Do you treat synchronous bilateral breast cancers with RT simultaneously or sequentially?
We see a fair number of synchronous bilateral cases here. I am not aware of any compelling arguments or data for sequential treatment over simultaneous. Simultaneous is more efficient in terms of overall length of time, and allows for better coordination of the fields (but there is more time on the ...
Although data on this is limited, I have treated a number of patients over the years with bilateral simultaneous treatment and do not feel that sequential treatment with the extended time required on the patient and resources is necessary. I personally simply do bilateral 3 D conformal with bilatera...
I will use strong words here. In almost all cases, sequential is approaching unethical.
I have seen it many times, having worked at multiple centers and seeing follow ups.
It doubles the cost to the patient/system.
And doubles the time. Pre hypo-era, this meant 12-13 weeks - 14 when they did 1.8 fo...
The earliest series I know of examining this issue in a series of patients was one from the Joint Center for Radiation Therapy in Boston of 24 patients treated from 1977-1989. Outcome and complication rates were the same as for patients with unilateral cancers treated in the same era (Gollamudi et a...
I also treat these simultaneously. I think patients tolerate bilateral treatment well and can't really think of when I would intentionally separate the treatments to sequential delivery. I think that might actually be a higher risk for unintentional overlap. As an aside, we recently published our bi...