Time to Radiation After Oncoplastic Reduction

Kapadia, Sameer M.; Reitz, Alexandra; Hart, Alexandra M.; Broecker, Justine S.; Torres, Mylin A.; Carlson, Grant W.; Styblo, Toncred M.; Losken, Albert

doi:10.1097/sap.0000000000001598

Cited by 32 publications

(45 citation statements)

References 20 publications

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“…However, a more recent study from the same group reported their institutional experience with 118 cases of oncoplastic reduction, of which 22% experienced complications including cellulitis, delayed healing, seroma, and dehiscence. The median time to radiation was significantly higher amongst patients who had complications (74 versus 54 days, P<0.001) (44).…”

Section: Complications and Delay Of Adjuvant Therapymentioning

confidence: 89%

Oncoplastic partial breast reconstruction: concepts and techniques

Chu¹,

Hanson²,

Hwang³

et al. 2021

Gland Surg

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Rationale & goals of oncoplastic breast reconstructionOf the approximately 250,000 new cases of breast cancer diagnosed in the United States each year, the majority present with localized disease that is confined to the primary site (1). Over the past decades, numerous observational and randomized controlled trials have demonstrated the equivalent survival conferred by breast-conserving surgery (BCS) with adjuvant radiation compared with mastectomy for patients with early-stage breast cancer (2-7). With the added benefits of less invasive and shorter surgeries, faster recovery, less frequent complications, preservation of sensation, and psychosocial advantages, breast conservation therapy (BCT) has thus evolved to become a nationallyaccepted standard of care treatment for this patient population (8).

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Section: Complications and Delay Of Adjuvant Therapymentioning

confidence: 89%

Oncoplastic partial breast reconstruction: concepts and techniques

Chu¹,

Hanson²,

Hwang³

et al. 2021

Gland Surg

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“…We also found no significant difference in delays to adjuvant radiotherapy. Any potential differences in incidence of IBTR could not be estimated due to the relatively short follow-up times and very few IBTR events, which were limitations also noted in previous studies [8,11,14,15,17,18]. Finally, we evaluated the relationship between the ratio of the CTV volume to tumor size and reception of BRT.…”

Section: Discussionmentioning

confidence: 99%

Implications of Oncoplastic Breast Surgery on Radiation Boost Delivery in Localized Breast Cancer

Gladwish¹,

DiDiodato²,

Conway³

et al. 2021

Cureus

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BackgroundOncoplastic partial mastectomy (OPM) is a technique utilized to improve aesthetic and survivorship outcomes in patients with localized breast cancer. This technique leads to breast tissue rearrangement, which can have an impact on target definition for boost radiotherapy (BRT). The aim of this study was to determine if the choice of surgical technique independently affected the decision to deliver a radiation boost. Materials and methodsThis was a retrospective study of patients treated between January 2017 and December 2018. We selected consecutive patients based on surgical procedure: 50 undergoing standard breast-conserving surgery and 50 having had an OPM. The primary outcome was average treatment effect (ATE) of surgery type on reception of BRT. Secondary outcomes included ATE of surgery type on the time to reception of radiotherapy and incidence of ipsilateral breast tumor recurrence (IBTR). The ratio of boost clinical target volume (CTV) to pathologic tumor size was also compared between the two groups. Treatment effects regression adjustment and inverse-probability weighted analysis was used to estimate ATEs for both primary and secondary outcomes. ResultsFor the entire cohort, the median age was 64 years (range: 37-88 years). The median tumor size was 1.5 cm (range: 0.1-6.5 cm). The majority of patients were with ≤ stage IIA (78%), invasive ductal subtype (80%), negative lymphovascular space invasion (78%), negative margin (90%), and positive ER/PR (estrogen receptor/progesterone receptor) (69%). Overall, surgical technique was not associated with differences in the proportion of patients receiving BRT (ATE: 6.0% [95% CI: -4.5 to 16.0]). There were no differences in delays to radiation treatment between the two groups (ATE: 32.8 days [95% CI: -22.1 to 87.7]). With a median follow-up time of 419 days (range: 30-793 days), there were only five recurrences, with one case of IBTR in each group. There was no difference in the ratio of CTV volume to tumor size between the two groups (p=0.38). ConclusionsOPM did not affect the decision to offer localized BRT following standard whole breast radiotherapy or significantly affect treatment times or radiation volumes. The decision to offer OPM should include a multidisciplinary approach.

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“…We also found no signi cant difference in delays to adjuvant radiotherapy. Any potential differences in incidence of IBTR could not be estimated due to the relatively short follow-up times and very few IBTR events, which were limitations also noted in previous studies [8,11,14,15,17,18]. Finally, we evaluated the relationship between the ratio of post-operative seroma volume to tumor size and reception of BRT.…”

Section: Discussionmentioning

confidence: 99%

Implications of Oncoplastic Breast Surgery on Radiation Boost Delivery in Localized Breast Cancer

Gladwish

Sauve²,

DiDiodato³

et al. 2020

Preprint

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Background:Oncoplastic partial mastectomy (OPM) is a technique utilized to improve aesthetic and survivorship outcomesin patients with localized breast cancer. This technique leads to breast tissue rearrangement, which can have an impact on target definition for boost radiotherapy (BRT). The aim of this study was to determine if the choice of surgical technique independently affected the decision to deliver a radiation boost.Materials and Methods: This was a retrospective study of patients treated between January 2017 and December 2018. We selected consecutive patients based on surgical procedure; 50 undergoing standard breast conserving surgery and 50 having had an OPM. The primary outcome was average treatment effect (ATE) of surgery type on reception of BRT, accounting for patient age, tumor grade, lymphovascular space invasion, margin status and ER status as potential confounding variables. Secondary outcomes included ATE of surgery type on the time to reception of radiotherapy and incidence of ipsilateral breast tumor recurrence (IBTR). The ratio of boost seroma volume to pathologic tumor size was also compared between the two groups. Treatment effects regression adjustment and inverse-probability weighted analysis was used to estimate ATEs for both primary and secondary outcomes.Results: Median age was 64 years (range 37 – 88). The median tumor size was 1.5 cm (range 0.1 – 6.5). The majority of patients were ≤ stage IIA (78%), invasive ductal subtype (80%), LVSI negative (78%), margin negative (90%) and ER/PR +ve (69%). Overall, surgical technique was not associated with differences in the proportion of patients receiving BRT (ATE 6.0% (95% CI -4.5, 16.0)). There were no differences in delays to radiation treatment between the two groups (ATE 32.8 days (95% CI -22.1, 87.7)). With a median follow-up time of 419 days (range 30 – 793), there were only 5 recurrences, with 1 case of IBTR in each group. There was no difference in the ratio of seroma volume to tumor size between the two groups (p=0.38).Conclusions: OPM did not affect the decision to offer localized BRT following standard whole breast radiotherapy, or significantly affect treatment times or radiation volumes. The decision to offer OPM should include a multi-disciplinary approach.

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Time to Radiation After Oncoplastic Reduction

Cited by 32 publications

References 20 publications

Oncoplastic partial breast reconstruction: concepts and techniques

Oncoplastic partial breast reconstruction: concepts and techniques

Implications of Oncoplastic Breast Surgery on Radiation Boost Delivery in Localized Breast Cancer

Implications of Oncoplastic Breast Surgery on Radiation Boost Delivery in Localized Breast Cancer

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