Breast Conserving Surgery in Combination With Targeted Intraoperative Radiotherapy Compared to Mastectomy for In-breast-tumor-recurrence

Kolberg, Hans‐Christian; Niesing, Helena; Vaidya, Jayant S; Akpolat-Basci, Leyla; Maguz, Abdrhman; Hoffmann, Oliver; Loevey, Gyoergy; Stephanou, Miltiades; Kolberg‐Liedtke, Cornelia

doi:10.21873/anticanres.16212

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…The application of B-ultrasound, mammography, PET and other diagnosis methods has increased the detection rate of early breast cancer. Breast-conserving surgery combined with radiotherapy has become a more preferred choice for patients with high quality of life and aesthetic effects [1][2][3]. Adjuvant whole breast radiotherapy (WBRT) with conventional fractionation or hypofractionation is presently considered the standard of care after breast-conserving surgery (BCS) for in situ and invasive breast cancer at an early stage [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Geometric factor analysis for dose distribution in the whole breast irradiation

Chen,

Pan,

Liu

et al. 2024

Preprint

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Background Protecting the heart and left lung is important for left-sided breast cancer radiotherapy. So，this study was to investigate the effect of geometric parameters on the dose of left lung and heart in whole breast radiotherapy. Methods A plan was designed for each patient using VMAT technology for thirty patients. A triangular ABC of the target was defined layer by layer. The geometric parameters were defined: Rat-H (the ratio of heart), Rat-L (the ratio of lung), the curvature and thickness of the target ρ and d. Explored the relationships between these parameters and the dose-volume of heart (V5,h, V10,h, V20,h, MHD) and left lung (V5,LL, V10,LL, V20,LL, V30,LL, V40,LL, MLD). Results The V5,h, V10,h and MHD were all significantly associated with Rat-H (p<0.05). The V5,LL, V10,LL, V20,LL, V30,LL, V40,LL and MLD were all significantly associated with Rat-L (p<0.05). And the V20,LL, V30,LL and V40,LL were all significantly associated with d (p<0.05). Meanwhile，V30,LL and V40,LL were all significantly associated with ρ (p<0.05) . The correlations of the dose-volume of left lung and the four geometric parameters could be expressed by linear functions. Conclusions The geometric parameters Rat-H, Rat-L, d and ρ were closely related to the dose-volume of heart and left lung in whole breast radiotherapy.

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Section: Introductionmentioning

confidence: 99%

Geometric factor analysis for dose distribution in the whole breast irradiation

Chen,

Pan,

Liu

et al. 2024

Preprint

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“…Patients undergoing BCS require longterm monitoring and follow-up to detect recurrence (5). Additionally, radiation therapy is often recommended to minimize the risk of local recurrence, introducing another layer to the treatment regimen that may extend the duration and introduce potential side effects (6). Consequently, BCS may not be the optimal choice for every patient, with suitability varying based on tumor size, location, and patient preferences (7).…”

mentioning

confidence: 99%

Evaluating Recurrence Risk in Patients Undergoing Breast-conserving Surgery Using E-cadherin Staining as a Biomarker

KAO,

CHEN,

CHU

et al. 2024

In Vivo

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Background/Aim: Following the National Comprehensive Cancer Network guidelines, radiotherapy is administered after breast-conserving surgery (BCS) in patients with more than four positive lymph nodes. Four positive lymph nodes are typically considered an indicator to assess disease spread and patient prognosis. However, the subjective counting of positive axillary lymph nodes underscores the need for biomarkers to improve diagnostic precision and reduce the risk of unnecessary treatments. Loss of E-cadherin expression is associated with cancer metastasis, but its potential as a predictive marker for cancer treatment remains uncertain. This study aimed to investigate the validity of E-cadherin as a reference for adjuvant radiotherapy in breast cancer patients with positive lymph nodes post-mastectomy. Materials and Methods: Immunohistochemistry was performed on 60 clinical tissue specimens to assess these implications. Results: Although no significant result was found in a single E-cadherin subgroup (low, medium, and high subgroups according to the X-tile algorithm), the proposed multivariate model, including the Ecadherin category, breast cancer subtype, and tumor size, yielded satisfactory recurrence risk estimation results for patients undergoing BCS. Patients with a low E-cadherin category, triple-negative breast cancers, and tumor size over 5 cm could have an increased risk of recurrence. Conclusion:Our study proposed a multivariate model that serves as a candidate prognostic factor for recurrence-free survival in patients undergoing BCS and radiotherapy. Utilizing this model for patient stratification in high-risk diseases and as a standard for assessing postoperative intensified therapy can potentially improve patient outcomes.Breast-conserving surgery (BCS), also known as lumpectomy or partial mastectomy, aims to excise a tumor or a section of the breast while preserving as much healthy tissue as possible (1, 2). Despite its benefits, BCS may carry a slightly higher risk of local recurrence compared to mastectomy, particularly when the tumor is large or margins 1143

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