Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Focused Guideline Update

Recht, Abram; Comen, Elizabeth; Fine, Richard E.; Fleming, Gini F.; Hardenbergh, Patricia H.; Ho, Alice Y.; Hudis, Clifford A.; Hwang, E. Shelley; Kirshner, Jeffrey J.; Morrow, Monica; Salerno, Kilian E.; Sledge, George W.; Solin, Lawrence J.; Spears, Patricia A.; Whelan, Timothy J.; Somerfield, Mark R.; Edge, Stephen B.

doi:10.1200/jco.2016.69.1188

Cited by 220 publications

(113 citation statements)

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“…Accurate preoperative staging of the axilla is important to allow decisions regarding neoadjuvant therapy to be made; it is also an important factor in the planning of postmastectomy radiotherapy and consequently may affect reconstructive options 21,22 . The present multicentre study involving a large cohort of women demonstrates that pretreatment AUS has a lower sensitivity for axillary staging of ILC compared with that for IDC.…”

Section: Discussionmentioning

confidence: 99%

Population-based study of the sensitivity of axillary ultrasound imaging in the preoperative staging of node-positive invasive lobular carcinoma of the breast

Morrow

Lannigan

Doughty

et al. 2018

British Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Population-based study of the sensitivity of axillary ultrasound imaging in the preoperative staging of node-positive invasive lobular carcinoma of the breast

Morrow

Lannigan

Doughty

et al. 2018

British Journal of Surgery

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“…These indications increased following the Early Breast Cancer Trialists' Collaborative Group 9 meta-analyses, which showed significantly improved disease-free and overall survival after PMRT and regional node irradiation in women at intermediate risk (tumour size 50 mm or less and 1-3 positive lymph nodes) 10 . Newly proposed US guidelines 11 emphasize the need to consider the lower recurrence rates associated with contemporary practice and the benefits of systemic therapy 12 . Current recommendations for PMRT in the intermediate-risk group remain controversial, pending the results of the SUPREMO (Selective Use of Postoperative Radiotherapy aftEr MastectOmy) trial, evaluating chest wall and/or axillary radiotherapy 13,14 .…”

Section: Introductionmentioning

confidence: 99%

Immediate and delayed autologous abdominal microvascular flap breast reconstruction in patients receiving adjuvant, neoadjuvant or no radiotherapy: a meta-analysis of clinical and quality-of-life outcomes

et al. 2019

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Background Effects of postmastectomy radiotherapy (PMRT) on autologous breast reconstruction (BRR) are controversial regarding surgical complications, cosmetic appearance and quality of life (QOL). This systematic review evaluated these outcomes after abdominal free flap reconstruction in patients undergoing postoperative adjuvant radiotherapy (PMRT), preoperative radiotherapy (neoadjuvant radiotherapy) and no radiotherapy, aiming to establish evidence‐based optimal timings for radiotherapy and BRR to guide contemporary management. Methods The study was registered on PROSPERO (CRD42017077945). Embase, MEDLINE, Google Scholar, CENTRAL, Science Citation Index and ClinicalTrials.gov were searched (January 2000 to August 2018). Study quality and risk of bias were assessed using GRADE and Cochrane's ROBINS‐I respectively. Results Some 12 studies were identified, involving 1756 patients (350 PMRT, 683 no radiotherapy and 723 neoadjuvant radiotherapy), with a mean follow‐up of 27·1 (range 12·0–54·0) months for those having PMRT, 16·8 (1·0–50·3) months for neoadjuvant radiotherapy, and 18·3 (1·0–48·7) months for no radiotherapy. Three prospective and nine retrospective cohorts were included. There were no randomized studies. Five comparative radiotherapy studies evaluated PMRT and four assessed neoadjuvant radiotherapy. Studies were of low quality, with moderate to serious risk of bias. Severe complications were similar between the groups: PMRT versus no radiotherapy (92 versus 141 patients respectively; odds ratio (OR) 2·35, 95 per cent c.i. 0·63 to 8·81, P = 0·200); neoadjuvant radiotherapy versus no radiotherapy (180 versus 392 patients; OR 1·24, 0·76 to 2·04, P = 0·390); and combined PMRT plus neoadjuvant radiotherapy versus no radiotherapy (272 versus 453 patients; OR 1·38, 0·83 to 2·32, P = 0·220). QOL and cosmetic studies used inconsistent methodologies. Conclusion Evidence is conflicting and study quality was poor, limiting recommendations for the timing of autologous BRR and radiotherapy. The impact of PMRT and neoadjuvant radiotherapy appeared to be similar.

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“…Despite improved screening and detection modalities, tumor molecular and genetic profiling, and systemic therapeutic options, the survival rates for locally advanced disease is 30–50% at 10 years and 30–40% at 20 years [3-5]. Trimodality therapy is the mainstay of treatment for advanced invasive disease not eligible for breast conservation [6]. Recurrent disease after mastectomy poses unique therapeutic challenges as such recurrences often cannot be surgically resected with acceptable morbidity.…”

Section: Introductionmentioning

confidence: 99%

Durable Local Control Following Concurrent Hypofractionated Chemoradiation for a Massive Inflammatory Breast Cancer Chest Wall Recurrence

Dyer¹,

Nguyen²,

Shukla³

et al. 2017

Cureus

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Breast cancer is the leading new cancer diagnosis in women in the United States and is the second most lethal cancer in this patient population after lung cancer. Chest wall recurrence after mastectomy poses unique clinical challenges, as such tumors are often not amenable to surgical resection and durable local control with radiation or systemic therapy is challenging. When uncontrolled, chest wall recurrence can lead to severe pain and other morbidity. Herein, we describe a patient with inflammatory breast cancer with a massive, rapidly growing chest wall recurrence treated with a regimen of hypofractionated concurrent chemoradiation resulting in a complete chest wall response with durable local control.

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Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Focused Guideline Update

Abstract: Purpose.

Cited by 220 publications

References 69 publications

Population-based study of the sensitivity of axillary ultrasound imaging in the preoperative staging of node-positive invasive lobular carcinoma of the breast

Population-based study of the sensitivity of axillary ultrasound imaging in the preoperative staging of node-positive invasive lobular carcinoma of the breast

Immediate and delayed autologous abdominal microvascular flap breast reconstruction in patients receiving adjuvant, neoadjuvant or no radiotherapy: a meta-analysis of clinical and quality-of-life outcomes

Durable Local Control Following Concurrent Hypofractionated Chemoradiation for a Massive Inflammatory Breast Cancer Chest Wall Recurrence

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