1
|
Vanni G, Pellicciaro M, Di Lorenzo N, Barbarino R, Materazzo M, Tacconi F, Squeri A, D’Angelillo RM, Berretta M, Buonomo OC. Surgical De-Escalation for Re-Excision in Patients with a Margin Less Than 2 mm and a Diagnosis of DCIS. Cancers (Basel) 2024; 16:743. [PMID: 38398134 PMCID: PMC10886566 DOI: 10.3390/cancers16040743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
The current surgical guidelines recommend an optimal margin width of 2 mm for the management of patients diagnosed with ductal carcinoma in situ (DCIS). However, there are still many controversies regarding re-excision when the optimal margin criteria are not met in the first resection. The purpose of this study is to understand the importance of surgical margin width, re-excision, and treatments to avoid additional surgery on locoregional recurrence (LRR). The study is retrospective and analyzed surgical margins, adjuvant treatments, re-excision, and LRR in patients with DCIS who underwent breast-conserving surgery (BCS). A total of 197 patients were enrolled. Re-operation for a close margin rate was 13.5%, and the 3-year recurrence was 7.6%. No difference in the LRR was reported among the patients subjected to BCS regardless of the margin width (p = 0.295). The recurrence rate according to margin status was not significant (p = 0.484). Approximately 36.9% (n: 79) patients had resection margins < 2 mm. A sub-analysis of patients with margins < 2 mm showed no difference in the recurrence between the patients treated with a second surgery and those treated with radiation (p = 0.091). The recurrence rate according to margin status in patients with margins < 2 mm was not significant (p = 0.161). The margin was not a predictive factor of LRR p = 0.999. Surgical re-excision should be avoided in patients with a focally positive margin and no evidence of the disease at post-surgical imaging.
Collapse
Affiliation(s)
- Gianluca Vanni
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.M.); (O.C.B.)
| | - Marco Pellicciaro
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.M.); (O.C.B.)
- Ph.D. Program in Applied Medical-Surgical Sciences, Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy
| | - Nicola Di Lorenzo
- Department of Surgical Sciences, Tor Vergata University, 00133 Rome, Italy;
| | - Rosaria Barbarino
- Radiotherapy, Department of Oncoematology, Policlinico Tor Vergata, 00133 Rome, Italy; (R.B.); (R.M.D.)
| | - Marco Materazzo
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.M.); (O.C.B.)
- Ph.D. Program in Applied Medical-Surgical Sciences, Department of Surgical Science, Tor Vergata University, 00133 Rome, Italy
| | - Federico Tacconi
- Department of Surgical Sciences, Unit of Thoracic Surgery, Tor Vergata University, 00133 Rome, Italy;
| | - Andrea Squeri
- School of Specialization in Medical Oncology Unit, Department of Human Pathology “G. Barresi”, University of Messina, 98100 Messina, Italy;
| | - Rolando Maria D’Angelillo
- Radiotherapy, Department of Oncoematology, Policlinico Tor Vergata, 00133 Rome, Italy; (R.B.); (R.M.D.)
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy;
| | - Oreste Claudio Buonomo
- Breast Unit Policlinico Tor Vergata, Department of Surgical Science, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy; (G.V.); (M.M.); (O.C.B.)
| |
Collapse
|
2
|
Wang Y, Peng D, Zhou X, Hu W, Li F. Treatments and Prognosis of the Breast Ductal Carcinoma In Situ. Clin Breast Cancer 2024; 24:122-130.e2. [PMID: 38016910 DOI: 10.1016/j.clbc.2023.11.001] [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] [Received: 10/18/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION With progress in treatments, breast ductal carcinoma in situ (DCIS) outcomes have substantially improved. However, as various treatment methods are used in different countries and institutions, consensus on the optimal treatment method is lacking. This study aimed to analyze the prognostic factors and provide a reference for optimizing the clinical treatment of DCIS. PATIENTS AND METHODS This retrospective clinical study collected data from DCIS patients at the Sun Yat-sen University Cancer Center from 2010 to 2017. The Kaplan-Meier method and Cox regression model were used to assess disease-free survival (DFS), overall survival (OS), and local control (LC) rates. RESULTS Among the 483 included patients, 83.6% (404) underwent mastectomies. The median follow-up time was 101 months. The number of patients undergoing breast-conserving surgery (BCS) with radiotherapy has gradually increased. Axillary lymph node dissection was the main surgery performed from 2010 to 2015, and the proportion of sentinel lymph node biopsies (SLNBs) has increased. LC and DFS rates with BCS without radiotherapy were significantly lower than those with mastectomy (P = .002; P < .001). Additionally, the patients who did not undergo axillary surgery had worse LC and OS rates than those who underwent SLNB (P = .028 and P = .038). Endocrine therapy (ET) or its duration had no significant effect on prognosis. CONCLUSION In conclusion, BCS without radiotherapy and lack of axillary surgery were independent prognostic factors. We recommend performing BCS with radiotherapy and SLNB more in clinical practice, as well as shortening the ET duration.
Collapse
Affiliation(s)
- Yaxue Wang
- State Key Laboratory of Oncology, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, PR China
| | - Dingsheng Peng
- Department of Radiation Oncology, Huizhou Central People's Hospital, Huizhou, PR China
| | - Xinhui Zhou
- State Key Laboratory of Oncology, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, PR China
| | - Wendie Hu
- State Key Laboratory of Oncology, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, PR China
| | - Fengyan Li
- State Key Laboratory of Oncology, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
| |
Collapse
|
3
|
Amadou A, Praud D, Coudon T, Deygas F, Grassot L, Dubuis M, Faure E, Couvidat F, Caudeville J, Bessagnet B, Salizzoni P, Leffondré K, Gulliver J, Severi G, Mancini FR, Fervers B. Long-term exposure to nitrogen dioxide air pollution and breast cancer risk: A nested case-control within the French E3N cohort study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 317:120719. [PMID: 36435283 DOI: 10.1016/j.envpol.2022.120719] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 06/16/2023]
Abstract
Nitrogen dioxide (NO2) is an important air pollutant due to its adverse effects on human health. Yet, current evidence on the association between NO2 and the risk of breast cancer lacks consistency. In this study, we investigated the association between long-term exposure to NO2 and breast cancer risk in the French E3N cohort study. Association of breast cancer risk with NO2 exposure was assessed in a nested case-control study within the French E3N cohort including 5222 breast cancer cases identified over the 1990-2011 follow-up period and 5222 matched controls. Annual mean concentrations of NO2 at participants' residential addresses for each year from recruitment 1990 through 2011, were estimated using a land use regression (LUR) model. Multivariable conditional logistic regression models were used to compute odds ratios (ORs) and their 95% confidence intervals (CIs). Additional analyses were performed using NO2 concentrations estimated by CHIMERE, a chemistry transport model. Overall, the mean NO2 exposure was associated with an increased risk of breast cancer. In all women, for each interquartile range (IQR) increase in NO2 levels (LUR: 17.8 μg/m3), the OR of the model adjusted for confounders was 1.09 (95% CI: 1.01-1.18). The corresponding OR in the fully adjusted model (additionally adjusted for established breast cancer risk factors) was 1.07 (95% CI: 0.98-1.15). By menopausal status, results for postmenopausal women were comparable to those for all women, while no association was observed among premenopausal women. By hormone receptor status, the OR of estrogen receptor positive breast cancer = 1.07 (95% CI: 0.97-1.19) in the fully adjusted model. Additional analyses using the CHIMERE model showed slight differences in ORs estimates. The results of this study indicate an increased risk of breast cancer associated with long-term exposure to NO2 air pollution. Observing comparable effects of NO2 exposure estimated by two different models, reinforces these findings.
Collapse
Affiliation(s)
- Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France
| | - Delphine Praud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France.
| | - Thomas Coudon
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France; Ecole Centrale de Lyon, INSA Lyon, Université Claude Bernard Lyon 1, Ecully, France
| | - Floriane Deygas
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France
| | - Lény Grassot
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France
| | - Mathieu Dubuis
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France
| | - Elodie Faure
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Université Paris-Saclay, UVSQ, Inserm U1018, CESP, "Exposome Heredity, Cancer and Health", Gustave Roussy, Villejuif, France
| | - Florian Couvidat
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Julien Caudeville
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Bertrand Bessagnet
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France; Citepa, Technical Reference Center for Air Pollution and Climate Change, Paris, France
| | - Pietro Salizzoni
- Ecole Centrale de Lyon, INSA Lyon, Université Claude Bernard Lyon 1, Ecully, France
| | - Karen Leffondré
- Univ Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, UMR1219, Bordeaux, France
| | - John Gulliver
- Centre for Environmental Health and Sustainability, School of Geography, Geology and the Environment, University of Leicester, United Kingdom
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, "Exposome Heredity, Cancer and Health", Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Italy
| | - Francesca Romana Mancini
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, "Exposome Heredity, Cancer and Health", Gustave Roussy, Villejuif, France
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France
| |
Collapse
|
4
|
Kada Mohammed S, Dabakuyo Yonli TS, Desmoulins I, Manguem Kamga A, Jankowski C, Padeano MM, Loustalot C, Costaz H, Causeret S, Peignaux K, Rouffiac M, Coutant C, Arnould L, Ladoire S. Prognosis of local invasive relapses after carcinoma in situ of the breast: a retrospective study from a population-based registry. Breast Cancer Res Treat 2023; 197:377-385. [PMID: 36417042 PMCID: PMC9823085 DOI: 10.1007/s10549-022-06807-w] [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: 07/01/2022] [Accepted: 10/30/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The prognosis of local invasive recurrence (LIR) after prior carcinoma in situ (CIS) of the breast has not been widely studied and existing data are conflicting, especially considering the specific prognosis of this entity, compared to de novo invasive breast cancer (de novo IBC) and with LIR after primary IBC. METHODS We designed a retrospective study using data from the specialized Côte d'Or Breast and Gynecological cancer registry, between 1998 and 2015, to compare outcomes between 3 matched groups of patients with localized IBC: patients with LIR following CIS (CIS-LIR), patients with de novo IBC (de novo IBC), and patients with LIR following a first IBC (IBC-LIR). Distant relapse-free (D-RFS), overall survival (OS), clinical, and treatment features between the 3 groups were studied. RESULTS Among 8186 women initially diagnosed with IBC during our study period, we retrieved and matched 49 CIS-LIR to 49 IBC, and 46 IBC-LIR patients. At diagnosis, IBC/LIR in the 3 groups were mainly stage I, grade II, estrogen receptor-positive, and HER2 negative. Metastatic diseases at diagnosis were higher in CIS-LIR group. A majority of patients received adjuvant systemic treatment, with no statistically significant differences between the 3 groups. There was no significant difference between the 3 groups in terms of OS or D-RFS. CONCLUSION LIR after CIS does not appear to impact per se on survival of IBC.
Collapse
Affiliation(s)
- Samia Kada Mohammed
- grid.414153.60000 0000 8897 490XDepartment of Gynaecology and Obstetrics, Assistance Publique des Hôpitaux de Paris (APHP), Jean Verdier Hospital, Avenue du 14 Juillet, 93140 Bondy, France
| | - Tienhan Sandrine Dabakuyo Yonli
- Breast and Gynaecologic Cancer Registry of Côte d’Or, Epidemiology and Quality of Life Research Unit, Georges-François Leclerc Comprehensive Cancer Centre-UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France ,INSERM U1231, 21000 Dijon, France
| | - Isabelle Desmoulins
- Department of Medical Oncology, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France
| | - Ariane Manguem Kamga
- Breast and Gynaecologic Cancer Registry of Côte d’Or, Epidemiology and Quality of Life Research Unit, Georges-François Leclerc Comprehensive Cancer Centre-UNICANCER, 1 rue du Professeur Marion, 21000 Dijon, France ,INSERM U1231, 21000 Dijon, France
| | - Clémentine Jankowski
- Department of Surgery, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France
| | - Marie-Martine Padeano
- Department of Surgery, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France
| | - Catherine Loustalot
- Department of Surgery, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France
| | - Hélène Costaz
- Department of Surgery, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France
| | - Sylvain Causeret
- Department of Surgery, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France
| | - Karine Peignaux
- Department of Radiotherapy, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France
| | - Magali Rouffiac
- Department of Radiotherapy, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France
| | - Charles Coutant
- Department of Surgery, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France ,grid.5613.10000 0001 2298 9313University of Burgundy-Franche Comté, 21000 Dijon, France
| | - Laurent Arnould
- Unit of Pathology, Department of Tumour Biology and Pathology, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France
| | - Sylvain Ladoire
- INSERM U1231, 21000 Dijon, France ,Department of Medical Oncology, Georges-François Leclerc Centre, 1 rue du Professeur Marion, 21000 Dijon, France ,grid.5613.10000 0001 2298 9313University of Burgundy-Franche Comté, 21000 Dijon, France
| |
Collapse
|
5
|
Preneoplastic Low-Risk Mammary Ductal Lesions (Atypical Ductal Hyperplasia and Ductal Carcinoma In Situ Spectrum): Current Status and Future Directions. Cancers (Basel) 2022; 14:cancers14030507. [PMID: 35158775 PMCID: PMC8833401 DOI: 10.3390/cancers14030507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 02/04/2023] Open
Abstract
Intraepithelial mammary ductal neoplasia is a spectrum of disease that varies from atypical ductal hyperplasia (ADH), low-grade (LG), intermediate-grade (IG), to high-grade (HG) ductal carcinoma in situ (DCIS). While ADH has the lowest prognostic significance, HG-DCIS carries the highest risk. Due to widely used screening mammography, the number of intraepithelial mammary ductal neoplastic lesions has increased. The consequence of this practice is the increase in the number of patients who are overdiagnosed and, therefore, overtreated. The active surveillance (AS) trials are initiated to separate lesions that require active treatment from those that can be safely monitored and only be treated when they develop a change in the clinical/radiologic characteristics. At the same time, the natural history of these lesions can be evaluated. This review aims to evaluate ADH/DCIS as a spectrum of intraductal neoplastic disease (risk and histomorphology); examine the controversies of distinguishing ADH vs. DCIS and the grading of DCIS; review the upgrading for both ADH and DCIS with emphasis on the variation of methods of detection and the definitions of upgrading; and evaluate the impact of all these variables on the AS trials.
Collapse
|
6
|
Affiliation(s)
- Christiane K Kuhl
- From the Department of Diagnostic and Interventional Radiology, University Hospital Aachen, RWTH Pauwelsstr 30, 52074 Aachen, Germany
| |
Collapse
|
7
|
van Dooijeweert C, van Diest PJ, Baas IO, van der Wall E, Deckers IAG. Grading variation in 2,934 patients with ductal carcinoma in situ of the breast: the effect of laboratory- and pathologist-specific feedback reports. Diagn Pathol 2020; 15:52. [PMID: 32393303 PMCID: PMC7216330 DOI: 10.1186/s13000-020-00970-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/04/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Histologic grade of ductal carcinoma in situ of the breast (DCIS) may become the single biomarker that decides whether patients will be treated. Yet, evidence shows that grading variation in daily practice is substantial. To facilitate quality improvement, feedback reports, in which laboratory-specific case-mix adjusted proportions per grade were benchmarked against other laboratories, were sent to the individual laboratories by March 1, 2018. One year later, the effect of these feedback reports on inter-laboratory variation was studied. METHODS Synoptic pathology reports of all pure DCIS resection specimens between March 1, 2017 and March 1, 2019 were retrieved from PALGA (the nationwide Dutch pathology registry). Laboratory-specific proportions per grade were compared to the overall proportion in the year before and after feedback. The absolute deviation for all three grades at once, represented by the overall deviation score (ODS), was calculated as the sum of deviations from the grade-specific overall proportions. Case-mix adjusted, laboratory-specific odds ratios (ORs) for high- (grade III) versus low-grade (grade I-II) DCIS were obtained by multivariable logistic regression. RESULTS Overall, 2954 DCIS reports from 31 laboratories were included. After feedback, the range between laboratories decreased by 22 and 6.5% for grades II and III, while an increase of 6.2% was observed for grade I. Both the mean ODS (27.2 to 24.1%) and maximum ODS (87.7 to 59.6%) decreased considerably. However, the range of case-mix adjusted ORs remained fairly stable and substantial (0.39 (95% CI: 0.18-0.86) to 3.69 (95% CI: 1.30-10.51)). CONCLUSION A promising decrease in grading variation was observed after laboratory-specific feedback for DCIS grades II-III, while this was not observed for DCIS grade I. Overall, grading variation remained substantial which needs to be addressed considering its clinical implications. Nationwide consensus on a classification, and training of (expert breast) pathologists, for example by e-learning, may help to further improve grading standardization.
Collapse
Affiliation(s)
- Carmen van Dooijeweert
- Department of Pathology, University Medical Center Utrecht, PO Box 85500, 3508, GA, Utrecht, the Netherlands
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, PO Box 85500, 3508, GA, Utrecht, the Netherlands.
| | - Inge O Baas
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elsken van der Wall
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ivette A G Deckers
- Foundation PALGA (the nationwide network and registry of histo- and cytopathology in the Netherlands), Houten, the Netherlands
| |
Collapse
|
8
|
Arenas M, Selek U, Kaidar-Person O, Perrucci E, Montero Luis A, Boersma L, Coles C, Offersen B, Meattini I, Bölükbaşı Y, Leonardi MC, Pfeffer R, Cutuli B, Vidali C, Franco P, Kouloulias V, Masiello V, Rivera S, Bourgier C, Ciabattoni A, Lancellotta V, Trigo L, Valentini V, Poortmans P, Aristei C. The 2018 assisi think tank meeting on breast cancer: International expert panel white paper. Crit Rev Oncol Hematol 2020; 151:102967. [PMID: 32450277 DOI: 10.1016/j.critrevonc.2020.102967] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/27/2020] [Accepted: 04/15/2020] [Indexed: 01/13/2023] Open
Abstract
We report on the second Assisi Think Tank Meeting (ATTM) on breast cancer which was held under the auspices of the European Society for RadioTherapy & Oncology (ESTRO). In discussing in-depth current evidence and practice it was designed to identify grey areas in diverse forms of the disease. It aimed at addressing uncertainties and proposing future trials to improve patient care. Before the meeting, three key topics were selected: 1) primary systemic therapy, mastectomy, breast reconstruction and post-mastectomy radiation therapy, 2) therapeutic options in ductal carcinoma in situ, and 3) therapy de-escalation in early stage breast cancer. Clinical practice in these areas was investigated by means of an online questionnaire. The time lapse period between the survey and the meeting was used to review the literature and on-going clinical trials. At the ATTM both were discussed in depth and research protocols were proposed.
Collapse
Affiliation(s)
| | - Ugur Selek
- Radiation Oncology, Koc University School of Medicine, Istambul, Turkey
| | - Orit Kaidar-Person
- Radiation Oncology, Oncology Institute, Rambam Medical Center, Haifa, Israel
| | | | | | - Liesbeth Boersma
- Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Charlotte Coles
- Radiation Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Icro Meattini
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi (AOUC), Florence, Italy
| | - Yasemin Bölükbaşı
- Radiation Oncology, Koc University School of Medicine, Istambul, Turkey
| | | | - Raphael Pfeffer
- Radiation Oncology, Assuta Medical Centres, Tel Aviv, Israel
| | - Bruno Cutuli
- Radiation Oncology, Institut du Cancer Courlancy, Reims, France
| | - Cristiana Vidali
- Radiation Oncology, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - Pierfrancesco Franco
- Radiation Oncology, Department of Oncology, University of Turin School of Medicine, Turin, Italy
| | - Vassilis Kouloulias
- Radiation Oncology, National and Kapodistrian University of Athens, Medical School, Attikon University Hospital, Athens, Greece
| | - Valeria Masiello
- Radiation Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Sofia Rivera
- Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Céline Bourgier
- Radiation Oncology, ICM-Val d'Aurelle, University Montpellier, Montpellier, France
| | | | - Valentina Lancellotta
- Radiation Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Lurdes Trigo
- Radiation Oncology, Instituto Portugues de Oncologia Francisco Martins Porto E.P.E, Porto, Portugal
| | - Vincenzo Valentini
- Radiation Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Philip Poortmans
- Radiation Oncology, Iridium Kankernetwerk, Wilrijk-Antwerp - University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk-Antwerp, Belgium
| | - Cynthia Aristei
- Radiation Oncology, University of Perugia and Perugia General Hospital, Perugia, Italy.
| |
Collapse
|