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Early-Stage Breast Cancer Radiotherapy

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Breast Cancer

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Abstract

Radiotherapy is part of breast cancer treatment. The addition of radiotherapy to breast-conserving surgery decreases the risk of local recurrence by half in insitu disease. In invasive disease, postmastectomy radiotherapy (PMRT) in patients with 4 or more lymph nodes with metastatic involvement is the standart of care. A recent meta-analysis provided more evidence for PMRT benefit in patients with 1–3 involved nodes. After lumpectomy, whole-breast radiotherapy is still considered the standard of care. A meta-analysis showed a statistically significant increase in in-breast control and a decrease in breast cancer-specific deaths. In addition, boost radiotherapy to the tumor bed after breast-conserving surgery was shown to decrease local failure from 10.2% to 6.2%; the largest benefit was observed in patients ≤40 years of age (local failure decreased from 23.9% to 13%). The results of accelerated partial-breast irradiation (APBI) in patients with low local recurrence risk are controversial. Two large randomized APBI trials showed higher in-breast recurrences in patients treated with APBI than in those treated with whole-breast radiotherapy. Hypofractionation is also an appropriate therapeutic option for most patients with early breast cancer with comparable long-term toxicity profiles. A disease-free survival benefit of regional lymphatic irradiation has been demonstrated in patients with high-risk features with no axillary nodal involvement.

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Authors and Affiliations

  1. Istanbul Medical Faculty, Department of Radiation Oncology, Istanbul University, Institute of Oncology, Istanbul, Turkey

    Kamuran Arslan Ibis & Seden Kucucuk

  2. Department of Radiation Oncology, University of Health Sciences, Okmeydanı Training and Research Hospital, Istanbul, Turkey

    Makbule Tambas

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  1. Internal Medicine, Medical Oncology, Istanbul Medical Faculty, Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey

    Adnan Aydiner

  2. General Surgery, Istanbul Medical Faculty, Department of Surgery, Istanbul University, Istanbul, Turkey

    Abdullah Igci

  3. Surgical Oncology, Magee-Women’s Hospital, University of Pittsburgh Medical Centre, Pittsburgh, PA, USA

    Atilla Soran

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Arslan Ibis, K., Tambas, M., Kucucuk, S. (2019). Early-Stage Breast Cancer Radiotherapy. In: Aydiner, A., Igci, A., Soran, A. (eds) Breast Cancer . Springer, Cham. https://doi.org/10.1007/978-3-319-96947-3_19

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