Radiother Oncol 2019 May 17
ESTRO ACROP consensus guideline for target volume delineation in the setting of postmastectomy radiation therapy after implant-based immediate reconstruction for early stage breast cancer.
Abstract
Immediate breast reconstruction (IBR) rates after mastectomy are increasing. Postmastectomy radiation therapy (PMRT) contouring guidelines for target volumes in the setting of IBR are lacking. Therefore, many patients who have had IBR receive PMRT to target volumes similar to conventional simulator-based whole breast irradiation. The aim of this paper is to describe delineation guidelines for PMRT after implant-based IBR based on a thorough understanding of the surgical procedures, disease stage, patterns of recurrence and radiation techniques. They are based on a consensus endorsed by a global multidisciplinary group of breast cancer experts.
Related Questions
Are there any recommendations on ways to reduce capsulitis in patient with implants receiving adjuvant whole breast radiation?
There are no specific ways, but based on clinical factors, consider options to reduce volume of RT by PBI with EBRT or brachy, if the patient is suitable for partial breast RT. For whole breast, try to have good dose homogeneity like V105 in single digit (<10%), and with V110 as zero. Avoid any hot ...
How would you treat a patient who has a large DCIS status post mastectomy and implant with extensive positive margins?
I would treat with PMRT to 50 Gy in 25 fractions followed by boost as it looks like the patient has a significant margin positive.Based on the location of implant (pre pectoral or retro pectoral) contouring and at risk volume is different. The consensus guidelines addresses this: https://www.ncbi.nl...