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Cozzi S, Finocchi Ghersi S, Tava F, Bardoscia L, Najafi M, Ruggieri MP, Serre AA, Roukoz C, Gutierrez Miguelez C, Lazrek A, Sardaro A, Taverna C. Radiation-Associated Angiosarcoma of the Breast: The State of the Art of a Rare and Aggressive Disease. J Pers Med 2024; 14:859. [PMID: 39202050 PMCID: PMC11355165 DOI: 10.3390/jpm14080859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
INTRODUCTION Considering the increasing number of conservative surgeries (quadrantectomies) for primary breast carcinoma, especially in the early stages, often followed by adjuvant radiotherapy, the incidence of radiation-associated angiosarcoma (RAS) is expected to rise in the coming decades, and it will represent a clinical and therapeutic challenge, as limited data are available due to the rarity and heterogeneity of the disease. Though the prognosis of these patients is poor, a number of clinical and pathological factors can be evaluated to better understand the course of RAS. The aim of this systematic review is to explore the available clinical-pathological, therapeutic, and prognostic data regarding RAS to evaluate its occurrence, diagnosis, treatment, and outcomes. METHOD RAS clinical data were identified by a systematic review conducted in five different databases (Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane). Only RAS works published in English, with access to the full manuscript text, and with clear results, were considered as eligible. RESULTS We considered 52 papers comprising 319 RAS cases. The patient age at diagnosis ranged from 37 to 93 years, with most cases occurring from 5 to 10 years after breast irradiation. The most common clinical presentation was an aggressive development of macules, papules, or erythematous-violaceous skin discoloration at the site of previous radiation treatment for primary breast carcinoma. Complete surgical excision appeared to be the first-line treatment of the disease, in some cases followed by adjuvant local and/or systemic therapies. Despite different treatments, local recurrence rates ranged from 40% to 90%, leading to negative outcomes and poor prognosis for patients. CONCLUSION Although the literature is limited and the data are heterogeneous and contentious, our review aims to highlight the importance of early diagnosis, multimodal treatment, and long-term follow-up of RAS in order to limit and prevent the aggressiveness of this neoplasm.
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Affiliation(s)
- Salvatore Cozzi
- Radiation Oncology Department, Centre Léon Bérard, 69373 Lyon, France; (A.-A.S.); (C.R.)
| | - Sebastiano Finocchi Ghersi
- Radiation Therapy Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.F.G.); (M.P.R.)
| | - Francesca Tava
- Pathology Unit, Azienda Sanitaria Locale, Ospedale San Giacomo, 15067 Novi Ligure, Italy; (F.T.); (C.T.)
| | - Lilia Bardoscia
- Radiation Oncology Unit, San Luca Hospital, AUSL Toscana Nord Ovest, 55100 Lucca, Italy
| | - Masoumeh Najafi
- Department of Radiation Oncology, Shohadaye Haft-e-Tir Hospital, Iran University of Medical Science, Teheran 1997667665, Iran;
| | - Maria Paola Ruggieri
- Radiation Therapy Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.F.G.); (M.P.R.)
| | - Anne-Agathe Serre
- Radiation Oncology Department, Centre Léon Bérard, 69373 Lyon, France; (A.-A.S.); (C.R.)
| | - Camille Roukoz
- Radiation Oncology Department, Centre Léon Bérard, 69373 Lyon, France; (A.-A.S.); (C.R.)
| | - Cristina Gutierrez Miguelez
- Brachytherapy Unit, Department of Radiation Oncology, Catalan Institute of Oncology, University of Barcelona, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
| | - Amina Lazrek
- Radiation Oncology Unit, International University Hospital Cheikh Zaid, Rabat 10000, Morocco;
| | - Angela Sardaro
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Cecilia Taverna
- Pathology Unit, Azienda Sanitaria Locale, Ospedale San Giacomo, 15067 Novi Ligure, Italy; (F.T.); (C.T.)
- Department of Health Sciences, Università del Piemonte Orientale UNIUPO, 28100 Novara, Italy
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Ghilli M, Lisa AVE, Salgarello M, Papa G, Rietjens M, Folli S, Curcio A, Ferrari G, Caruso F, Altomare V, Friedman D, De Santis MC, De Rose F, Meduri B, De Felice F, Marino L, Cucciarelli F, Montemezzi S, Panizza P, Belli P, Caumo F, Vinci V, De Santis G, Klinger M, Roncella M. Oncoplastic and reconstructive surgery in SENONETWORK Italian breast centers: lights and shadows. Breast 2024; 73:103601. [PMID: 38043223 PMCID: PMC10731356 DOI: 10.1016/j.breast.2023.103601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 12/05/2023] Open
Abstract
•Despite the significance of oncoplastic procedure, an italian database is lacking. •Senonetwork established a multidisciplinary survey to assess their safety and efficacy. •Reconstructive outcomes were positive across low and high-volume centers. •After mastectomy, implant-based techniques are common. DTI reconstruction is advantageuos. •This contributes to the global understanding of effective strategies against breast cancer.
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Affiliation(s)
- Matteo Ghilli
- Breast Centre, University Hospital of Pisa (AOUP), Pisa, Italy.
| | - Andrea Vittorio Emanuele Lisa
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, University of Milan, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marzia Salgarello
- Department of Plastic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCSDirector of the Residency Program of Plastic Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Papa
- Department of Plastic Surgery, UCO, University of Trieste, Trieste Italy
| | - Mario Rietjens
- Division of Plastic and Reconstructive Surgery, IEO, IRCCS European Institute of Oncology, Milan Italy
| | - Secondo Folli
- Chirurgia Senologica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Italy
| | - Annalisa Curcio
- Chirurgia Senologica Forlì-Ravenna, ASL della Romagna, Italy
| | - Guglielmo Ferrari
- S.C. di Chirurgia Senologica, A.U.S.L.-IRCCS di Reggio Emilia, Italy
| | - Francesco Caruso
- Breast centre, UO Chirurgia oncologica - Dipartimento Oncologico - Humanitas Istituto Clinico Catanese, Misterbianco (CT), Italy
| | - Vittorio Altomare
- UOC Chirurgia Senologica, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Daniele Friedman
- UOC Chirurgia Senologica, Ospedale Policlinico San Martino di Genova, Italy
| | - Maria Carmen De Santis
- SC Radioterapia, SS Radioterapia Tumori della Mammella, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fiorenza De Rose
- Department of Radiation Oncology, Santa Chiara Hospital, Trento, Italy
| | - Bruno Meduri
- Department of Radiation Oncology, Azienda Ospedaliera - Universitaria di Modena, Italy
| | - Francesca De Felice
- Radiation Oncology, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Italy
| | - Lorenza Marino
- Radioterapia Oncologica, Humanitas Istituto Clinico Catanese, Misterbianco (CT), Italy
| | - Francesca Cucciarelli
- Radiotherapy Department, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| | - Stefania Montemezzi
- Dipartimento Patologia e Diagnostica Azienda Ospedaliera Universitaria Integrata di Verona, Italy
| | - Pietro Panizza
- IRCCS Ospedale San Raffaele, U.O. Radiologia Senologica, Milan, Italy
| | - Paolo Belli
- Dipartimento Diagnostica per Immagini, Radioterapia Oncologica Ed Ematologia, Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesca Caumo
- UOC Radiologia Senologica Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Valeriano Vinci
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, University of Milan, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital, Rozzano - Milan, Italy
| | - Giorgio De Santis
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, UNIMORE, Modena, Italy
| | - Marco Klinger
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, University of Milan, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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3
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Andreoletti S, Klinger F, Vinci V. Comment on "Oncological Safety of Autologous Fat Grafting in Breast Reconstruction: A Meta-analysis Based on Matched Cohort Studies". Aesthetic Plast Surg 2023; 47:2207-2208. [PMID: 37217604 DOI: 10.1007/s00266-023-03373-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/24/2023]
Affiliation(s)
- Stefania Andreoletti
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, IRCCS Humanitas Research Hospital, University of Milan, Rozzano, Milan, Italy.
| | - Francesco Klinger
- Department of Health Sciences, Ospedale San Paolo University of Milan, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Valeriano Vinci
- Department of Biomedical Sciences, IRCCS Humanitas University, Pieve Emanuele, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Noblet C, Duthy M, Coste F, Saliou M, Samain B, Drouet F, Papazyan T, Moreau M. Implementation of volumetric-modulated arc therapy for locally advanced breast cancer patients: Dosimetric comparison with deliverability consideration of planning techniques and predictions of patient-specific QA results via supervised machine learning. Phys Med 2022; 96:18-31. [DOI: 10.1016/j.ejmp.2022.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/10/2022] [Accepted: 02/15/2022] [Indexed: 12/21/2022] Open
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Metz G, Snook K, Sood S, Baron-Hay S, Spillane A, Lamoury G, Carroll S. Breast Radiotherapy after Oncoplastic Surgery-A Multidisciplinary Approach. Cancers (Basel) 2022; 14:1685. [PMID: 35406457 PMCID: PMC8996843 DOI: 10.3390/cancers14071685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/02/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
Oncoplastic breast surgery encompasses a range of techniques used to provide equitable oncological outcomes compared with standard breast surgery while, simultaneously, prioritizing aesthetic outcomes. While the outcomes of oncoplastic breast surgery are promising, it can add an extra complexity to the treatment paradigm of breast cancer and impact on decision-making surrounding adjuvant therapies, like chemotherapy and radiotherapy. As such, early discussions at the multidisciplinary team meeting with surgeons, medical oncologists, and radiation oncologists present, should be encouraged to facilitate best patient care.
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Affiliation(s)
- Gabrielle Metz
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW 2065, Australia; (S.S.); (S.B.-H.); (G.L.); (S.C.)
| | - Kylie Snook
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; (K.S.); (A.S.)
- Breast and Surgical Oncology, The Poche Centre, Sydney, NSW 2060, Australia
- The Mater Hospital, Sydney, NSW 2060, Australia
| | - Samriti Sood
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW 2065, Australia; (S.S.); (S.B.-H.); (G.L.); (S.C.)
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; (K.S.); (A.S.)
- Breast and Surgical Oncology, The Poche Centre, Sydney, NSW 2060, Australia
- The Mater Hospital, Sydney, NSW 2060, Australia
- Breast and Melanoma Surgery Unit, Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Sally Baron-Hay
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW 2065, Australia; (S.S.); (S.B.-H.); (G.L.); (S.C.)
| | - Andrew Spillane
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; (K.S.); (A.S.)
- Breast and Surgical Oncology, The Poche Centre, Sydney, NSW 2060, Australia
- The Mater Hospital, Sydney, NSW 2060, Australia
- Breast and Melanoma Surgery Unit, Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Gillian Lamoury
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW 2065, Australia; (S.S.); (S.B.-H.); (G.L.); (S.C.)
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; (K.S.); (A.S.)
- The Mater Hospital, Sydney, NSW 2060, Australia
| | - Susan Carroll
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW 2065, Australia; (S.S.); (S.B.-H.); (G.L.); (S.C.)
- Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; (K.S.); (A.S.)
- The Mater Hospital, Sydney, NSW 2060, Australia
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6
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Caviggioli F, Agnelli B, Murolo M, Siliprandi M, Bozzo G, Vinci V. Additional Thoughts on the Future of Fat Grafting. Aesthet Surg J 2022; 42:NP83-NP84. [PMID: 34324629 DOI: 10.1093/asj/sjab298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Fabio Caviggioli
- University of Milan, Reconstructive and Aesthetic Plastic Surgery School, MultiMedica Holding S.p.A., Plastic Surgery Unit, Sesto San Giovanni (Milan), Milan, Italy
| | - Benedetta Agnelli
- Humanitas University Department of Biomedical Sciences, Milan, Italy
| | - Matteo Murolo
- Humanitas Clinical and Research Center—IRCCS, Rozzano, Milan, Italy
| | | | - Giulia Bozzo
- Humanitas Clinical and Research Center—IRCCS, Rozzano, Milan, Italy
| | - Valeriano Vinci
- Humanitas Clinical and Research Center—IRCCS, Rozzano, Milan, Italy
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7
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Le Fèvre C, Lacornerie T, Noël G, Antoni D. Management of metallic implants in radiotherapy. Cancer Radiother 2021; 26:411-416. [PMID: 34955412 DOI: 10.1016/j.canrad.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The number of patients with metallic implant and treated with radiotherapy is constantly increasing. These hardware are responsible for the deterioration in the quality of the CT images used at each stage of the radiation therapy, during delineation, dosimetry and dose delivery. We present the update of the recommendations of the French society of oncological radiotherapy on the pros and cons of the different methods, existing and under evaluation, which limit the impact of metallic implants on the quality and safety of radiation treatments.
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Affiliation(s)
- C Le Fèvre
- Service de radiothérapie, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, BP 23025, 67033 Strasbourg, France
| | - T Lacornerie
- Département de physique médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - G Noël
- Service de radiothérapie, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, BP 23025, 67033 Strasbourg, France; Université de Strasbourg, CNRS, IPHC UMR 7178, centre Paul-Strauss, Unicancer, 67000 Strasbourg, France
| | - D Antoni
- Service de radiothérapie, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, BP 23025, 67033 Strasbourg, France; Université de Strasbourg, CNRS, IPHC UMR 7178, centre Paul-Strauss, Unicancer, 67000 Strasbourg, France.
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8
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Battistini A, Romeo MA, Bandi V, Caviggioli F, Vinci V. Comment on: "Oral and Maxillofacial Autologous Fat Transplantation: History, Clinical Application Status and Research Progress". Aesthetic Plast Surg 2021; 45:3071-3072. [PMID: 33903931 DOI: 10.1007/s00266-021-02311-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
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Postirradiation Capsular Contracture in Implant-Based Breast Reconstruction: Management and Outcome. Plast Reconstr Surg 2021; 148:843e-844e. [PMID: 34605795 DOI: 10.1097/prs.0000000000008444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Reply: Postirradiation Capsular Contracture in Implant-Based Breast Reconstruction: Management and Outcome. Plast Reconstr Surg 2021; 148:844e-845e. [PMID: 34605798 DOI: 10.1097/prs.0000000000008445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Comment on: "Postmastectomy Pain Syndrome: A Primer for Plastic Surgeons". Ann Plast Surg 2021; 89:339-340. [PMID: 34670970 DOI: 10.1097/sap.0000000000003000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Safety and Effectiveness of Autologous Fat Grafting after Breast Radiotherapy: A Systematic Review and Meta-Analysis. Plast Reconstr Surg 2021; 148:658e-659e. [PMID: 34468480 DOI: 10.1097/prs.0000000000008339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Comment on: "Breast Reconstruction Does Not Increase the Incidence of Postmastectomy Pain Syndrome". Ann Plast Surg 2021; 89:338-339. [PMID: 34510084 DOI: 10.1097/sap.0000000000002999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Francesco K, Benedetta A, Valeria B, Andrea B, Stefano V, Giulia B, Valeriano V. Comment to "Early Intervention with Autologous Fat Grafting to Reduce Hypertrophic Scar Formation: A Preliminary Study". Aesthetic Plast Surg 2021; 46:223-224. [PMID: 34378074 DOI: 10.1007/s00266-021-02510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Klinger Francesco
- Plastic Surgery Unit, Reconstructive and Aesthetic Plastic Surgery School, MultiMedica Holding S.p.A., University of Milan, Milan, Sesto San Giovanni, Italy
| | - Agnelli Benedetta
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.
| | - Bandi Valeria
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Battistini Andrea
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Vaccari Stefano
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Bozzo Giulia
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Vinci Valeriano
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
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Comment on: "Effects of gas-filled temporary breast tissue expanders on radiation dose from modulated rotational photon beams". Med Dosim 2021; 46:382-383. [PMID: 34045127 DOI: 10.1016/j.meddos.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 11/22/2022]
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Lisa A, Losurdo A, Testori A, Tinterri C, Santoro A, Klinger M. Comment on: "Oncologic Safety of Autologous Fat Grafting in Breast Reconstruction". Clin Breast Cancer 2021; 21:e693. [PMID: 34052106 DOI: 10.1016/j.clbc.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Andrea Lisa
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Rozzano, Milan, Italy.
| | - Agnese Losurdo
- UO of Medical Oncology, Department of Oncology Hematology, Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy
| | - Alberto Testori
- Breast Surgery Department, Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy
| | - Corrado Tinterri
- Breast Surgery Department, Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy
| | - Armando Santoro
- UO of Medical Oncology, Department of Oncology Hematology, Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy; Humanitas University Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy
| | - Marco Klinger
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Rozzano, Milan, Italy
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Galtelli L, Battistini A, Bandi V, Vinci V, Klinger F. Comment on: ``The safety and efficacy of autologous fat grafting during second stage breast reconstruction". J Plast Reconstr Aesthet Surg 2021; 74:2392-2442. [PMID: 33926831 DOI: 10.1016/j.bjps.2021.03.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Leonardo Galtelli
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, Rozzano, 20090 Milan, Italy.
| | - Andrea Battistini
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, Rozzano, 20090 Milan, Italy
| | - Valeria Bandi
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, Rozzano, 20090 Milan, Italy
| | - Valeriano Vinci
- Humanitas University Department of Biomedical Sciences, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Francesco Klinger
- Plastic Surgery Unit, MultiMedica Holding S.p.A., Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Sesto San Giovanni, Milan, Italy
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Kairn T, Lathouras M, Grogan M, Green B, Sylvander SR, Crowe SB. Effects of gas-filled temporary breast tissue expanders on radiation dose from modulated rotational photon beams. Med Dosim 2021; 46:13-20. [DOI: 10.1016/j.meddos.2020.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/29/2020] [Accepted: 06/11/2020] [Indexed: 02/08/2023]
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Chang KH, Chang JS, Park K, Chung SY, Kim SY, Park RH, Han MC, Kim J, Kim H, Lee H, Kim DW, Kim YB, Kim JS, Hong CS. A Retrospective Dosimetric Analysis of the New ESTRO-ACROP Target Volume Delineation Guidelines for Postmastectomy Volumetric Modulated Arc Therapy After Implant-Based Immediate Breast Reconstruction. Front Oncol 2020; 10:578921. [PMID: 33194701 PMCID: PMC7606939 DOI: 10.3389/fonc.2020.578921] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/16/2020] [Indexed: 01/07/2023] Open
Abstract
Purpose: The European Society of Radiation & Oncology and Advisory Committee on Radiation Oncology Practice (ESTRO-ACROP) presented new guidelines for clinical target volume (CTV) delineation in post-mastectomy radiation therapy (PMRT) after implant-based immediate breast reconstruction (IBR-i). This study evaluated the dosimetric characteristics, dosimetric accuracy, and delivery accuracy of these guidelines in volumetric modulated arc therapy (VMAT). Methods and Materials: This retrospective study included 15 patients with left breast cancer who underwent mastectomy with tissue expander placement followed by PMRT. An experienced radiation oncologist delineated the CTV twice on the same image datasets based on the ESTRO-ACROP (EA-TVD) and conventional target volume delineation (C-TVD) guidelines. All VMAT plans, which used a double partial arc, were generated using six MV photons. Clinically relevant dose-volume parameters for organs at risk were compared. Dosimetric accuracy of the treatment plans and delivery accuracy were assessed. Results: Target volume of EA-TVD was significantly smaller than that of C-TVD. Although no statistically significant difference was noted in the target coverage between the two VMAT plans, EA-TVD VMAT significantly reduced the mean heart dose (3.99 ± 1.02 vs. 5.84 ± 1.78 Gy, p = 0.000), the maximum left anterior descending coronary artery (LAD) dose (9.43 ± 3.04 vs. 13.97 ± 6.04 Gy, p = 0.026), and the mean LAD dose (4.52 ± 1.31 vs. 6.35 ± 2.79 Gy, p = 0.028) compared with C-TVD VMAT. No significant difference was observed with respect to the total monitor units, plan complexity, and delivery quality assurance. Conclusions: This is the first study to show significant dose reduction for the normal heart and LAD tissue offered by the EA-TVD, while maintaining dosimetric and delivery accuracy, in PMRT after IBR-i in VMAT for left-sided breast cancer patients.
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Affiliation(s)
- Kyung Hwan Chang
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Jee Suk Chang
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Kwangwoo Park
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Yeun Chung
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - Se Young Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Ryeong Hwang Park
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Min Cheol Han
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Jihun Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Hojin Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Ho Lee
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Wook Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Bae Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Sung Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Chae-Seon Hong
- Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
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20
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Shumway DA, Momoh AO, Sabel MS, Jagsi R. Integration of Breast Reconstruction and Postmastectomy Radiotherapy. J Clin Oncol 2020; 38:2329-2340. [PMID: 32442071 DOI: 10.1200/jco.19.02850] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Dean A Shumway
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - Adeyiza O Momoh
- Section of Plastic Surgery, University of Michigan, Ann Arbor, MI
| | - Michael S Sabel
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
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21
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Haussmann J, Corradini S, Nestle-Kraemling C, Bölke E, Njanang FJD, Tamaskovics B, Orth K, Ruckhaeberle E, Fehm T, Mohrmann S, Simiantonakis I, Budach W, Matuschek C. Recent advances in radiotherapy of breast cancer. Radiat Oncol 2020; 15:71. [PMID: 32228654 PMCID: PMC7106718 DOI: 10.1186/s13014-020-01501-x] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/18/2020] [Indexed: 01/08/2023] Open
Abstract
Radiation therapy is an integral part of the multidisciplinary management of breast cancer. Regional lymph node irradiation in younger trials seems to provide superior target coverage as well as a reduction in long-term toxicity resulting in a small benefit in the overall survival rate. For partial breast irradiation there are now two large trials available which support the role of partial breast irradiation in low risk breast cancer patients. Multiple randomized trials have established that a sequentially applied dose to the tumor bed improves local control with the cost of worse cosmetic results.
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Affiliation(s)
- Jan Haussmann
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Carolin Nestle-Kraemling
- Department of Gynecologic and Obstetrics, Evanglisches Krankenhaus Dusseldorf, Dusseldorf, Germany
| | - Edwin Bölke
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany.
| | | | - Bálint Tamaskovics
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Klaus Orth
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Eugen Ruckhaeberle
- Department of Gynecology, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Tanja Fehm
- Department of Gynecology, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Svjetlana Mohrmann
- Department of Gynecology, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Ioannis Simiantonakis
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Wilfried Budach
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Christiane Matuschek
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
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22
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Post-mastectomy immediate breast reconstruction and adjuvant radiotherapy: long term results of a mono institutional experience. Radiol Med 2020; 125:887-893. [DOI: 10.1007/s11547-020-01161-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/02/2020] [Indexed: 12/30/2022]
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23
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Dziemianowicz E, Gardner SJ, Chin Snyder K, Wen N, Walker EM, Fraser C, Reding A, Chetty IJ. Modeling AeroForm tissue expander for postmastectomy radiation therapy. J Appl Clin Med Phys 2019; 20:87-97. [PMID: 31332943 PMCID: PMC6698810 DOI: 10.1002/acm2.12682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/03/2019] [Accepted: 06/26/2019] [Indexed: 11/10/2022] Open
Abstract
The AeroForm chest wall tissue expander (TE) is a silicon shell containing a metallic CO2 reservoir, placed surgically after mastectomy. The patient uses a remote control to release compressed CO2 from the reservoir to inflate the expander. AeroForm poses challenges in a radiation therapy setting: The high density of the metallic reservoir causes imaging artifacts on the planning CT, which encumber structure definition and cause misrepresentation of density information, in turn affecting dose calculation. Additionally, convolution-based dose calculation algorithms may not be well-suited to calculate dose in and around high-density materials. In this study, a model of the AeroForm TE was created in Eclipse treatment planning system (TPS). The TPS model was validated by comparing measured to calculated transmission through the AeroForm. Transmission was measured with various geometries using radiochromic film. Dose was calculated with both Varian's Anisotropic Analytical Algorithm (AAA) and Acuros External Beam (AXB) algorithms. AAA and AXB were compared using dose profile and gamma analyses. While both algorithms modeled direct transmission well, AXB better modeled lateral scatter from the AeroForm TE. Clinical significance was evaluated using clinical data from four patients with AeroForm TEs. The AeroForm TPS model was applied, and RT plans were optimized using AAA, then re-calculated with AXB. Structures of clinical significance were defined and dose volume histogram analysis was performed. Compared to AXB, AAA overestimates dose in the AeroForm device. Changes in clinically significant regions were patient- and plan-specific. This study proposes a clinical procedure for modeling the AeroForm in a commercial TPS, and discusses the limitations of dose calculation in and around the device. An understanding of dose calculation accuracy in the vicinity of the AeroForm is critical for assessing individual plan quality, appropriateness of different planning techniques and dose calculation algorithms, and even the decision to use the AeroForm in a postmastectomy radiation therapy setting.
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Affiliation(s)
| | - Stephen J Gardner
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Karen Chin Snyder
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Ning Wen
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Eleanor M Walker
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Correen Fraser
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Anne Reding
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Indrin J Chetty
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
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