DCIS: When is accelerated partial breast irradiation an option? A meta-analysis on outcomes and eligibility

Chua, Vannesza Hendricke; Chua, Joyce Hazel; Aniceto, Celina Joyce; Antonio, Jane April; Harina, Ma Dara Hannah; Martinez, Karen Claire

doi:10.1016/j.amjsurg.2023.03.004

Cited by 1 publication

(2 citation statements)

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“…Looking at the characteristics of the DCIS, in the Group Européen de Curiethérapie/European Society for Radiotherapy and Oncology (GEC-ESTRO) trial [73] only low-and intermediate-risk DCIS (Van nuys Prognostic index = 8) with 5 mm clear surgical margins were eligible, while in the National Surgical Breast and Bowel Project B-39 Trial, all the types of DCIS were allowed, including 28% grade 3 and 12% hormonal receptornegative tumours [74]. A recent meta-analysis comparing PBI and WBRT by Chua et al [9] including 6 studies highlighted the importance of DCIS selection. In fact, DCIS in the Suitable group fared significantly better than those in the Unsuitable group [odds ratio 2.69, 95% CI (1.…”

Section: Partial Breast Irradiationmentioning

confidence: 99%

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Tools to Guide Radiation Oncologists in the Management of DCIS

Leonardi,

Zerella,

Lazzeroni

et al. 2024

Healthcare

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Similar to invasive breast cancer, ductal carcinoma in situ is also going through a phase of changes not only from a technical but also a conceptual standpoint. From prescribing radiotherapy to everyone to personalized approaches, including radiotherapy omission, there is still a lack of a comprehensive framework to guide radiation oncologists in decision making. Many pieces of the puzzle are finding their place as high-quality data mature and are disseminated, but very often, the interpretation of risk factors and the perception of risk remain very highly subjective. Sharing the therapeutic choice with patients requires effective communication for an understanding of risks and benefits, facilitating an informed decision that does not increase anxiety and concerns about prognosis. The purpose of this narrative review is to summarize the current state of knowledge to highlight the tools available to radiation oncologists for managing DCIS, with an outlook on future developments.

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Section: Partial Breast Irradiationmentioning

confidence: 99%

“…The challenge for the decision making revolves around not only the omission of treatment but also around the modality of RT delivery, including de-escalation (boost omission, partial breast irradiation-PBI) or escalation (dose intensification) programs [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%