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NCI CANCERLIT® Search: Radiotherapy for Breast Cancer - October 2002
National Cancer Institute®
Ultima Vez Modificado: 1 de octubre del 2002
- Impact of boost irradiation with surgically placed radiopaque clips on local control in breast-conserving therapy.
- Prognostic and predictive factors in the adjuvant treatment of breast cancer.
- Immunohistochemically detected p53 mutations in epithelial tumors and results of treatment with chemotherapy and radiotherapy. A
- Monitoring clinical trials. Latest data from START trial should be made available.
- Clinical aspects of intensity-modulated radiotherapy in the treatment of breast cancer.
- Evaluation of an education program for patients with breast cancer receiving radiation therapy.
- ATM induction insufficiency in a radiosensitive breast-cancer patient.
- Facing breast cancer far from radiation therapy centres.
- A case of cutaneous lymphangiectasis secondary to breast cancer treatment.
- Enhancement of radiosensitivity of the MCF-7 breast cancer cell line with human chorionic gonadotropin.
- Primary breast lymphoma successfully treated with combination therapy including local radiation therapy: a report of two cases.
- Treatment of necrotic infection on the anterior chest wall secondary to mastectomy and postoperative radiotherapy by the application of omentum
- Effects of patient selection on the applicability of results from a randomised clinical trial (EORTC 10853) investigating breast-conserving
- A trial of two questions.
- Tamoxifen, radiation therapy, or both for prevention of ipsilateral breast tumor recurrence after lumpectomy in women with invasive breast
- Long-term results (10 years) of intensive breast conserving therapy including a high-dose and large-volume interstitial brachytherapy boost
- Efficacy of homeopathic treatment of skin reactions during radiotherapy for breast cancer: a randomised, double-blind clinical trial.
- Racial differences in treatment and survival from early-stage breast carcinoma.
- Radiotherapy and breast reconstruction: complications and cosmesis with TRAM versus tissue expander/implant.
- Radical choices in mastectomy.
Table of Contents
1
UI - 11668244
AU - Kokubo M; Mitsumori M; Yamamoto C; Fujishiro S; Mise K; Kodama H; Nagata
TI -
Y; Hiraoka M
Impact of boost irradiation with surgically placed radiopaque clips on
local control in breast-conserving therapy.
SO - Breast Cancer 2001;8(3):222-8
AD - Department of Therapeutic Radiology and Oncology, Graduate School of
Medicine, Kyoto University, Japan.
BACKGROUND:The purpose of this study was to determine whether boost
irradiation relying on radiopaque clips placed surgically around the
resected margin of breast cancer contributes to increasing the local
control rate in patients with close or positive margins in
breast-conserving therapy (BCT). METHODS: Among 837 patients with breast
patients with close or positive surgical margins received boost
irradiation following conventional tangential whole breast irradiation.
Since 1994, four radiopaque clips were surgically placed around the
resected margin of the breast cancer in 155 patients treated with wide
excision. The four clips were clearly and accurately identified with a
CT-simulator (CT-S). The boost irradiation field was automatically
determined with a safety margin of 3 cm according to one-to-one
correspondence of radiopaque clips to pathologically close or positive
surgical margins. In the remaining 26 patients treated before 1994, the
boost irradiation field was determined according to the skin tattoo of
the primary tumor. RESULTS: The median follow-up period of the 155
patients receiving the radiopaque clips was 42 months (range: 19 to 78),
and that of the 26 patients without the clips was 87 months. Local
recurrence was observed in two of the 155 patients who underwent boost
irradiation using the radiopaque clips 39 and 54 months after the
surgery, while 4 of the 26 patients developed local recurrence 14, 23,
51, and 76 months after BCT. In three of the four patients without the
clips developing local recurrences, local recurrences were observed at
the margin of the boost irradiation field. The 5-year local
recurrence-free survival rate of patients who received boost irradiation
with the radiopaque clips was 97%, and that of patients without the
clips was 88%. The difference of local recurrence-free survival rates
between the patients with and without the clips was significant
(p<0.05). CONCLUSION: Surgically placed radiopaque clips appear to be
useful for determining adequate boost field in the BCT using the CT-S
and help increase the local control rate.
2
UI - 12016387
AU - Fukutomi T; Akashi-Tanaka S
TI -
Prognostic and predictive factors in the adjuvant treatment of breast
cancer.
SO - Breast Cancer 2002;9(2):95-9
AD - Breast Surgery Division, National Cancer Center Hospital, 5-1-1,
Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
The selection of systemic adjuvant therapy should be based on the
appropriate prognostic and predictive factors. The established
prognostic factors currently used in cases of primary breast cancer
include axillary lymph node involvement, histologic subtype, tumor size,
nuclear or histologic grade, estrogen (ER) and progesterone receptor
(PR) status and proliferative index. Adjuvant chemotherapy has had an
impact on the management of node-positive breast cancer, while the St.
Gallen recommendations were established for postoperative adjuvant
therapy for node-negative breast cancer. However, there is some
contention regarding the histological (or nuclear) grading systems among
different pathologists. With regard to biological measurements, the most
useful prognostic/predictive factors are hormone receptor status and
HER-2 overexpression. ER and PR status can be used to establish the
necessity of hormone therapy in the adjuvant setting. If the anti-HER-2
antibody and/or antiangiogenic agents are introduced into the adjuvant
setting in the near future, determination of these factors is also
recommended.
3
UI - 12240546
AU - Thames HD; Petersen C; Petersen S; Nieder C; Baumann M
TI -
Immunohistochemically detected p53 mutations in epithelial tumors and
results of treatment with chemotherapy and radiotherapy. A
treatment-specific overview of the clinical data.
SO - Strahlenther Onkol 2002 Aug;178(8):411-21
AD - Department of Biomathematics, University of Texas M.D. Anderson Cancer
Center, Houston, TX, USA.
BACKGROUND: The aim was to ascertain whether many hundreds of clinical
reports over the last decade are consistent with the prediction of a
poorer outcome in cancer patients with p53 abnormalities treated with
cytotoxic drugs and radiation. MATERIAL AND METHOD: There are 301
studies on the influence of p53 overexpression published through summer
2000, in which chemotherapy or radiotherapy was used alone or in
combination with surgery. From 45 reports meeting stringent selection
rules, comparison groups are identified in whom the same measure of
outcome was reported for the same treatment applied to the same tumor,
with results corrected for important prognostic factors. Metaanalysis
techniques are then applied to the comparison groups. Attention was
limited to reports using immunohistochemical techniques, to form
comparison groups of sufficient size. RESULTS: Four comparison groups
were identified by treatment and endpoint: 1) Stage I-III breast cancer
(surgery and chemotherapy, disease-free survival, seven studies); 2)
stage I-III breast cancer (surgery and chemotherapy, overall survival,
six studies); 3) stage II-IV head and neck cancer (radiotherapy and
chemotherapy, overall survival, five studies); 4) FIGO I-IV ovarian
cancer (surgery and chemotherapy, overall survival, six studies). In the
breast (disease-free survival) and ovarian (overall survival) comparison
groups, the hazard ratio for a deleterious effect of p53 overexpression
was significant or marginally significant, depending on assumed ranges
for unreported hazard ratios in non-significant studies. CONCLUSIONS:
Despite the many caveats related to metaanalysis applied to
retrospective data, high variability of immunohistochemical technique,
etc., a nearly significant negative effect of p53 overexpression on
outcome of treatment with cytotoxic drugs and radiation emerges in the
few studies where heterogeneity can be sufficiently reduced or accounted
for.
4
UI - 11778592
AU - Henk JM
TI -
Monitoring clinical trials. Latest data from START trial should be made
available.
SO - BMJ 2001 Dec 15;323(7326):1425-6
5
UI - 12118390
AU - Krueger EA; Fraass BA; Pierce LJ
TI -
Clinical aspects of intensity-modulated radiotherapy in the treatment of
breast cancer.
SO - Semin Radiat Oncol 2002 Jul;12(3):250-9
AD - Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
48109, USA.
In recent years, interest has grown throughout the radiotherapy
community in investigation and clinical application of
intensity-modulated radiation therapy (IMRT) for adjuvant treatment of
breast cancer. IMRT removes the usual reliance on flat (or
uniform-intensity) radiation fields, and instead replaces that simple
paradigm with a variable-intensity pattern that is usually determined
with the aid of a computerized optimization algorithm. The main goal of
much IMRT and optimization work is the delivery of more conformal plans
to the patient. Thus, IMRT has the potential to improve target coverage
and reduce inhomogeneities observed within the breast (and regional
lymph nodes) that are obtained with standard plans. Furthermore, IMRT
may be able to reduce doses delivered to the heart and lungs, and may
potentially minimize further the probability of complications from
radiotherapy. Copyright 2002, Elsevier Science (USA). All rights
reserved.
6
UI - 12181495
AU - Jahraus D; Sokolosky S; Thurston N; Guo D
TI -
Evaluation of an education program for patients with breast cancer
receiving radiation therapy.
SO - Cancer Nurs 2002 Aug;25(4):266-75
AD - Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary,
Alberta, Canada.
The acquisition of knowledge is presumed to be part of the coping
process for women facing increased stress because of a breast cancer
diagnosis. The purpose of this study was to evaluate the impact of an
education program on the perceived adequacy of knowledge of patients
with breast cancer receiving radiation therapy. Second, the intent was
to investigate the patients' preferences regarding involvement in
decision making, amount and type of information wanted, and preferred
information-seeking activities.A priori quota sampling was planned to
ensure that at least 20 subjects were recruited to each of 3 age
categories, assumed to represent premenopausal, perimenopausal, and
postmenopausal patients with breast cancer receiving radiation therapy.
Subjects (N = 79) completed questionnaires before and after the
evidence-based education program. The education consisted of a 20-minute
interactive video (first session); individualized education, including
technical procedures and self-care (second session); and a 1-hour class
(third session). Individual teaching as required was provided afterward
during radiation therapy.Significant increases in perceived adequacy of
knowledge scores indicate that the program was effective, especially
with information concerning disease and treatment for postmenopausal
subjects. Subjects' participation in 7 of the information-seeking
strategies suggests that many had actively sought information before
undergoing radiation therapy. Preferences for information that may be
indicative of individual coping patterns were similar for more than half
of the subjects. The majority preferred as many details as possible, as
much information as possible (good and bad), and to participate in
decision making. However, not all subjects wanted complete information,
except for the information on all side effects. Findings from this study
suggest that individual patients' information preferences, priority
information needs, and preferred information-seeking activities should
be identified early and incorporated within educational programs to
target resources and maximize the likelihood that positive patient
outcomes will result.
7
UI - 12196249
AU - Clarke RA; Fang ZH; Marr PJ; Lee CS; Kearsley JH; Papadatos G
TI -
ATM induction insufficiency in a radiosensitive breast-cancer patient.
SO - Australas Radiol 2002 Sep;46(3):329-35
AD - Molecular Genetics Laboratories, Cancer Care Center, Division of Cancer
Services, The St George Hospital and University of New South Wales,
Australia. r.clarke@unsw.edu.au
The ataxia telangiectasia (A-T) gene (ATM) is a dominant breast cancer
gene with tumour suppressor activity. ATM also regulates cellular
sensitivity to ionising radiation (IR) presumably through its role as a
facilitator of DNA repair. In normal cells and tissues the ATM protein
is rapidly induced by IR to threshold/maximum levels. The kinase
function of the ATM protein is also rapidly activated in response to IR.
The fact that women carriers of ATM mutations can have an increased risk
of developing breast cancer and that many sporadic breast tumours have
reduced levels of the ATM protein broadens the scope of ATM's tumour
suppressor within the breast. This report describes the downregulation
of ATM protein levels in a radiosensitive breast cancer patient.
Postinduction ATM levels were up to tenfold lower in the patient's fresh
tissues compared to normal controls. These results might indicate a much
broader role for ATM anomalies in breast cancer aetiology.
8
UI - 9269193
AU - Bathe OF; Brosseuk DT
TI -
Facing breast cancer far from radiation therapy centres.
SO - CMAJ 1997 Aug 1;157(3):251-3
9
UI - 11903671
AU - Kaya TI; Kokturk A; Polat A; Tursen U; Ikizoglu G
TI -
A case of cutaneous lymphangiectasis secondary to breast cancer
treatment.
SO - Int J Dermatol 2001 Dec;40(12):760-1
AD - Department of Dermatology, Faculty Of Medicine, Mersin University,
Turkey. tikaya@mersin.edu.tr
10
UI - 12000219
AU - Pond-Tor S; Rhodes RG; Dahlberg PE; Leith JT; McMichael J; Dahlberg AE
TI -
Enhancement of radiosensitivity of the MCF-7 breast cancer cell line
with human chorionic gonadotropin.
SO - Breast Cancer Res Treat 2002 Mar;72(1):45-51
AD - Milkhaus Laboratory, Inc, Brown University Medical School, Providence,
RI 02912, USA.
Secretion of human chorionic gonadotropin (hCG) during pregnancy induces
differentiation of the mammary gland, thereby making breast tissue less
susceptible to carcinogenesis. HCG binds to specific hCG receptors on
mammary epithelial cells inducing changes in gene expression that can
inhibit cell proliferation and, therefore, interfere with tumorigenesis.
Since breast cancer cells also contain a relatively high level of the
hCG receptor, hCG has potential as a therapeutic agent. We postulated
that hCG might also enhance the radiosensitivity of breast cancer cells
and, therefore, be useful as an adjunctive therapy. In the present
study, MCF-7 breast cancer cells grown in cell culture were treated with
hCG (0.2-5 IU/ml) for 24 h prior to exposing the cells to 0 Gy, 3 Gy, 4
Gy, or 5 Gy of radiation. Following irradiation, the MCF-7 cells were
incubated either in the presence or absence of hCG. Cell survival was
monitored with an MTT assay 1 day, 4 days, and 7 days after irradiation.
All of the concentrations of hCG tested enhanced radiosensitivity of
MCF-7 cells. The maximum enhancement occurred with MCF-7 cells that had
been exposed to 2 IU/ml of hCG for at least 24 h prior to irradiation
with 4 Gy. The use of higher concentrations of hCG or a higher dose of
radiation did not increase the enhancement effect. Treatment of MCF-7
cells with hCG for only 24 h was sufficient to achieve the maximum
effect. However, maintaining the cells in hCG beyond 24 h increased the
effectiveness of the lowest hCG concentration. Using a linear-quadratic
equation to analyze the data, we determined that the use of hCG would
result in an 8-10% reduction in MCF-7 cell survival at a dose of 2 Gy, a
typical dose used in conventional cancer therapy.
11
UI - 12002602
AU - Suzuki Y; Ito J; Hasegawa M; Katano S; Saito J; Ito H
TI -
Primary breast lymphoma successfully treated with combination therapy
including local radiation therapy: a report of two cases.
SO - Radiat Med 2002 Jan-Feb;20(1):37-9
AD - Department of Radiology, Maebashi Red Cross Hospital, Japan.
Recently, a combination of local irradiation and chemotherapy has been
suggested as a standardized treatment for localized lymphoma. However,
it has been difficult to establish a standard treatment for localized
primary breast lymphoma simply because of its rarity. We report two
cases of primary breast lymphoma successfully treated with a combination
therapy including local radiation therapy. A 46-year-old woman with
stage I primary breast lymphoma was irradiated with 30 Gy to the
involved breast by 4 MV X-rays and 9 Gy to the involved field by
electron beam after tumorectomy. Then three cycles of CHOP therapy were
performed. She has been well and has shown no evidence of disease for 58
months. A 72-year-old woman with stage II primary breast lymphoma was
treated with three cycles of CHOP therapy followed by irradiation with
40 Gy per breast by 4 MV X-rays. She is well and has been disease-free
for 49 months. We suggest that a combination of local irradiation and
short course of chemotherapy can be useful in the treatment of primary
breast lymphoma.
12
UI - 11991513
AU - Sato M; Tanaka F; Wada H
TI -
Treatment of necrotic infection on the anterior chest wall secondary to
mastectomy and postoperative radiotherapy by the application of omentum
and mesh skin grafting: report of a case.
SO - Surg Today 2002;32(3):261-3
AD - Division of Respiratory Disease, Matsue Red Cross Hospital, Shimane,
Japan.
We report herein the case of a patient who initially underwent right
radical mastectomy for breast carcinoma in 1988, followed by left
breast-conserving surgery in 1997. On both occasions she was given
postoperative radiation therapy of 50 Gy. Repeated dressings and the
administration of antibiotics failed to heal ulcerative infected lesions
that had formed on the anterior chest wall in early 1998. In 1999, the
sternum and surrounding tissue were debrided and the anterior chest wall
was reconstructed by omentum transposition and mesh skin grafting. The
patient is currently well and alive without any evidence of recurrence
of either infection or breast cancer.
13
UI - 12237770
AU - Bijker N; Peterse JL; Fentiman IS; Julien JP; Hart AA; Avril A;
TI -
Cataliotti L; Rutgers EJ
Effects of patient selection on the applicability of results from a
randomised clinical trial (EORTC 10853) investigating breast-conserving
therapy for DCIS.
SO - Br J Cancer 2002 Sep 9;87(6):615-20
AD - Department of Radiation Oncology, The Netherlands Cancer Institute
Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. n.bijker@nki.nl
Selection of patients for randomised clinical trials may have a large
impact on the applicability of the study results to the general
population presenting the same disorder. However, clinical
characteristics and outcome data on non-entered patients are usually not
available. The effects of patient selection for the EORTC 10853 trial
investigating the role of radiotherapy in breast conserving therapy for
ductal carcinoma in situ have been studied, in an analysis of all
patients treated for ductal carcinoma in situ in five participating
institutes. The reasons for not entering patients were evaluated and
treatment results of the randomised patients were compared to those not
entered. A total of 910 patients were treated for ductal carcinoma in
situ. Of these, 477 (52%) were ineligible, with the size of the lesion
being the main reason for ineligibility (30% of all ductal carcinoma in
situ). Of the 433 eligible patients, 278 (64%) were randomised into the
trial. The main reasons for non-entry of eligible patients were either
physicians' preference for one of the treatment arms (26%) or patients'
refusal (9%). These percentages showed significant variation among the
institutes. At 4 years follow-up, those patients not entered in the
trial and treated with local excision and radiotherapy, had higher local
recurrence rates than the patients randomised in the trial and treated
with the same approach, (17 vs 2%, P=0.03). The patients treated with
local excision alone had equal local recurrence rates (11% in both
groups). Selection of patients may explain the differences in outcome of
the randomised patients, and those not-entered. Thus, the results of
this trial may not be applicable to all patients with ductal carcinoma
in situ.
14
UI - 12377955
AU - Whelan T
TI -
A trial of two questions.
SO - J Clin Oncol 2002 Oct 15;20(20):4135-8
15
UI - 12377957
AU - Fisher B; Bryant J; Dignam JJ; Wickerham DL; Mamounas EP; Fisher ER;
TI -
Margolese RG; Nesbitt L; Paik S; Pisansky TM; Wolmark N; National
Surgical Adjuvant Breast and Bowel Project
Tamoxifen, radiation therapy, or both for prevention of ipsilateral
breast tumor recurrence after lumpectomy in women with invasive breast
cancers of one centimeter or less.
SO - J Clin Oncol 2002 Oct 15;20(20):4141-9
AD - National Surgical Adjuvant Breast and Bowel Project Biostatistical
Center, Division of Pathology, and Breast Committee, Pittsburgh, PA,
USA. bernard.fisher@nsabp.org
PURPOSE: This trial was prompted by uncertainty about the need for
breast irradiation after lumpectomy in node-negative women with invasive
breast cancers of 16
UI - 12065103
AU - Resch A; Potter R; Van Limbergen E; Biber E; Klein T; Fellner C;
TI -
Handl-Zeller L; Langbauer G; Schurer-Waldheim H; Staffen A; Jakesz R;
Kubista E; Lehr S; Seitz W
Long-term results (10 years) of intensive breast conserving therapy
including a high-dose and large-volume interstitial brachytherapy boost
(LDR/HDR) for T1/T2 breast cancer.
SO - Radiother Oncol 2002 Apr;63(1):47-58
AD - Department of Radiotherapy and Radiobiology, Vienna University, Medical
School, General Hospital of Vienna, Wahringer Gurtel 18-22, Vienna,
Austria.
BACKGROUND AND PURPOSE: During the past 15 years many retrospective
studies and prospective randomized trials have been published supporting
the use of breast conserving treatment (BCT) including surgery and
radiotherapy. However, there are still many controversies on the
necessary amount of resection, the width of the resection margins and
the optimal radiation technique, dose and volume, in particular of the
boost. In this retrospective study a large cohort of 410 women with
early breast cancer treated with BCT including an interstitial
brachytherapy (BT) boost is evaluated after a long follow-up period.
MATERIAL AND METHODS: In order to clarify the impact of the different
treatment-related factors on local control, these were carefully
discriminated, based on widely accepted classification and reporting
systems for surgery as well as for radiotherapy. The surgical approach
was classified according to EORTC criteria and a high rate of
quadrantectomies (60%) was found. Dose and volume of interstitial BT is
reported according to recommendations of ICRU 58, and reveals a
significant radiation dose and volume: minimum target dose, mean central
dose (MCD) and '85% of MCD' for low-dose rate (LDR) BT was mean 20, 28
and 24 Gy, for high-dose rate (HDR) BT it was mean '10, 15 and 13 Gy,
respectively; the treated volume was 104 cc for LDR BT and 83 cc for HDR
BT. RESULTS: The actuarial rates for overall survival, disease-free
survival and disease-specific survival were 97, 90 and 98% at 5 years
and 85, 79 and 92% at 10 years. There have been only 16 breast
recurrences in 410 treated patients resulting in a 5- and 10-year
actuarial local recurrence rate of 2 and 3.9%, respectively; six
recurrences (1.5%) were in the original quadrant. Except age and
menopausal status, all tumour- and patient-related risk factors had no
significant impact on local control. CONCLUSIONS: Our data confirm that
intensive BCT leads to excellent long-term results in terms of local
control, masking classical risk factors. This high-dose and large-volume
interstitial BT seems to be superior to classical BCT without BT.
17
UI - 10703904
AU - Balzarini A; Felisi E; Martini A; De Conno F
TI -
Efficacy of homeopathic treatment of skin reactions during radiotherapy
for breast cancer: a randomised, double-blind clinical trial.
SO - Br Homeopath J 2000 Jan;89(1):8-12
AD - Rehabilitation and Palliative Care Department, National Cancer
Institute, Milan, Italy.
The aim of this study was to assess the effects of Belladonna 7cH and
X-ray 15cH associated in the treatment of acute radiodermatitis. A
randomized double-blind placebo-controlled clinical trial involving 66
patients who had been operated on for breast cancer and were undergoing
radiotherapy was conducted. The following parameters were assessed over
ten weeks: breast skin colour, warmth, swelling and pigmentation. The
efficacy of the treatment was assessed by the comparison of these
parameters taken individually and by calculating an Index of Total
Severity (sum of the scores of the four parameters) during radiotherapy,
and during recovery, 15 and 30 d after the end of the radiotherapy. The
differences of the scores of the Index of Total Severity during
Radiotherapy were not statistically significant, but showed a trend
towards a better activity of the homoeopathic medicine compared to
placebo. Analysis of the data on Total Severity during recovery, showed
a statistically significant benefit of the active medicines over
placebo. The homeopathic medicines had particular effectiveness on the
heat of the skin. The limited number of patients observed and the
posology employed could have interfered with the significance of the
results. Chemotherapy and hormonotherapy do not seem to affect the
results.
18
UI - 12365025
AU - Joslyn SA
TI -
Racial differences in treatment and survival from early-stage breast
carcinoma.
SO - Cancer 2002 Oct 15;95(8):1759-66
AD - Division of Health Promotion and Education, University of Northern Iowa,
Cedar Falls, Iowa 50614-0241, USA. sue.joslyn@uni.edu
BACKGROUND: African-American women have a significantly worse prognosis
from breast carcinoma compared with white women, even when the stage at
diagnosis is equivalent. The purpose of this study was to analyze racial
differences in the treatment (use of breast-conserving surgery and
radiation therapy) of women with early-stage breast carcinoma and the
resulting effects on survival rates. METHODS: Subjects included 10,073
African-American and 123,127 white women diagnosed with Stage I, IIA, or
IIB breast carcinoma in the National Cancer Institute's Surveillance,
Epidemiology, and End Results program between 1988 and 1998. Comparisons
were made by race with treatment, age, hormone receptor status, and
stage at the time of diagnosis. Survival analyses were conducted to
compare risk of death for African-American and white women while
controlling for age, stage, and hormone receptor status. RESULTS: Among
women diagnosed with early-stage breast carcinoma who receive
breast-conserving surgery, African-American women were significantly
less likely to receive follow-up radiation therapy in every 10-year age
group except in the older than 85 age group. Whether treatment was
equivalent or suboptimal, survival for African-American women with
early-stage breast carcinoma was significantly worse. However, when
treatment was equivalent, the effects of racial differences on survival
were significantly less compared with survival associated with
suboptimal treatment. CONCLUSIONS: Significant racial differences exist
in the treatment of women with early-stage breast carcinoma. Public
health efforts to eliminate suboptimal treatment would reduce, but not
eliminate, racial disparity in survival. Copyright 2002 American Cancer
Society.
19
UI - 12243831
AU - Chawla AK; Kachnic LA; Taghian AG; Niemierko A; Zapton DT; Powell SN
TI -
Radiotherapy and breast reconstruction: complications and cosmesis with
TRAM versus tissue expander/implant.
SO - Int J Radiat Oncol Biol Phys 2002 Oct 1;54(2):520-6
AD - Department of Radiation Oncology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, USA.
PURPOSE: Radiotherapy (RT) has an important role in breast cancer
treatment after modified radical mastectomy. Many of these patients also
undergo breast reconstruction. We reviewed our institutions' experience
to determine the outcome of patients treated with breast reconstruction
and RT. METHODS AND MATERIALS: Between 1981 and 1999, 48 breast cancer
patients underwent modified radical mastectomy, breast reconstruction,
and ipsilateral breast RT during their treatment course. Reconstruction
either preceded or followed RT. Autologous reconstruction with a
transverse rectus abdominus myocutaneous (TRAM) flap was performed in 30
patients, and 18 underwent expander and implant (E/I) reconstruction.
The primary endpoint was the quality of the reconstructed, irradiated
breast, as measured by analyzing the actuarial incidence of
complications. The cosmetic outcome was also assessed by
multidisciplinary review of the follow-up visits. RESULTS: The median
follow-up from reconstruction was 32 months. The actuarial 2-year
complication rate was 53% for patients receiving E/I vs. 12% for those
receiving TRAM reconstruction (p <0.01). No other patient or
treatment-related factors had a significant impact on complications. The
cosmetic outcome was also significantly better in the TRAM subgroup than
in the E/I subgroup. CONCLUSION: The tolerance and cosmetic outcome of
breast reconstruction for breast cancer patients in irradiated sites
depends significantly on the type of reconstruction used.
20
UI - 9141981
AU - Leask DE
TI -
Radical choices in mastectomy.
SO - CMAJ 1997 Apr 15;156(8):1119, 1121
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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