International Journal of Radiation Oncology * Biology * Physics
Volume 74, Issue 3 , Pages 695-701 , 1 July 2009

The Dynamic Tumor Bed: Volumetric Changes in the Lumpectomy Cavity During Breast-Conserving Therapy

  • Brendan Prendergast, M.D.

      Affiliations

    • Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL
    • ,
  • Daniel J. Indelicato, M.D.

      Affiliations

    • University of Florida Proton Therapy Institute, Jacksonville, FL
    • Corresponding Author InformationReprint requests to: Daniel J. Indelicato, M.D., Department of Radiation Oncology, University of Florida, 2000 SW Archer Road, PO Box 100385, Gainesville, FL 32610-0385. Tel: (352) 413-7990; Fax: (352) 265-0759
    • ,
  • Stephen R. Grobmyer, M.D.

      Affiliations

    • Department of Surgery, University of Florida College of Medicine, Gainesville, FL
    • ,
  • Anneyuko I. Saito, M.D.

      Affiliations

    • Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
    • ,
  • Judith L. Lightsey, M.D.

      Affiliations

    • Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL
    • ,
  • Felicia E. Snead, M.D.

      Affiliations

    • University of Florida Proton Therapy Institute, Jacksonville, FL
    • ,
  • Christopher G. Morris, M.S.

      Affiliations

    • Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL
    • ,
  • Edward M. Copeland, M.D.

      Affiliations

    • Department of Surgery, University of Florida College of Medicine, Gainesville, FL
    • ,
  • Nancy P. Mendenhall, M.D.

      Affiliations

    • University of Florida Proton Therapy Institute, Jacksonville, FL

Received 18 July 2008 ,Revised 15 August 2008 ,Accepted 29 August 2008.

References 

  1. Blichert-Toft M, Rose C, Andersen JA, et al. Danish randomized trial comparing breast conservation therapy with mastectomy: Six years of life-table analysis. Danish Breast Cancer Cooperative Group. J Natl Cancer Inst Monogr. 1992;19–25
  2. Jacobson JA, Danforth DN, Cowan KH, et al. Ten-year results of a comparison of conservation with mastectomy in the treatment of Stage I and II breast cancer. N Engl J Med. 1995;332:907–911
  3. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–1241
  4. Bartelink H, Horiot JC, Poortmans PM, et al. Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-Year results of the randomized boost versus no boost EORTC 22881-10882 trial. J Clin Oncol. 2007;25:3259–3265
  5. Clark RM, Whelan T, Levine M, et al. Randomized clinical trial of breast irradiation following lumpectomy and axillary dissection for node–negative breast cancer: an update. Ontario Clinical Oncology Group. J Natl Cancer Inst. 1996;88:1659–1664
  6. Liljegren G, Holmberg L, Bergh J, et al. 10-Year results after sector resection with or without postoperative radiotherapy for stage I breast cancer: a randomized trial. J Clin Oncol. 1999;17:2326–2333
  7. Veronesi U, Marubini E, Mariani L, et al. Radiotherapy after breast-conserving surgery in small breast carcinoma: Long-term results of a randomized trial. Ann Oncol. 2001;12:997–1003
  8. Holli K, Saaristo R, Isola J, et al. Lumpectomy with or without postoperative radiotherapy for breast cancer with favourable prognostic features: results of a randomized study. Br J Cancer. 2001;84:164–169
  9. Romestaing P, Lehingue Y, Carrie C, et al. Role of a 10-Gy boost in the conservative treatment of early breast cancer: Results of a randomized clinical trial in Lyon, France. J Clin Oncol. 1997;15:963–968
  10. Landis DM, Luo W, Song J, et al. Variability among breast radiation oncologists in delineation of the postsurgical lumpectomy cavity. Int J Radiat Oncol Biol Phys. 2007;67:1299–1308
  11. Petersen RP, Truong PT, Kader HA, et al. Target volume delineation for partial breast radiotherapy planning: clinical characteristics associated with low interobserver concordance. Int J Radiat Oncol Biol Phys. 2007;69:41–48
  12. Pierce LJ, Moughan J, White J, et al. 1998–1999 Patterns of care study process survey of national practice patterns using breast-conserving surgery and radiotherapy in the management of Stage I–II breast cancer. Int J Radiat Oncol Biol Phys. 2005;62:183–192
  13. NSABPB-39, RTOG 0413: A Randomized Phase III Study of conventional whole breast irradiation versus partial breast irradiation for women with stage 0, I, or II breast cancer. Clin Adv Hematol Oncol. 2006;4:719–721
  14. Machtay M, Lanciano R, Hoffman J, et al. Inaccuracies in using the lumpectomy scar for planning electron boosts in primary breast carcinoma. Int J Radiat Oncol Biol Phys. 1994;30:43–48
  15. Regine WF, Ayyangar KM, Komarnicky LT, et al. Computer-CT planning of the electron boost in definitive breast irradiation. Int J Radiat Oncol Biol Phys. 1991;20:121–125
  16. Denham JW, Sillar RW, Clarke D. Boost dosage to the excision site following conservative surgery for breast cancer: it's easy to miss!. Clin Oncol (R Coll Radiol). 1991;3:257–261
  17. Oh KS, Kong FM, Griffith KA, et al. Planning the breast tumor bed boost: changes in the excision cavity volume and surgical scar location after breast-conserving surgery and whole breast irradiation. Int J Radiat Oncol Biol Phys. 2006;66:680–686
  18. Benda RK, Yasuda G, Sethi A, et al. Breast boost: Are we missing the target?. Cancer. 2003;97:905–909
  19. Weed DW, Yan D, Martinez AA, et al. The validity of surgical clips as a radiographic surrogate for the lumpectomy cavity in image-guided accelerated partial breast irradiation. Int J Radiat Oncol Biol Phys. 2004;60:484–492
  20. Jacobson G, Betts V, Smith B. Change in volume of lumpectomy cavity during external-beam irradiation of the intact breast. Int J Radiat Oncol Biol Phys. 2006;65:1161–1164
  21. Indelicato D, Grobmyer SR, Newlin H, et al. Association between operative closure type and acute infection, local recurrence, and disease surveillance in patients undergoing breast conserving therapy for early-stage breast cancer. Surgery. 2007;141:645–653
  22. Indelicato DJ, Grobmyer SR, Newlin H, et al. Delayed breast cellulitis: An evolving complication of breast conservation. Int J Radiat Oncol Biol Phys. 2006;66:1339–1346
  23. Smitt MC, Birdwell RL, Goffinet DR. Breast electron boost planning: Comparison of CT and US1. Radiology. 2001;219:203–206
  24. Nichols EM, Flannery TW, Markham KM, et al. Repeat Computed Tomography Simulation to Assess Lumpectomy Cavity Volume During Whole Breast Irradiation. Int J Radiat Oncol Biol Phys. 2007;69:S221
  25. Holland R, Veling SH, Mravunae M, et al. Histologic multifocality of Tis, T1–2 breast carcinomas. Implications for clinical trials for breast-conserving surgery. Cancer. 1985;56:979–990
  26. Muller A, Tschahargane C, Anton HW, et al. Multicentric primaries and residual tumor masses following wide excision in breast cancer: a basis for irradiation. Eur J Gynaecol Oncol. 1989;10:310–318
  27. Hurkmans C, Admiraal M, van der SM, et al. Significance of breast boost volume changes during radiotherapy in relation to current clinical interobserver variations. Radiother Oncol. 2008;
  28. van der Laan HP, Dolsma WV, Maduro JH, et al. Dosimetric consequences of the shift towards computed tomography guided target definition and planning for breast conserving radiotherapy. Radiat Oncol. 2008;3:6
  29. Bellon JR, Come SE, Gelman RS, et al. Sequencing of chemotherapy and radiation therapy for patients with early stage breast cancer: Updated results of a prospective randomized trial. [Abstr.] Int J Radiat Oncol Biol Phys. 2001;51:2S–3S
  30. Huang J, Barbera L, Brouwers M, et al. Does delay in starting treatment affect the outcomes of radiotherapy? A systematic review. J Clin Oncol. 2003;21:555–563
  31. Hebert-Croteau N, Freeman CR, Latreille J, et al. A population-based study of the impact of delaying radiotherapy after conservative surgery for breast cancer. Breast Cancer Res Treat. 2004;88:187–196

 Conflict of interest: none.

PII: S0360-3016(08)03426-3

doi: 10.1016/j.ijrobp.2008.08.044

International Journal of Radiation Oncology * Biology * Physics
Volume 74, Issue 3 , Pages 695-701 , 1 July 2009

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