Ipsilateral Breast Tumor Relapse: Local Recurrence Versus New Primary Tumor and the Effect of Whole-Breast Radiotherapy on the Rate of New Primaries

Gujral, Dorothy M.; Sumo, Georges; Owen, John R.; Ashton, Anita; Bliss, Judith M.; Haviland, J.S.; Yarnold, John

doi:10.1016/j.ijrobp.2009.10.074

Cited by 47 publications

(32 citation statements)

References 32 publications

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“…In a large retrospective study on 1,410 patients, Gujral et al [24] reported a cumulative incidence rate of new primaries after whole-breast irradiation at 5, 10, and 15 years of 0.8%, 2%, and 3.5%, respectively. The authors concluded that whole-breast irradiation approximately halves the rate of new primaries.…”

Section: Therapy Of Ipsilateral Breast Tumor Recurrencementioning

confidence: 99%

Current Treatment of Isolated Locoregional Breast Cancer Recurrences

et al. 2015

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Patients with isolated locoregional breast cancer recurrences should be treated with curative intent. Mastectomy is regarded as the standard of care for patients with ipsilateral breast tumor recurrence. In a selected group of patients, partial breast irradiation after second breast-conserving surgery is a viable alternative to mastectomy. If a second breast conservation is performed, additional irradiation should be mandatory, especially in patients who had not been irradiated previously. In case of re-irradiation, the largest experience exists for multi-catheter brachytherapy. Prospective clinical trials are needed to clearly define selection criteria, long-term local control, and toxicity. In patients with resectable locoregional breast cancer recurrences after mastectomy, multi-modal therapy comprising complete resection, radiation therapy in previously unirradiated patients, and systemic therapy results in 5-year disease-free and overall survival rates of 69% and 88%, respectively. In radiation-naive patients with unresectable, isolated locoregional recurrences, radiation therapy is mandatory. In selected patients with previous irradiations and unresectable locoregional recurrences, a second irradiation as part of an individual treatment concept can be applied. The increased risk of severe toxicity should always be weighed up against the potential clinical benefit. A combination therapy with hyperthermia can further improve the treatment results.

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Section: Therapy Of Ipsilateral Breast Tumor Recurrencementioning

confidence: 99%

Current Treatment of Isolated Locoregional Breast Cancer Recurrences

et al. 2015

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“…Undoubtedly, tumor recurrence occurs in the original tumor bed in the early follow-up period, while, the long-term tumor recurrences tend to be more distant from the primary area. In the IORT technique findings such as redness, warmth, and hyper-pigmentation can be seen at the irradiation field (49,50).…”

Section: Side Effects Of the Iort Techniquementioning

confidence: 99%

Intraoperative Period and Breast Cancer: Review

Akan

Simsek

2014

J Breasth Health

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Intraoperative radiation therapy in breast cancer (IORT) delivers a concentrated dose of radiation therapy to a tumor bed during surgery. IORT offers some of the following advantages with typically fewer complications like; maximum effect, sparing healthy tissues and organs, to help the patients finish treatment and get back to their normal activities. The goal of IORT is to improve local tumor control and survival rates for patients with breast cancer. IORT can both be performed with electron beams (ELIOT) and X-rays. Two main randomised trials testing intraoperative partial breast radiotherapy are TARGIT trial and the ELIOT (intraoperative radiotherapy with electrons) trial, but the techniques are fundamentally different. Whereas TARGIT delivers radiation from within the undisturbed tumour bed, for ELIOT, the mammary gland is mobilised, a prepectoral lead shield is inserted, the edges of the tumour bed are apposed, and radiation is delivered from without. Key words: Intraoperative period, breast cancer, treatment IntroductionCurrently, breast cancer is one of the leading causes of cancer in women. Nevertheless, there are rapid developments and changes in the diagnosis, treatment and follow-up methods of this disease. Today breast cancer can be diagnosed at earlier stages, with a chance for cure with limited surgery, and the patients have improved quality of life. Today, based on recent studies, the type of breast cancer surgery that led to complete loss of the breast has been replaced by breast-conserving surgery (BCS) in all appropriate patients (1-4). According to the results from large multicenter studies on early breast cancer, there were no significant differences in terms of disease-free survival and overall survival between mastectomy, and BCS and whole breast radiotherapy (RT). Therefore, conserving surgery and whole breast irradiation has been accepted as the standard treatment in early breast cancer, and it has been reported that local control also plays an important role on survival. One of the most feared clinical situations in the treatment of breast cancer, especially after BCS, is local recurrence (LR) at the site of operation. Undoubtedly, one of the most important ways to avoid this dreaded complication is application of RT to the tumor itself and around the tumor bed. Most of the LRs usually occur at the same quadrant with the tumor area that has been operated, due to the microscopic tumor remaining after BCS. A number of risk factors have been identified for the occurrence of LR, including large tumor size, high tumor grade, young patient age, lymph node involvement, and presence of tumor deposit close to surgical resection margin (5,6). There is a decrease in LR rates due to earlier diagnosis of breast cancer patients, high quality standards in pathological examinations, better individual treatment planning, and increased awareness on breast cancer. The focus of the discussion regarding the causes of LR and the developments leading to decreased LR rates is centered around mostly the...

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“…Les deux facteurs le plus souvent pris en compte sont la localisation de la récidive par rapport à la première tumeur et le type histologique (c'est-à-dire canalaire, lobulaire, tubuleux… mais non in situ versus invasif) [37,48,58,71,89,110]. La différence entre vraie récidive et nouveau cancer repose actuellement sur des critères mal défi nis, non standardisés.…”

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