Información sobre riesgo, prevención, detección, síntomas, diagnosis, tratamiento y apoyo para el cáncer.
Información sobre el tratamiento del cáncer incluyendo quirúrgica, quimioterapia, radioterapia, estudios clínicos, terapia con protón, medicina complementaria avanzadas.
OncoLink se complace en ofrecer una amplia lista de lista completa de los agentes quimioterapéuticos más comúnmente usados??. Esta guía de referencia incluye información sobre la forma en que cada fármaco se administra, cómo funcionan, y los pacientes los efectos secundarios comunes pueden experimentar.
Maneras que los pacientes de cáncer y las personas que le cuidan puedan enfrentar el cáncer, los efectos secundarios, nutrición, cuestiones en general sobre el apoyo para el cáncer, duelo/decisiones sobre el termino de vida, y experiencias compartidas por sobrevivientes.
National Cancer Institute®
Ultima Vez Modificado: 1 de octubre del 2002
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.
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.
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.
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.
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.
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. email@example.com
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.
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. firstname.lastname@example.org
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.
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.
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.
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. email@example.com
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.
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. firstname.lastname@example.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 = 1 cm, by speculation that tamoxifen (TAM) might be as or more effective than radiation therapy (XRT) in reducing the rate of ipsilateral breast tumor recurrence (IBTR) in such women, and by the thesis that both modalities might be more effective than either alone. PATIENTS AND METHODS: After lumpectomy, 1,009 women were randomly assigned to TAM (n = 336), XRT and placebo (n = 336), or XRT and TAM (n = 337). Rates of IBTR, distant recurrence, and contralateral breast cancer (CBC) were among the end points for analysis. Cumulative incidence of IBTR and of CBC was computed accounting for competing risks. Results with two-sided P values of.05 or less were statistically significant. RESULTS: XRT and placebo resulted in a 49% lower hazard rate of IBTR than did TAM alone; XRT and TAM resulted in a 63% lower rate than did XRT and placebo. When compared with TAM alone, XRT plus TAM resulted in an 81% reduction in hazard rate of IBTR. Cumulative incidence of IBTR through 8 years was 16.5% with TAM, 9.3% with XRT and placebo, and 2.8% with XRT and TAM. XRT reduced IBTR below the level achieved with TAM alone, regardless of estrogen receptor (ER) status. Distant treatment failures were infrequent and not significantly different among the groups (P =.28). When TAM-treated women were compared with those who received XRT and placebo, there was a significant reduction in CBC (hazard ratio, 0.45; 95% confidence interval, 0.21 to 0.95; P =.039). Survival in the three groups was 93%, 94%, and 93%, respectively (P =.93). CONCLUSION: In women with tumors = 1 cm, IBTR occurs with enough frequency after lumpectomy to justify considering XRT, regardless of tumor ER status, and TAM plus XRT when tumors are ER positive.
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.
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.
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. email@example.com
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.
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.
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.
Endocrine System Cancers
Head and Neck Cancers
Urinary Tract Cancers
Bone Marrow Transplants
General Treatment Concerns
Newly Diagnosed Patients
Causes and Prevention
Legal and Financial Information for Patients
Cancer Resource List
Resources for Young Adults