Are breast cancer patients treated with radiotherapy younger now than ten years ago?

Bonet, Marta; Godoy, Pere; Cambra, M.J.; Mur, E.; Algara, Manuel; Fernández, Luís; Dalmau, E.; Arcusa, Àngels; Seguí, M. Á.; Saigí, Eugeni; González, Sónia; Cirera, Lluís; Solé, Josep María Macias i

doi:10.1016/j.rpor.2014.05.003

Cited by 1 publication

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“…Recent studies concentrated on tailoring RT to the patient's individual risk according to pathological and bio-molecular prognostic factors, in order to reduce the volume and the duration of complementary RT in selected patients (2)(3)(4). In fact, irradiation of a smaller volume, i.e., the tumour bed with a safety margin, allows an increase of the daily dose by hypofractionation without increasing the risk of late toxicity.…”

Section: Introductionmentioning

confidence: 99%

Patient selection for partial breast irradiation by intraoperative radiation therapy: can magnetic resonance imaging be useful?—perspective from radiation oncology point of view

Krengli

Pisani²,

Deantonio

2016

J. Thorac. Dis.

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The guidelines of the European and American Societies of Radiation Oncology (GEC-ESTRO and ASTRO) defined the selection criteria to offer partial breast irradiation (PBI) after lumpectomy in patients with low risk breast cancer regardless pre-operative staging. A recent publication by Tallet et al.explored the impact of preoperative magnetic resonance imaging (MRI) on patient eligibility for PBI. From their study, an ipsilateral BC was detected in 4% of patients, excluding these patients from intraoperative radiotherapy (IORT). The authors suggested that preoperative MRI should be used routinely for patient's candidate to IORT, because of the rate of ipsilateral breast cancer detected. In view of Tallet's article, we analyzed some aspects of this issue in order to envisage some possible perspective on how to better identify those patients who could benefit from PBI, especially using IORT. From historical studies, the risk of breast cancer recurrence outside index quadrant without irradiation is in the range of 1.5-3.5%. MRI sensitivity for detection of invasive cancer is reported up to 100%, and it is particularly useful in dense breast. Other imaging technique did not achieve the same sensibility and specificity as conventional MRI. Of note, none of randomized trials published and ongoing on PBI included preoperative MRI as part of staging. To perform a preoperative MRI in PBI setting is an interesting issue, but the available data suggest that this issue should be preferably studied in the setting of prospective clinical trials to clarify the role of MRI and the clinical meaning of the discovered additional foci.

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Section: Introductionmentioning

confidence: 99%