Are there any special radiotherapy considerations for women who have double lumpectomy?
ACOSOG Z11102 mandated radiation with a boost. Hypofractionation was prohibited. This isn't how we practice nowadays and some women might otherwise meet CALGB or PRIME II criteria for omission. How do you approach this?
2 Answers
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Radiation Oncology · Allegheny Health Network, Pittsburgh
Answered on
Z11102 looked at multiple ipsilateral breast cancers and lumpectomies. For these cases, I would be fine with hypofractionated WBI. Boost would be based on features of each cancer so if it was otherwise low risk for both, I would omit boost vs. if both were higher risk (< 50, ER-), I would boost both...
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
If treating with tangent beams, then make sure there is a 5-10 mm gap between two medial fields with no change in dose or fraction.
If suitable for APBI on both sides, that is also an option with IMRT/IGRT.
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