Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-26T03:35:01.623Z Has data issue: false hasContentIssue false
  • English
  • Français

Can ‘boost’ be avoided in pre-invasive and early breast cancer with free surgical margins after breast conservation surgery and irradiation?

Published online by Cambridge University Press:  19 August 2011

Federico L. Ampil ,
Quyen Chu ,
Gloria Caldito ,
Benjamin D.L. Li ,
Gary V. Burton  and
Roger H. Kim
Federico L. Ampil*
Affiliation:
Department of Radiology, Louisiana State University Health Sciences CenterShreveport, Louisiana, USA
Quyen Chu
Affiliation:
Department of Surgery, Louisiana State University Health Sciences CenterShreveport, Louisiana, USA
Gloria Caldito
Affiliation:
Department of Biometry, Louisiana State University Health Sciences CenterShreveport, Louisiana, USA
Benjamin D.L. Li
Affiliation:
Department of Surgery, Louisiana State University Health Sciences CenterShreveport, Louisiana, USA
Gary V. Burton
Affiliation:
Department of Medicine, Louisiana State University Health Sciences Center, and Feist-Weiller Cancer Center, Shreveport, Louisiana, USA
Roger H. Kim
Affiliation:
Department of Surgery, Louisiana State University Health Sciences CenterShreveport, Louisiana, USA
*
Correspondence to: Federico L. Ampil, MD, Division of Therapeutic Radiology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, Louisiana 71130, USA. Tel: (318) 675–5334; Fax: (318) 675–4697. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Guidelines concerning early stage breast cancer do not clearly recommend tumour bed boost dose after breast conserving surgery and irradiation when the resection margins are negative. Because the number of these patients is expected to increase, we evaluated the results of our treatment scheme in which the additional tumour bed dose was omitted. One hundred consecutive individuals with ductal carcinomain-situ or stage I or II cancer of the breast were identified for this retrospective analysis. The observed ipsilateral breast tumour recurrence and 10-year disease-free survival rates were 4% and 91% respectively. Univariate analysis indicated that triple receptor negative tumour is the most independent prognostic risk factor. In conclusion, the observed low rate of local recurrence and many long-term survivors in this study seem to legitimize the omission of the tumour bed boost dose after whole breast irradiation in women with early carcinoma of the breast and free breast conserving surgical margins.

Keywords

Breast cancerbreast conservation surgeryradiotherapy
Type
Short Communication
Information
Journal of Radiotherapy in Practice , Volume 10 , Issue 3 , September 2011 , pp. 209 - 212
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Jalali, R, Singh, S, Budrukkar, A. Techniques of tumour bed boost irradiation in breast conserving therapy: current evidence and suggested guidelines. Acta Oncol 2007; 46:879–892.CrossRefGoogle ScholarPubMed
Collette, S, Collette, L, Budiharto, Tet al. Predictors of the risk of fibrosis at 10 years after breast conserving therapy for early breast cancer: a study based on the EORTC Trial 22881–10882 ‘boost versus no boost’. Eur J Cancer 2008; 44:2587–2599.Google Scholar
Arthur, DW, Cuttino, LW, Neuschatz, ACet al. Tumor bed boost omission after negative re-excision in breast-conservation treatment. Ann Surg Oncol 2006; 13:794–801.Google Scholar
Pezner, RD, Lipsett, JA, Desai, Ket al. To boost or not to boost: decreasing radiation therapy in conservative breast cancer treatment when “inked” tumor resection margins are pathologically free of cancer. Int J Radiat Oncol Biol Phys 1988; 14:873–877.CrossRefGoogle ScholarPubMed
Wai, ES, Lesperance, ML, Alexander, CSet al. Effect of radiotherapy boost and hypofractionation on outcomes in ductal carcinoma in situ. Cancer 2011; 117:54–62.Google Scholar
Singletary, SE. Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy. Am J Surg 2002; 184:383–393.Google Scholar
Kaufmann, M, Morrow, M, von Minckwitz, G, Harris, JR. Locoregional treatment of primary breast cancer: consensus recommendations from an International Expert Panel. Cancer 2010; 116:1184–1191.CrossRefGoogle ScholarPubMed