Evolution of radiotherapy techniques in breast conservation treatment

John Boyages, Lesley Baker

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Radiation therapy (RT) is an important component of breast cancer treatment that reduces local recurrence and improves survival after breast conservation. Breast conservation rates have increased significantly since the late 1980s and techniques have improved with greater awareness of the impact of radiation on the heart. An overview of randomized controlled trials of breast conservation using standard whole breast irradiation, whole breast hypofractionation, accelerated partial breast irradiation (APBI) and intraoperative radiation are reviewed. Selection criteria for breast conservation and the utility of adding a boost dose to the primary tumor site are reviewed. Modern dose constraints are documented and 10 different radiation techniques from the 1980s through to modern volumetric modulated arc therapy (VMAT) are compared for a patient where the breast and internal mammary nodes are treated. A radiation boost reduces the risk of a recurrence for most, but not all patients. Short courses of RT over 3-4 weeks are generally as effective as longer courses. Short-term follow-up of trials of APBI show promise for selected good prognosis subgroups. The role of intraoperative radiation remains controversial. In the last 30 years, there have been significant advances in radiation techniques. Modern radiotherapy equipment and techniques will reduce complications and improve survival rates.

LanguageEnglish
Pages576-595
Number of pages20
JournalGland Surgery
Volume7
Issue number6
DOIs
Publication statusPublished - 1 Dec 2018

Fingerprint

Breast
Radiotherapy
Radiation
Therapeutics
Recurrence
Intensity-Modulated Radiotherapy
Patient Selection
Survival Rate
Randomized Controlled Trials
Breast Neoplasms
Equipment and Supplies
Survival
Neoplasms

Keywords

  • Breast neoplasms
  • Local
  • Mastectomy
  • Neoplasm recurrence
  • Radiotherapy
  • Segmental
  • Survival

Cite this

@article{d564dff8fe4f46fc9fe2ac63fca87074,
title = "Evolution of radiotherapy techniques in breast conservation treatment",
abstract = "Radiation therapy (RT) is an important component of breast cancer treatment that reduces local recurrence and improves survival after breast conservation. Breast conservation rates have increased significantly since the late 1980s and techniques have improved with greater awareness of the impact of radiation on the heart. An overview of randomized controlled trials of breast conservation using standard whole breast irradiation, whole breast hypofractionation, accelerated partial breast irradiation (APBI) and intraoperative radiation are reviewed. Selection criteria for breast conservation and the utility of adding a boost dose to the primary tumor site are reviewed. Modern dose constraints are documented and 10 different radiation techniques from the 1980s through to modern volumetric modulated arc therapy (VMAT) are compared for a patient where the breast and internal mammary nodes are treated. A radiation boost reduces the risk of a recurrence for most, but not all patients. Short courses of RT over 3-4 weeks are generally as effective as longer courses. Short-term follow-up of trials of APBI show promise for selected good prognosis subgroups. The role of intraoperative radiation remains controversial. In the last 30 years, there have been significant advances in radiation techniques. Modern radiotherapy equipment and techniques will reduce complications and improve survival rates.",
keywords = "Breast neoplasms, Local, Mastectomy, Neoplasm recurrence, Radiotherapy, Segmental, Survival",
author = "John Boyages and Lesley Baker",
year = "2018",
month = "12",
day = "1",
doi = "10.21037/gs.2018.11.10",
language = "English",
volume = "7",
pages = "576--595",
journal = "Gland Surgery",
issn = "2227-684X",
publisher = "AME Publishing Company",
number = "6",

}

Evolution of radiotherapy techniques in breast conservation treatment. / Boyages, John; Baker, Lesley.

In: Gland Surgery, Vol. 7, No. 6, 01.12.2018, p. 576-595.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Evolution of radiotherapy techniques in breast conservation treatment

AU - Boyages, John

AU - Baker, Lesley

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Radiation therapy (RT) is an important component of breast cancer treatment that reduces local recurrence and improves survival after breast conservation. Breast conservation rates have increased significantly since the late 1980s and techniques have improved with greater awareness of the impact of radiation on the heart. An overview of randomized controlled trials of breast conservation using standard whole breast irradiation, whole breast hypofractionation, accelerated partial breast irradiation (APBI) and intraoperative radiation are reviewed. Selection criteria for breast conservation and the utility of adding a boost dose to the primary tumor site are reviewed. Modern dose constraints are documented and 10 different radiation techniques from the 1980s through to modern volumetric modulated arc therapy (VMAT) are compared for a patient where the breast and internal mammary nodes are treated. A radiation boost reduces the risk of a recurrence for most, but not all patients. Short courses of RT over 3-4 weeks are generally as effective as longer courses. Short-term follow-up of trials of APBI show promise for selected good prognosis subgroups. The role of intraoperative radiation remains controversial. In the last 30 years, there have been significant advances in radiation techniques. Modern radiotherapy equipment and techniques will reduce complications and improve survival rates.

AB - Radiation therapy (RT) is an important component of breast cancer treatment that reduces local recurrence and improves survival after breast conservation. Breast conservation rates have increased significantly since the late 1980s and techniques have improved with greater awareness of the impact of radiation on the heart. An overview of randomized controlled trials of breast conservation using standard whole breast irradiation, whole breast hypofractionation, accelerated partial breast irradiation (APBI) and intraoperative radiation are reviewed. Selection criteria for breast conservation and the utility of adding a boost dose to the primary tumor site are reviewed. Modern dose constraints are documented and 10 different radiation techniques from the 1980s through to modern volumetric modulated arc therapy (VMAT) are compared for a patient where the breast and internal mammary nodes are treated. A radiation boost reduces the risk of a recurrence for most, but not all patients. Short courses of RT over 3-4 weeks are generally as effective as longer courses. Short-term follow-up of trials of APBI show promise for selected good prognosis subgroups. The role of intraoperative radiation remains controversial. In the last 30 years, there have been significant advances in radiation techniques. Modern radiotherapy equipment and techniques will reduce complications and improve survival rates.

KW - Breast neoplasms

KW - Local

KW - Mastectomy

KW - Neoplasm recurrence

KW - Radiotherapy

KW - Segmental

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=85058899523&partnerID=8YFLogxK

U2 - 10.21037/gs.2018.11.10

DO - 10.21037/gs.2018.11.10

M3 - Review article

VL - 7

SP - 576

EP - 595

JO - Gland Surgery

T2 - Gland Surgery

JF - Gland Surgery

SN - 2227-684X

IS - 6

ER -