Advances in Breast Cancer Radiotherapy: Implications for Current and Future Practice

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 2720

Special Issue Editor


E-Mail Website1 Website2
Guest Editor
1. Northern Cancer Service, North West Cancer Centre, Burnie, TAS 7320, Australia
2. Rural Clinical School, Northwest Regional Hospital, University of Tasmania, Burnie, TAS 7320, Australia
Interests: breast cancer; radiotherapy; radiation oncology; molecular genetics

Special Issue Information

Dear Colleagues,

Breast cancer is the leading cause of cancer in women and the second most common cause of cancer death. Radiotherapy is one of the pillars of breast cancer treatment. It is an exciting time in breast cancer radiotherapy, where the landscapes for diagnosis, treatment and prognosis are rapidly evolving. You are invited to contribute to this Special Issue of JCM entitled “Advances in Breast Cancer Radiotherapy: Implications for Current and Future Practice”.

Molecular biology is impacting the breast cancer treatment with the development of prognostic gene expression signatures. In early breast cancer, the eligibility criteria for the omission of post-lumpectomy radiotherapy are expanding, while hypofractionation has impacted standard practice and is being actively explored in locally advanced disease; its extension to ultrahypofractionation is revolutionizing treatment schemes. The indications for postmastectomy radiotherapy are actively evolving, while subsets of breast cancer patients with oligometastatic disease, suitable for ablative radiotherapy, are actively being sought.

We look forward to receiving your submissions to this Special Issue.

Prof. Dr. Michael J. McKay
Guest Editor

Manuscript Submission Information

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Keywords

  • breast conserving surgery
  • post-mastectomy radiotherapy
  • accelerated partial breast irradiation
  • radiotherapy hypofractionation
  • radiotherapy hypofractionation and ultrahypofractionation
  • metastasis-directed therapy
  • radiotherapy clinical trials
  • breast cancer
  • radiotherapy

Published Papers (3 papers)

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Research

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10 pages, 874 KiB  
Article
Impact of Varying Chest Wall Target Volume Delineation on Postmastectomy Radiation Therapy Outcomes in Breast Cancer Patients with Implant-Based Reconstruction
by Pei-Yu Hou, Chen-Hsi Hsieh, Chen-Xiong Hsu, Deng-Yu Kuo, Yueh-Feng Lu and Pei-Wei Shueng
J. Clin. Med. 2023, 12(21), 6882; https://doi.org/10.3390/jcm12216882 - 31 Oct 2023
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Abstract
Background: The target volume for post-mastectomy radiation therapy (PMRT) in breast cancer patients with reconstruction has been a subject of debate. Traditionally, the RT chest wall (CW) volume encompasses the entire implant. For patients with retropectoral implants, the deep lymphatic plexus dorsal part [...] Read more.
Background: The target volume for post-mastectomy radiation therapy (PMRT) in breast cancer patients with reconstruction has been a subject of debate. Traditionally, the RT chest wall (CW) volume encompasses the entire implant. For patients with retropectoral implants, the deep lymphatic plexus dorsal part of the implant is no longer considered high risk and can be omitted. This study aimed to assess the radiation dose distribution and treatment outcomes associated with different CW delineation according to ESTRO ACROP guideline for patients who have undergone implant-based reconstruction. Methods: We conducted a retrospective review of breast cancer patients who underwent a mastectomy followed by two-stage implant-based breast reconstruction and adjuvant radiation therapy (RT) between 2007 and 2022. The expanders/implants were positioned retropectorally. The chest wall target volumes were categorized into two groups: the prepectoral group, which excluded the deep lymphatic plexus, and the whole expander group. Results: The study included 26 patients, with 15 in the prepectoral group and 11 in the whole expander group. No significant differences were observed in normal organ exposure between the two groups. There was a trend toward a lower ipsilateral lung mean dose in the prepectoral group (10.2 vs. 11.1 Gy, p = 0.06). Both groups exhibited limited instances of reconstruction failure and local recurrence. Conclusions: For patients undergoing two-stage expander/implant retropectoral breast reconstruction and PMRT, our data provided comparable outcomes and normal organ exposure for those omitting the deep lymphatic plexus. Full article
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15 pages, 712 KiB  
Article
Objective, Clinician- and Patient-Reported Evaluation of Late Toxicity Following Adjuvant Radiation for Early Breast Cancer: Long-Term Follow-Up Results of a Randomised Series
by Cas Stefaan Dejonckheere, Alina Abramian, Kira Lindner, Anne Bachmann, Katharina Layer, Teresa Anzböck, Julian Philipp Layer, Gustavo Renato Sarria, Davide Scafa, David Koch, Christina Leitzen, Christina Kaiser, Andree Faridi and Leonard Christopher Schmeel
J. Clin. Med. 2023, 12(13), 4212; https://doi.org/10.3390/jcm12134212 - 22 Jun 2023
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Abstract
Background and Purpose: This study aimed to differentially assess the frequency and severity of late radiation-induced toxicity following adjuvant whole-breast irradiation for early breast cancer with conventional fractionation (CF) and moderate hypofractionation (mHF). Materials and Methods: Patients recruited in a previous randomised controlled [...] Read more.
Background and Purpose: This study aimed to differentially assess the frequency and severity of late radiation-induced toxicity following adjuvant whole-breast irradiation for early breast cancer with conventional fractionation (CF) and moderate hypofractionation (mHF). Materials and Methods: Patients recruited in a previous randomised controlled trial comparing acute toxicity between CF and mHF without disease recurrence were included in a post hoc analysis. Spectrophotometric and ultrasonographic examinations were performed for an objective evaluation and subsequent comparison of long-term skin toxicity. Furthermore, patient- and clinician-reported outcomes were recorded. Results: Sixty-four patients with a median age of 58 (37–81) years were included. The median follow-up was 57 (37–73) months. A total of 55% underwent CF and 45% mHF. A total of 52% received a sequential boost to the tumour bed. A significant decrease in mean L* (p = 0.011) and an increase in a* (p = 0.040) and b* values (p < 0.001) were observed, indicating hyperpigmentation. In comparison with the non-irradiated breast, there was a significant increase in both cutis (+14%; p < 0.001) and subcutis (+17%; p = 0.011) thickness, significantly more pronounced in CF patients (p = 0.049). In CF patients only, a sequential boost significantly increased the local cutis thickness and oedema compared to non-boost regions in the same breast (p = 0.001 and p < 0.001, respectively). Conclusions: mHF objectively resulted in reduced long-term skin toxicity compared to CF. A sequential boost increased the local fibrosis rate in CF, but not in mHF. This might explain the subjectively reported better cosmetic outcomes in patients receiving mHF and reinforces the rationale for favouring mHF as the standard of care. Full article
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Review

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20 pages, 1588 KiB  
Review
PET Molecular Imaging in Breast Cancer: Current Applications and Future Perspectives
by Sanaz Katal, Michael J. McKay and Kim Taubman
J. Clin. Med. 2024, 13(12), 3459; https://doi.org/10.3390/jcm13123459 - 13 Jun 2024
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Abstract
Positron emission tomography (PET) plays a crucial role in breast cancer management. This review addresses the role of PET imaging in breast cancer care. We focus primarily on the utility of 18F-fluorodeoxyglucose (FDG) PET in staging, recurrence detection, and treatment response evaluation. Furthermore, [...] Read more.
Positron emission tomography (PET) plays a crucial role in breast cancer management. This review addresses the role of PET imaging in breast cancer care. We focus primarily on the utility of 18F-fluorodeoxyglucose (FDG) PET in staging, recurrence detection, and treatment response evaluation. Furthermore, we delve into the growing interest in precision therapy and the development of novel radiopharmaceuticals targeting tumor biology. This includes discussing the potential of PET/MRI and artificial intelligence in breast cancer imaging, offering insights into improved diagnostic accuracy and personalized treatment approaches. Full article
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