Optimising post-operative radiation therapy after oncoplastic and reconstructive procedures

The King is in the altogether: Radiation therapy after oncoplastic breast surgery

“…Nowadays, breast RT is done with CT-based planning, and for modern RT planning it mandates target volume delineation for planning and appreciation of the RT plan. The aim of target volume delineation is not to include the outdated field-encompassed volumes that were encompassed by the 2D-bony landmarks fields [ 7 , 8 ], but rather to define the true target volumes, based on anatomy, histology and in depth understanding of breast cancer biology and therapy including the surgical procedure [ 7 , 37 , 38 ]. Large RT volumes, high radiation dose, and inhomogeneous dose delivery were shown to increase breast RT-related toxicity [ [9] , [10] , [11] , 39 ].…”

“…Volume replacement procedures that use tissue from outside the footprint of the breast (autologous tissue or implant) to correct the volume deficit are included in the definition of oncoplastic BCS. This may or may not result in additional breast augmentation/volume reduction from the original volume and may accompany contralateral augmentation/mastopexy [ 38 ].…”

De-escalation of loco-regional treatments: Time to find a balance

“…For this Special Issue, we have invited outstanding, international experts to provide an overview of the current situation for both surgical and radiation treatments as well as to share their view on future perspectives, taking into account the potential adverse consequences of too hasty de-escalation [ [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] ]. “Time to find a balance” is, in fact, the subtitle of this monographic work; a document that aims to give the reader a broader/more in-depth vision of the potential implications of this ongoing process.…”