Radiation Oncology

Radiation Therapy and Breast Reconstruction: Considerations and Timing
When women are diagnosed with breast cancer, they are immediately faced with an overwhelming amount of information and a need to make important decisions regarding treatment. The most important thing that must be decided on with their team of oncologists is how to best treat the cancer and reduce their risk of a recurrence or spread. However,

Why I Chose Breast Oncology
Carla Fisher, MD Like many others, my path into the field of oncology was not a direct one. After making the decision to enter medical school, I chose to pursue a career in surgery followed by a specialization in breast oncology. As I look back, each choice was made for different reasons at different times and ultimately I am so happy with the

DCIS: To radiate or not to radiate?
Dear OncoLink "Ask The Experts," I have had the removal of a 1/2 centimeter, stage 0, DCIS (ductal carcinoma in situ) from my left breast. The second biopsy was clear of cancer in the surrounding area. Is radiation necessary, or can I take a chemo drug like tamoxifen for 5 years instead and be considered quite safe from a return of cancer? I am

Second Malignancies after Treatment of Early Stage Breast Cancer with Lumpectomy and Radiation or Mastectomy without Radiation
Presenter: E. Obedian Affiliation: Yale University School of Medicine Summary:Multiple studies have demonstrated the clinical efficacy of breast conserving therapy (BCT) for early stage breast cancer. Despite decades of experience, however, there are limited data regarding the safety of this treatment, specificially the risk of second

Tamoxifen & Radiation at The Same Time?
Question I will be getting radiation and also tamoxifen treatment following a lumpectomy T2N0. Is there a downside to concurrent treatment? Answer Kevin Fox, MD, Medical Oncologist at Penn , responds: There have been several studies that have looked at concurrent versus sequential radiation and tamoxifen in early stage breast cancer. There

Radiotherapy

Surgery and Radiotherapy for Breast Cancer: A Look at the Studies
In December of 2005, the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) published the combined results of 78 clinical trials evaluating radiation therapy and surgery in breast cancer patients.The group has published updates of this data every 5 years, and this publication represents 15 years of follow-up. The paper is jam-packed with

Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomised trial
Reviewers: John Han-Chih Chang, MD Source: Lancet 1999 May 15; Volume 353(Number 9165): 1641-8Background/Discussion/CritiqueThe New England Journal publications in 1997 from Denmark and Canada demonstrated a survival benefit for postmastectomy radiation therapy (RT) in premenopausal women with high risk breast cancer. The benefits of tamoxifen in

Adjuvant Radiotherapy in Pre-Menopausal Women with Breast Cancer
Reviewers: John Han-Chih Chang, MD and Ken Blank, MD Source: N Engl J Med. 1997 Oct 2;337(14):956-62.Possibly more than any other cancer, the treatment of breast cancer has evolved over the past twenty years. Surgery to remove the entire breast (simple, modified and radical mastectomy) has been largely replaced by breast conserving surgery

Preliminary Analysis of Radiotherapy Data from CALGB 9082: Variability of Treatment Fields for Local/Regional Breast Cancer and the Impact of High Dose Chemotherapy on the Ability to Deliver Radiation Therapy
Presenter: Lawrence B. Marks, M.D. Affiliation: Duke University/CALGB/SWOG Summary:Positive contributions of radiotherapy (RT) and chemotherapy in patients with high-risk breast cancer are well documented, but the sequencing of these modalities and dosage of chemotherapy in such patients remains controversial. This offering examines the effect

Timescale of Evolution of Late Radiation Injury after Postoperative Radiotherapy of Breast Cancer Patients
Presenter: Silvia Johansson Affiliation: Umea University Hospital, Sweden Summary:Most of the modern randomized trials in breast cancer document toxicity associated with treatment, but none document these toxicities over the scale of decades. These data are important because many women are diagnosed with breast cancer at a relatively young age,

Irradiation

Partial Breast Irradiation Versus Traditional Radiation
Question Why do I have to come for radiation every day for weeks? I have heard about some radiation for breast cancer that is done in only 5 days- what is that and is it just as good? Answer Gary Freedman, MD, Radiation Oncologist at Penn , responds: The purpose of delivering radiation therapy in a relatively small dose once a day for about 6

Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy Plus Irradiation for the Treatment of Invasive Breast Cancer
Authors: Bernard Fisher, M.D., Stewart Anderson, Ph.D., John Bryant, Ph.D., et al. Source: N Engl J Med 2002, 347:1233-1241 Background The National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol B-04 showed that over 25 years of follow-up there was no significant difference in survival between women treated with a radical

Analysis of Interfraction and Intrafraction Variation During Tangential Breast Irradiation with an Electronic Portal Imaging Device
Source: Int J Radiat Oncol Biol Phys. 2005 Jun 1;62(2):373-8. Authors: Smith RP, Bloch P, Harris EE, McDonough J, Sarkar A, Kassaee A, Avery S, Solin LJ. Background During radiotherapy, a major goal is to deliver radiation to the target tissue while minimizing exposure to normal tissues. In tangential breast radiotherapy, the breast is the

Partial Breast Irradiation
Dear OncoLink "Ask The Experts," Can you please tell explain Partial Breast Irradiation? Lawrence J. Solin, MD, FACR, Professor of Radiation Oncology at the University of Pennsylvania, responds: For patients with early stage breast carcinoma undergoing breast conservation treatment, the standard method of delivering radiation is to treat the

Breast Irradiation and Respiratory Infections
Dear OncoLink "Ask The Experts," Is there a connection between radiation (Right breast, ductal carcinoma in situ) and later increase of upper respiratory infections (URI)? Neha Vapiwala , MD, Senior Editor of OncoLink and Chief Resident in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania, responds:There is no