information System (INIS)

    BACKGROUND: Early detection and multimodality therapy has resulted in an overall improvement of survival among breast cancer patients. Despite a significant shift in the treatment approach from radical mastectomy to breast conservation a significant number of patients develop lymphedema. This study was conducted to evaluate the prevalence and risk factors for development of lymphedema. SETTINGS AND DESIGN: Retrospective analysis for prevalence of lymphedema in a tertiary care regional cancer centre. MATERIAL AND METHODS: Three hundred treated breast cancer patients with a minimum follow up of one year were evaluated for the prevalence and risk factors for lymphedema. Lymphedema was assessed using a serial circumferential measurement method. More than 3 cm difference in circumference is considered as clinical significant lymphedema. Univariate and multivariate analysis were performed for evaluating the risk factors by using the Chi square test and Cox logistic regression analysis. RESULTS: The prevalence of clinically significant lymphedema was 33.5 % and 17.2 % had severe lymphedema. The prevalence of lymphedema was 13.4 % in patients treated with surgery only where as the prevalence was 42.4% in patients treated with surgery and radiotherapy. Stage of the disease, body surface area> 1.5 m2, presence of co-morbid conditions, post operative radiotherapy and anthracycline based chemotherapy were significant risk factors in univariate analysis where as axillary irradiation and presence of co-morbid conditions have emerged as independent risk factors in multivariate analysis (P < 0.001). CONCLUSION: Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions and axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection and axillary radiation should be avoided whenever feasible to avoid lymphedema. (author)

  11. Adaptive Replanning to Account for Lumpectomy Cavity Change in Sequential Boost After Whole-Breast Irradiation

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficiency of standard image-guided radiation therapy (IGRT) to account for lumpectomy cavity (LC) variation during whole-breast irradiation (WBI) and propose an adaptive strategy to improve dosimetry if IGRT fails to address the interfraction LC variations. Methods and Materials: Daily diagnostic-quality CT data acquired during IGRT in the boost stage using an in-room CT for 19 breast cancer patients treated with sequential boost after WBI in the prone position were retrospectively analyzed. Contours of the LC, treated breast, ipsilateral lung, and heart were generated by populating contours from planning CTs to boost fraction CTs using an auto-segmentation tool with manual editing. Three plans were generated on each fraction CT: (1) a repositioning plan by applying the original boost plan with the shift determined by IGRT; (2) an adaptive plan by modifying the original plan according to a fraction CT; and (3) a reoptimization plan by a full-scale optimization. Results: Significant variations were observed in LC. The change in LC volume at the first boost fraction ranged from a 70% decrease to a 50% increase of that on the planning CT. The adaptive and reoptimization plans were comparable. Compared with the repositioning plans, the adaptive plans led to an improvement in target coverage for an increased LC case (1 of 19, 7.5% increase in planning target volume evaluation volume V95%), and breast tissue sparing for an LC decrease larger than 35% (3 of 19, 7.5% decrease in breast evaluation volume V50%; P=.008). Conclusion: Significant changes in LC shape and volume at the time of boost that deviate from the original plan for WBI with sequential boost can be addressed by adaptive replanning at the first boost fraction

  12. Early breast cancer

    International Nuclear Information System (INIS)

    Breast cancer remains a common disease throughout the world. Here we review new knowledge about early breast cancer obtained during the past 5 years. The prognosis of early breast cancer is generally favorable. Especially, ductal carcinoma in situ has been regarded as a non-life-threatening disease. Therefore, early diagnosis and early onset of the treatment has been important. Early age at menarche, late age at first birth, and late age at menopause are related to breast cancer risk. Examination by mammography and ultrasonography is still the most effective means of detection for premenopausal and postmenopausal women, respectively. Additionally, there have been important advances in MRI, sentinel lymph node biopsy, breast-conserving surgery, partial breast irradiation, neoadjuvant systemic therapy, and adjuvant systemic therapy. Another approach to keeping the disease under control is the elucidation of breast cancer's molecular biological features. Assessment of potential molecular targets can lead to early diagnosis and molecular targeted treatment. (author)

  13. Safety and toxicology assessment of chicken breast for high-dose irradiation

    International Nuclear Information System (INIS)

    Feeding wholesomeness tests of irradiated chicken breast were studied by using acute oral toxicology, Ames, micronucleus of born marrow cell, sperm shape abnormality in mice and 30 d feeding test. The LD50 of all the rats and mice were more than 10 g/kg · BW, which means that the pet foods belonged to actually non-toxic grade; ames test, and the tests of micronucleus of born marrow cell, sampan shape abnormality in mice were all negative results; 30 d feeding test in rats demonstrated that it had no distinctive effects on routine blood, body weight and biochemical index. It is concluded that pet foods irradiated up to 25 kGy high dose were no safety and toxicology problems. (authors)

  14. Industrial technology transfer of the food irradiation treatment

    International Nuclear Information System (INIS)

    While the Joint Expert Committee on Food Irradiation (WHO-FAO-IAEA) concluded that all foods, irradiated up to a dose of 10 kGy is safe for human consumption from the toxicologic view point, the US FDA intends to clear food irradiated up to a dose of 1 kGy and has cleared spices up to 10 kGy. The various possible applications of food irradiation are discussed and so is the food irradiation project of the US DOE and its objectives. The main item on the DOE program is the treatment of pork meat, infested with Trichinella Spiralis, at doses of 0.3 kGy, and the diverse aspects of the research program are described. It was demonstrated experimentally that only 0.2 kGy is necessary for inactivation of the first generation of larvae, whereas inhibition of the second generation of larvae, encysted within the muscles requires a dose of 0.1 kGy. However, for complete inactivation a dose of 0.3 kGy was found necessary. The overall feasibility of pork meat irradiation is being studied, including estimation of consumer reaction. In expectation of FDA clearance of irradiated pork meat, further economic feasibility studies and a demonstration scale irradiation facility are planned. The radiation disinfestation of fruits for quarantine purposes is also discussed, presenting results obtained by the USDA with respect to pomela, infested with fruit flies, and the possible replacement of EDB looks feasible to the US authorities. A transportable Cs 137 irradiator for demonstration purposes has been designed and will be applied to different products. The possible application of irradiation to algae, produced in sewage processing plants, is considered with the aim of producing a high protein cattle feed. US AID and US DOE are jointly investigating the possible application of this technology in developing countries which export their products to the USA

  15. Adjusting to life after treatment: distress and quality of life following treatment for breast cancer

    OpenAIRE

    Costanzo, E S; Lutgendorf, S.K.; Mattes, M L; Trehan, S; Robinson, C B; Tewfik, F; Roman, S L

    2007-01-01

    Clinical and anecdotal findings suggest that the completion of cancer treatment may be marked by heightened distress and disrupted adjustment. The present study examined psychological adjustment during the 3 months following treatment among 89 women with stages 0–III breast cancer. Participants completed measures of depression, cancer-related anxiety, cancer concerns, and quality of life at three time points: during treatment, 3 weeks following the end of treatment, and 3 months post-treatmen...

  16. Treatment related morbidity in breast cancer patients

    OpenAIRE

    Rietman, J.S.; Geertzen, J. H. B.; Dijkstra, P U; Hoekstra, H. J.

    2007-01-01

    Background: Sentinel lymph node biopsy (SLNB) was introduced for staging of the axilla to reduce the number of unnecessary axillary lymph node dissections (ALND’s) and proved to be an accurate and safe procedure to predict metastatic disease in clinically negative axillary lymph nodes. SLNB was expected to have less treatment related morbidity in comparison to ALND. In a multicenter prospective cohort study, long term upper-limb morbidity, perceived disabilities in activities of daily life (A...

  17. Lipoplatin Treatment in Lung and Breast Cancer

    OpenAIRE

    Alberto Ravaioli; Alessandra Affatato; Cinzia Castellani; Fabrizio Drudi; Lorenzo Gianni; Carlotta Santelmo; Manuela Fantini; Mario Nicolini

    2010-01-01

    The introduction of cisplatin in cancer treatment represents an important achievement in the oncologic field. Many types of cancers are now treated with this drug, and in testicular cancer patients major results are reached. Since 1965, other compounds were disovered and among them carboplatin and oxaliplatin are the main Cisplatin analogues showing similar clinical efficacy with a safer toxicity profile. Lipoplatin is a new liposomal cisplatin formulation which seems to have these characteri...

  18. Study on innocent irradiation treatment of Trichinella spiralis pork

    International Nuclear Information System (INIS)

    The effects of 60Co gamma rays on pork Trichinella spiralis and nutritional hygiene evaluation of irradiated Trichinella spiralis pork were studied by using animal infestation test and artificial gastric juice digestion method. The results showed that when mouse was infested by Trichinella spiralis pork irradiated with a dose of 0.04 kGy, the number of the second generation larvae and the parasitism in the muscle were reduced. 0.08 kGy irradiation could render the intestine Trichinella spiralis sterile. 0.1 kGy blocked the growth of Trichinella spiralis, which were excreted from the body four days after infestation. 0.2-0.8 kGy irradiation could severely block the growth of Trichinella spiralis, which were excreted completely from the body within forth-eight hours when irradiated with 7 kGy and 8 kGy, the Trichinella spiralis body was not found in the intestine within twenty-four hours. 0.3 kGy and 1 kGy irradiation had no harmful effect on nutrition and wholesomeness of Trichinella spiralis pork. Innocent irradiation treatment of Trichinella spiralis pork is practicable, and the lowest dose should be 0.3 kGy

  19. Detection of irradiation treatment of foods using DNA 'comet assay'

    International Nuclear Information System (INIS)

    Microgel electrophoresis of single cells (DNA comet assay) has been investigated to detect irradiation treatment of some food samples. These samples of fresh and frozen rainbow trout, red lentil, gram and sliced almonds were irradiated to 1 or 2 kGy using 10 MeV electron beam from a linear accelerator. Rainbow trout samples yielded good results with samples irradiated to 1 or 2 kGy showing fragmentation of DNA and, therefore, longer comets with no intact cells. Unirradiated samples showed shorter comets with a significant number of intact cells. For rainbow trout stored in a freezer for 11 days the irradiated samples can still be discerned by electrophoresis from unirradiated samples, however, the unirradiated trouts also showed some longer comets besides some intact cells. Radiation treatment of red lentils can also be detected by this method, i.e. no intact cells in 1 or 2 kGy irradiated samples and shorter comets and some intact cells in unirradiated samples. However, the results for gram and sliced almond samples were not satisfactory since some intact DNA cells were observed in irradiated samples as well. Probably, incomplete lysis has led to these deviating results

  20. Detection of Irradiation Treatment of Foods Using DNA `Comet Assay'

    Science.gov (United States)

    Khan, Hasan M.; Delincée, Henry

    1998-06-01

    Microgel electrophoresis of single cells (DNA comet assay) has been investigated to detect irradiation treatment of some food samples. These samples of fresh and frozen rainbow trout, red lentil, gram and sliced almonds were irradiated to 1 or 2 kGy using 10 MeV electron beam from a linear accelerator. Rainbow trout samples yielded good results with samples irradiated to 1 or 2 kGy showing fragmentation of DNA and, therefore, longer comets with no intact cells. Unirradiated samples showed shorter comets with a significant number of intact cells. For rainbow trout stored in a freezer for 11 days the irradiated samples can still be discerned by electrophoresis from unirradiated samples, however, the unirradiated trouts also showed some longer comets besides some intact cells. Radiation treatment of red lentils can also be detected by this method, i.e. no intact cells in 1 or 2 kGy irradiated samples and shorter comets and some intact cells in unirradiated samples. However, the results for gram and sliced almond samples were not satisfactory since some intact DNA cells were observed in irradiated samples as well. Probably, incomplete lysis has led to these deviating results.

  1. The Impact of Comorbidities on Outcomes for Elderly Women Treated With Breast-Conservation Treatment for Early-Stage Breast Cancer

    International Nuclear Information System (INIS)

    Purpose: Breast cancer incidence increases with age and is a major cause of morbidity and mortality in elderly women, but is not well studied in this population. Comorbidities often impact on the management of breast cancer in elderly women. Methods and Materials: From 1979 to 2002, a total of 238 women aged 70 years and older with Stage I or II invasive carcinoma of the breast underwent breast-conservation therapy. Outcomes were compared by age groups and comorbidities. Median age at presentation was 74 years (range, 70-89 years). Age distribution was 122 women (51%) aged 70-74 years, 71 women (30%) aged 75-79 years, and 45 women (19%) aged 80 years or older. Median follow-up was 6.2 years. Results: On outcomes analysis by age groups, 10-year cause-specific survival rates for women aged 70-74, 75-79, and 80 years or older were 74%, 81%, and 82%, respectively (p = 0.87). Intercurrent deaths at 10 years were significantly higher in older patients: 20% in those aged 70-74 years, 36% in those aged 75-79 years, and 53% in those 80 years and older (p = 0.0005). Comorbidities were not significantly more common in the older age groups and did not correlate with cause-specific survival adjusted for age. Higher comorbidity scores were associated with intercurrent death. Conclusions: Older age itself is not a contraindication to standard breast-conservation therapy, including irradiation. Women of any age with low to moderate comorbidity indices should be offered standard breast-conservation treatment if otherwise clinically eligible

  2. Breast cancer causes and treatment: where are we going wrong?

    Directory of Open Access Journals (Sweden)

    Seymour CB

    2013-12-01

    Full Text Available Colin B Seymour, Carmel MothersillMedical Physics and Applied Radiation Sciences Department, McMaster University, Hamilton, ON, CanadaAbstract: This discussion paper seeks to provoke thoughts about cancer research in general, and why breast cancer in particular is not yet “curable”. It asks the question – are we looking at the disease in the right way? Should we regard cancer as a progressive state, which is part of aging? Should we tailor treatment to “reset” the system or slow progression rather than try using toxic and aggressive therapy to kill every cancer cell (and sometimes also the patient? The thesis is presented that we need to revisit our fundamental beliefs about the disease and then ask why we cling to beliefs that clearly are no longer valid. The paper also questions the role of ethics boards in hampering research and discusses the concept that breast cancer is an industry with vested interests involving profiteering by preventive, diagnostic, and therapeutic players. Finally, the paper suggests some ways forward based on emerging concepts in system biology and epigenetics.Keywords: breast cancer, causes, treatment, questioning paradigms

  3. [Neoadjuvant treatment of breast cancer: implications for the pathologist].

    Science.gov (United States)

    Le Guellec, Sophie; Perallon, Romain; Alunni, Jean-Philippe; Charitansky, Hélène; Leaha, Christina; Gonzalez, Aurélie Maran; Chateau, Marie-Christine; Simony-Lafontaine, Joelle; Jacot, William; Gutowski, Marian; Penault-Llorca, Frédérique; Dalenc, Florence; Lacroix-Triki, Magali

    2011-12-01

    These past few years, neoadjuvant strategy has taken an increasing place in the management of breast cancer patients. This strategy is mainly indicated to obtain a tumour bulk regression allowing a breast conserving surgery in patients that otherwise would have undergone mastectomy. Of note, development of new chemotherapy agents and targeted therapies has critically helped in the progress of neoadjuvant strategy as it is currently associated with better pathological response rates. In this context, the pathologist is at the crossroad of this multidisciplinary process. First, he provides on the initial core needle biopsy the tumour pathological characteristics that are critical for the choice of treatment strategy, i.e. histological type, histological grade, proliferative activity (mitotic count and Ki67/MIB1 index labeling), hormone receptor status (oestrogen receptor and progesterone receptor) and HER2 status. Secondly, the pathologist evaluates the pathological response and the status of surgical margins with regards to the residual tumour on the surgical specimen after neoadjuvant treatment. These parameters are important for the management of the patient, since it has been shown that complete pathological response is associated with improved disease free survival. Several grading systems are used to assess the pathological response in breast and axillary lymph nodes. The most frequently used in France are currently the systems described by Sataloff et al. and Chevallier et al. In this review, we detail the different steps involving the pathologist in neoadjuvant setting, with special regards to the quality process and future perspectives such as emerging predictive biomarkers. PMID:22172117

  4. Cosmetic evaluation of breast conserving treatment for mammary cancer

    International Nuclear Information System (INIS)

    In a population of 142 patients with stage I and II breast cancer, treated with tumor excision and external radiotherapy, using a wide range of radiation doses and fractionation schedules, an attempt was made to quantify the cosmetic outcome. Quantitative measurements of nipple displacement and breast contour retraction were compared and correlated with qualitative scoring by a panel. In the vast majority, the quantitative assessments correlate very well with subjective, qualitative scoring, making this method relevant for clinical use. There are a few exceptions, mainly cases where localized skin changes such as severe teleangiectasia or skin necrosis affect strongly the cosmetic result but can go undetected in this measuring system. Also limited surgical deformations, which can detract seriously from cosmetic success, particularly when they occur in the medio inferior quadrants, taken in standard conditions is needed. Measurements can be carried out quickly, using the plottin device of a treatment planning system. This system may be of great use for follow-up of new treatment modalities and the study of the development of radiation fibrosis in breast cancer. (author). 15 refs.; 3 figs.; 2 tabs

  5. A study on non-specific immunity of breast cancer patients with postoperative irradiation

    International Nuclear Information System (INIS)

    The influences of postoperative irradiation on the immune capacity of patients with breast cancer were estimated by some immunological methods. The patients were examined before, during and after irradiation by means of peripheral blood leucocyte, lymphocyte and T-cell counts and lymphoproliferative responses to Phytohemagglutinin (PHA), Concanavalin A (Con A) and Pogweed mitogen (PWM). 1) Leucocyte, Lymphocyte and T-cell counts diminished gradually during irradiation. This decrease persisted 3 weeks after end of radiotherapy. 2) The grade of reduction of lymphocyte was more remarked than of leucocyte. 3) Decrease of T-cell count was almost in parallel with lymphocyte, indicating the ratio of T-cell seemed to be not affected by radiotherapy. 4) In general lymphoproliferative response to PHA decreased in progress with radiotherapy, although in some cases this response temporarily rised after start of irradiation. This decrease did not recover 3 weeks after end of radiotherapy. 5) Response to Con A was variant during and after radiotherapy, indicating a difference in radiosensitivity between lymphocytes stimulated by PHA and Con A. 6) Response to PWM was hardly affected by radiotherapy. 7) PS-K administered during and after radiotherapy was slightly effective on recovery of lymphocyte and T-cell counts as well as lymphocyte response to PHA. (author)

  6. Accumulation of cyclophilin A isoforms in conditioned medium of irradiated breast cancer cells

    International Nuclear Information System (INIS)

    Secreted proteins play a key role in cell signaling and communication. We recently showed that ionizing radiations induced a delayed cell death of breast cancer cells, mediated by the death receptor pathways through the expression of soluble forms of 'death ligands'. Using the same cell model, the objective of our work was the identification of diffusible factors, secreted following cell irradiation, potentially involved in cell death signaling. Differential proteomics analysis of conditioned media using 2DE resulted in detection of numerous spots that were significantly modulated following cell irradiation. The corresponding proteins were identified using MALDI-TOF MS and LC-MS/MS approaches. Interestingly, five isoforms of cyclophilin A were observed as increased in conditioned medium of irradiated cells. These isoforms differed in isoelectric points and in accumulation levels. An increase of cyclophilin A secretion was confirmed by Western blotting of conditioned media of irradiated or radiosensitive mammary cells. These isoforms displayed an interesting pattern of protein maturation and post-translational modifications, including an alternating removal of N-terminal methionine, associated with a combination of acetylations and methylations. The role of the protein is discussed in relation with its potential involvement in the mechanisms of inter-cells relationships and radiosensitivity. (authors)

  7. Breast cancer causes and treatment: where are we going wrong?

    Science.gov (United States)

    Seymour, Colin B; Mothersill, Carmel

    2013-01-01

    This discussion paper seeks to provoke thoughts about cancer research in general, and why breast cancer in particular is not yet "curable". It asks the question - are we looking at the disease in the right way? Should we regard cancer as a progressive state, which is part of aging? Should we tailor treatment to "reset" the system or slow progression rather than try using toxic and aggressive therapy to kill every cancer cell (and sometimes also the patient)? The thesis is presented that we need to revisit our fundamental beliefs about the disease and then ask why we cling to beliefs that clearly are no longer valid. The paper also questions the role of ethics boards in hampering research and discusses the concept that breast cancer is an industry with vested interests involving profiteering by preventive, diagnostic, and therapeutic players. Finally, the paper suggests some ways forward based on emerging concepts in system biology and epigenetics. PMID:24648764

  8. The Suitability of Absorbable Mesh Insertion for Oncoplastic Breast Surgery in Patients with Breast Cancer Scheduled to Be Irradiated

    OpenAIRE

    Kim, Taehyun; Cho, Heunglae

    2013-01-01

    Purpose The objective of this study was to investigate the influence of radiotherapy on the cosmetic outcome after immediate breast reconstruction using an absorbable mesh in breast cancer. Methods From July 2008 to July 2009, 35 breast cancer patients who received immediate breast reconstruction with absorbable mesh insertion at the time of breast conserving surgery followed by radiotherapy were retrospectively studied. Results In 91% of cases there was an excellent or good cosmetic outcome ...

  9. Factors Associated with Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana

    Science.gov (United States)

    Dedey, Florence; Wu, Lily; Ayettey, Hannah; Sanuade, Olutobi A.; Akingbola, Titilola S.; Hewlett, Sandra A.; Tayo, Bamidele O.; Cole, Helen V.; de-Graft Aikins, Ama; Ogedegbe, Gbenga; Adanu, Richard

    2016-01-01

    Background: Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study…

  10. Mammographically detected DCIS treated with breast conserving therapy: an analysis of clinical, pathologic, and treatment related factors affecting outcome

    International Nuclear Information System (INIS)

    Purpose: We reviewed our institutions experience treating mammographically detected DCIS with breast conserving therapy (BCT) to determine if any clinical, pathologic, or treatment related factors affected outcome. Methods and Materials: From December of 1980 to November of 1991, 104 breasts in 102 patients were treated with breast conserving therapy at William Beaumont Hospital, Royal Oak, Michigan. All patients underwent at least an excisional biopsy and sixty three patients (61%) had a re-excision. All patients received whole breast irradiation to a median dose of 5040 cGy (range 4314 to 5600 cGy). Ninety seven patients received a supplemental boost to the tumor bed for a median total dose of 6040 cGy (range 4400 to 7183 cGy) using either photons (2 patients), electrons (67 patients), or interstitial implant (28 patients). Results: With a median follow-up of 6.1 years, 5 patients have failed in the treated breast for five and ten year actuarial local control rates of 95.8% and 94% respectively. Thirteen percent of the population have been followed for 10 years or more. Failures developed 27, 29, 36, 38, and 70 months after treatment. Three recurrences were invasive and two were DCIS. All patients were treated with mastectomy. Four patients remain NED a median of 26 months after surgery. One patient failed distantly 36 months after local recurrence for an ultimate cause specific survival of 99%. Potential clinical, pathologic, and treatment related factors affecting outcome are analyzed below. Conclusion: Patients treated with breast conserving therapy for mammographically detected DCIS achieve excellent rates of local control and survival. No clinical, pathologic, or treatment related factor has been associated with outcome. Additional studies are needed to define the subset of patients at risk for local recurrence with BCT

  11. An experimental investigation of wastewater treatment using electron beam irradiation

    Science.gov (United States)

    Emami-Meibodi, M.; Parsaeian, M. R.; Amraei, R.; Banaei, M.; Anvari, F.; Tahami, S. M. R.; Vakhshoor, B.; Mehdizadeh, A.; Fallah Nejad, N.; Shirmardi, S. P.; Mostafavi, S. J.; Mousavi, S. M. J.

    2016-08-01

    Electron beam (EB) is used for disinfection and treatment of different types of sewage and industrial wastewater. However, high capital investment required and the abundant energy consumed by this process raise doubts about its cost-effectiveness. In this paper, different wastewaters, including two textile sewages and one municipal wastewater are experimentally studied under different irradiation strategies (i.e. batch, 60 l/min and 1000 m3/day) in order to establish the reliability and the optimum conditions for the treatment process. According to the results, EB improves the efficiency of traditional wastewater treatment methods, but, for textile samples, coagulation before EB irradiation is recommended. The cost estimation of EB treatment compared to conventional methods shows that EB has been more expensive than chlorination and less expensive than activated sludge. Therefore, EB irradiation is advisable if and only if conventional methods of textile wastewater treatment are insufficient or chlorination of municipal wastewater is not allowed for health reasons. Nevertheless, among the advanced oxidation processes (AOP), EB irradiation process may be the most suitable one in industrial scale operations.

  12. Multiple cavities in myocardium of left ventricle after irradiation therapy for breast cancer. A case report

    International Nuclear Information System (INIS)

    A 68-year-old woman was admitted to our hospital with congestive heart failure. She had been diagnosed with hypertrophic cardiomyopathy 12 years ago in another hospital. She had received irradiation therapy for left breast cancer 33 years ago after resection of her left breast. Echocardiography revealed left ventricular hypertrophy and wall motion hypokinesis, and multiple cavities in the myocardium of the left ventricle, interventricular septum, and anterior wall. Some cavities were observed to connect to the left ventricular cavity and Doppler echocardiography showed slow velocity flows in them different from that of the coronary artery. The pathologic diagnosis was severe sclerosis of the left coronary artery, especially the left descending artery and its branch, which was the area with irradiation. Histopathology revealed sclerotic changes of the coronary artery causing acute and chronic myocardial infarction, and incomplete regeneration and hypertrophy of cardiac cells. There was no sign of hypertrophic cardiomyopathy. Myocardial degeneration and deciduation were present next to the cavities connected to left ventricle-like fistulas. (author)

  13. Nonbreast Second Malignancies After Treatment of Primary Breast Cancer

    International Nuclear Information System (INIS)

    Purpose: To determine the incidence and risk factors for nonbreast second malignancies (NBSMs) in women after treatment for primary breast cancer. Methods and Materials: Between January 1985 and December 1995, a total of 1,084 breast cancer patients were analyzed for NBSMs. Detailed analysis was carried out for age, family history, disease stage, radiation therapy, chemotherapy, hormone therapy, other clinical/pathologic characteristics, and site of NBSMs. The Cox proportional hazard regression model was used to estimate the relative risk of NBSMs. Results: Median follow-up was 12 years. In total, 33 cases of NBSMs were noted in 29 patients. The overall incidence of NBSM was 3%, and the median time for NBSMs was 7 years. The most common NBSMs were gynecologic (22 patients), gastrointestinal (4 patients), head and neck (3 patients), hematologic (2 patients), lung (1 patient), and thyroid (1 patient). The NBSMs rate at 12 years was 2.4% for both mastectomy and radiation therapy groups. In the subset of patients less than 45 years of age at the time of treatment, the NBSMs rate was 0.7% as compared with 4.6% in patients more than 45 years of age (p = 0.001). Statistically significant higher incidences of endometrial and ovarian cancer were seen in patients with hormonal therapy (5.2%) as compared with patients without hormonal therapy (1.8%, p = 0.002). Women with a family history of breast cancer had a higher incidence (6%) of endometrial and ovarian malignancy compared with women without such a history (2.1%, p = 0.003). Chemotherapy did not affect the risk of second malignancy. Conclusion: The most common NBSMs in this study were gynecologic. Family history of breast cancer was a high risk factor for NBSMs. No risk of NBSMs with radiotherapy was observed.

  14. Post-radiation malignant fibrous histiocytoma following treatment of breast cancer: A case report

    International Nuclear Information System (INIS)

    Post-radiation malignant fibrous histiocytoma (MFH) of the breast is extremely rare. We report a case of post-radiation MFH that presented a rapidly growing mass in a 52-year-old woman who underwent breast-conserving therapy and adjuvant whole breast irradiation 6 years ago. To the best of our knowledge, only one case of primary MFH of the female breast have been reported with sonographic findings. We analyzed the sonographic and MRI findings with correlative histopathologic features, and then confirmed with surgical excision.

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

    International Nuclear Information System (INIS)

    interval, 73–99%), respectively. Conclusion: Low-dose-rate accelerated partial breast irradiation with implant brachytherapy provides acceptable local control in select early-stage BCa patients. However, treatment-related toxicity and cosmetic complications were significant with longer follow-up and at higher doses.

  16. 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

    -free survival, and overall survival rate was 85% (95% confidence interval, 70-97%), 72% (95% confidence interval, 54-86%), and 87% (95% confidence interval, 73-99%), respectively. Conclusion: Low-dose-rate accelerated partial breast irradiation with implant brachytherapy provides acceptable local control in select early-stage BCa patients. However, treatment-related toxicity and cosmetic complications were significant with longer follow-up and at higher doses.

  17. In vivo monitoring of CD44+ cancer stem-like cells by γ-irradiation in breast cancer.

    Science.gov (United States)

    Kim, Mi Hyun; Kim, Min Hwan; Kim, Kwang Seok; Park, Myung-Jin; Jeong, Jae-Hoon; Park, Seung Woo; Ji, Young Hoon; Kim, Kwang Il; Lee, Tae Sup; Ryu, Phil Youl; Kang, Joo Hyun; Lee, Yong Jin

    2016-06-01

    There is increasing evidence that cancer contains cancer stem cells (CSCs) that are capable of regenerating a tumor following chemotherapy or radiotherapy. CD44 and CD133 are used to identify CSCs. This study investigated non-invasive in vivo monitoring of CD44-positive cancer stem-like cells in breast cancer by γ-irradiation using molecular image by fusing the firefly luciferase (fLuc) gene with the CD44 promoter. We generated a breast cancer cell line stably expressing fLuc gene by use of recombinant lentiviral vector controlled by CD44 promoter (MCF7-CL). Irradiated MCF7-CL spheres showed upregulated expression of CD44 and CD133, by immunofluorescence and flow cytometry. Also, gene expression levels of CSCs markers in irradiated spheres were clearly increased. CD44+ CSCs increased fLuc expression and tumor growth in vivo and in vitro. When MCF7-CL was treated with siCD44 and irradiated, CD44 expression was inhibited and cell survival ratio was decreased. MCF7-CL subsets were injected into the mice and irradiated by using a cobalt-60 source. Then, in vivo monitoring was performed to observe the bioluminescence imaging (BLI). When breast cancer was irradiated, relative BLI signal was increased, but tumor volume was decreased compared to non-irradiated tumor. These results indicate that increased CD44 expression, caused by general feature of CSCs by irradiation and sphere formation, can be monitored by using bioluminescence imaging. This system could be useful to evaluate CD44- expressed CSCs in breast cancer by BLI in vivo as well as in vitro for radiotherapy. PMID:27098303

  18. Vitamin D: Are We Ready to Supplement for Breast Cancer Prevention and Treatment?

    OpenAIRE

    Crew, Katherine D.

    2013-01-01

    Vitamin D deficiency is a potentially modifiable risk factor that may be targeted for breast cancer prevention and treatment. Preclinical studies support various antitumor effects of vitamin D in breast cancer. Numerous observational studies have reported an inverse association between vitamin D status, including circulating 25-hydroxyvitamin D (25(OH)D) levels, and breast cancer risk. The relationship between vitamin D and mammographic density, a strong predictor of breast cancer risk, remai...

  19. Fat necrosis after conserving surgery and interstitial brachytherapy and/or external-beam irradiation in women with breast cancer

    International Nuclear Information System (INIS)

    Purpose: to investigate the incidence of fat necrosis, breast tissue fibrosis and breast pain after conserving surgery and accelerated partial-breast irradiation (APBI, group A), whole-breast external-beam irradiation (EBRT, group B), or EBRT combined with an interstitial boost (EBIB, group C) in women with breast cancer. Patients and methods: 85 patients who received breast-conserving therapy from 02/2000 to 03/2002 were analyzed. 30 patients received EBRT, 33 patients APBI, and 22 patients EBIB. Median follow-up was 35.5, 35.0, and 37.5 months, respectively. Fat necrosis was detected and rated by mammograms, fibrosis and pain were clinically rated with the LENT-SOMA scores. Results: the incidence of fat necrosis was 15.3% for all patients; and 15.2%, 20.0%, and 9.0% for groups A, B, and C, respectively. The 3-year fat necrosis-free survival probability was 83%, 76%, and 95% (difference not significant). The mean time to first diagnosis of fat necrosis was 25.6, 26.2, and 26.0 months. No patient needed surgical intervention because of fat necrosis-related pain. Fibrosis was present in 27.3%, 63.3%, and 77.3% (p<0.001), breast pain in 9.0%, 33.4%, and 18.1% (p<0.05). Conclusion: asymptomatic fat necrosis is a common finding after both percutaneous and interstitial irradiation after breast-conserving surgery. This analysis did not support the hypothesis that APBI with multicatheter implants leads to higher rates of fat necrosis, fibrosis, or pain. (orig.)

  20. Dosimetric evaluation of incidental irradiation to the axilla during whole breast radiotherapy for patients with left-sided early breast cancer in the IMRT era.

    Science.gov (United States)

    Lee, Jayoung; Kim, Shin-Wook; Son, Seok Hyun

    2016-06-01

    The purpose of this study was to compare the dosimetric parameters for incidental irradiation to the axilla during whole breast radiotherapy (WBRT) with 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). Twenty left breast cancer patients treated with WBRT after breast-conserving surgery (BCS) were enrolled in this study. Remnant breast tissue, 3 levels of the axilla, heart, and lung were delineated. We used 2 different radiotherapy methods: 3D-CRT with field-in-field technique and 7-field fixed-beam IMRT. The target coverage of IMRT was significantly better than that of 3D-CRT (Dmean: 49.72 ± 0.64 Gy vs 50.24 ± 0.66 Gy, P IMRT, respectively). In the IMRT plan, a lower dose was delivered to a wider region of the heart and lung. Significantly lower axillary irradiation was shown throughout each level of axilla by IMRT compared to 3D-CRT (Dmean for level I: 42.58 ± 5.31 Gy vs 14.49 ± 6.91 Gy, P IMRT, respectively). In conclusion, the incidental dose delivered to the axilla was significantly lower for IMRT compared to 3D-CRT. Therefore, IMRT, which only includes the breast parenchyma, should be cautiously used in patients with limited positive sentinel lymph nodes and who do not undergo complete axillary lymph node dissection. PMID:27368030

  1. 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

    International Nuclear Information System (INIS)

    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, an