Radiotherapy of breast cancer.

{"article_title":"Radiotherapy of breast cancer.","author":"Hennequin C, Belkac\u00e9mi Y, Bourgier C, Cowen D, Cutuli B, Fourquet A, Hannoun-L\u00e9vi JM, Pasquier D, Racadot S, Rivera S","journal_title":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","issn":"1769-6658","isbn":"","publication_date":"2022-02-01","volume":"26","issue":"1-Feb","first_page":"221","page_count":"","accession_number":"34955414","doi":"10.1016\/j.canrad.2021.11.013","publisher":"Elsevier","doctype":"Journal Article","subjects":"France; Breast Neoplasms radiotherapy; Carcinoma, Intraductal, Noninfiltrating radiotherapy; Age Factors; Breast Neoplasms surgery; Carcinoma, Intraductal, Noninfiltrating surgery; Cardiotoxicity; Conservative Treatment methods; Female; France; Humans; Lymphatic Irradiation; Lymphatic Metastasis; Mastectomy, Segmental; Middle Aged; Neoplasm Recurrence, Local prevention & control; Postoperative Care; Radiation Oncology; Radiotherapy, Adjuvant methods; Radiotherapy, Conformal methods; Sentinel Lymph Node Biopsy","interest_area":["Obstetrics & Gynecology"," Oncology"," Radiology"],"abstract":"Adjuvant radiotherapy is an essential component of the treatment of breast cancer. After conservative surgery for an infiltrating carcinoma, radiotherapy must be systematically performed, regardless of the characteristics of the disease, because it decreases the rate of local recurrence and by this way, specific mortality. A boost dose over the tumour bed is required if the patient is younger than 50 years-old. Partial breast irradiation could be routinely proposed as an alternative to whole breast irradiation, but only in selected and informed patients. For ductal carcinoma in situ, adjuvant radiotherapy must be also systematically performed after lumpectomy. After mastectomy, chest wall irradiation is required for pT3-T4 tumours and if there is an axillary nodal involvement, whatever the number of involved lymph nodes. After neoadjuvant chemotherapy and mastectomy, in case of pN0 disease, chest wall irradiation is recommended if there is a clinically or radiologically T3-T4 or node positive disease before chemotherapy. Axillary irradiation is recommended only if there is no axillary surgical dissection and a positive sentinel lymph node. Supra- and infraclavicular irradiation is advised in case of positive axillary nodes. Internal mammary irradiation must be discussed case by case, according to the benefit\/risk ratio (cardiac toxicity). Hypofractionation regimens (42.5Gy in 16 fractions, or 41,6Gy en 13 or 40Gy en 15) are equivalent to conventional irradiation and must prescribe after tumorectomy in selected patients. Delineation of the breast, the chest wall and the nodal areas are based on clinical and radiological evaluations. 3D-conformal irradiation is the recommended technique, intensity-modulated radiotherapy must be proposed only in specific clinical situations. Respiratory gating could be useful to decrease the cardiac dose. Concomitant administration of chemotherapy in unadvised, but hormonal treatment could be start with or after radiotherapy. Copyright \u00a9 2021 Soci\u00e9t\u00e9 fran\u00e7aise de radioth\u00e9rapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=34955414","isPdfLink":false,"isSAML":false,"an":"34955414","number_other":"","type_pub":"","issn_electronic":"1769-6658","languages":"English","language":"eng","date_entry":"Date Created: 20211227 Date Completed: 20220217 Latest Revision: 20220217","date_update":"20240104","titleSource":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique [Cancer Radiother] 2022 Feb-Apr; Vol. 26 (1-2), pp. 221-230. Date of Electronic Publication: 2021 Dec 23.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2022-02-01","description":"Adjuvant radiotherapy is an essential component of the treatment of breast cancer. After conservative surgery for an infiltrating carcinoma, radiotherapy must be systematically performed, regardless of the characteristics of the disease, because it decreases the rate of local recurrence and by this way, specific mortality. A boost dose over the tumour bed is required if the patient is younger than 50 years-old. Partial breast irradiation could be routinely proposed as an alternative to whole breast irradiation, but only in selected and informed patients. For ductal carcinoma in situ, adjuvant radiotherapy must be also systematically performed after lumpectomy. After mastectomy, chest wall irradiation is required for pT3-T4 tumours and if there is an axillary nodal involvement, whatever the number of involved lymph nodes. After neoadjuvant chemotherapy and mastectomy, in case of pN0 disease, chest wall irradiation is recommended if there is a clinically or radiologically T3-T4 or node positive disease before chemotherapy. Axillary irradiation is recommended only if there is no axillary surgical dissection and a positive sentinel lymph node. Supra- and infraclavicular irradiation is advised in case of positive axillary nodes. Internal mammary irradiation must be discussed case by case, according to the benefit\/risk ratio (cardiac toxicity). Hypofractionation regimens (42.5Gy in 16 fractions, or 41,6Gy en 13 or 40Gy en 15) are equivalent to conventional irradiation and must prescribe after tumorectomy in selected patients. Delineation of the breast, the chest wall and the nodal areas are based on clinical and radiological evaluations. 3D-conformal irradiation is the recommended technique, intensity-modulated radiotherapy must be proposed only in specific clinical situations. Respiratory gating could be useful to decrease the cardiac dose. Concomitant administration of chemotherapy in unadvised, but hormonal treatment could be start with or after radiotherapy.<br \/> (Copyright © 2021 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&scope=site&db=mdl&AN=34955414&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Hennequin C, Belkac\u00e9mi Y, Bourgier C, Cowen D, Cutuli B, Fourquet A, Hannoun-L\u00e9vi JM, Pasquier D, Racadot S, Rivera S"}