Breast reconstruction and post-mastectomy radiation practice

Radiation Oncology

Mylin A Torres⁷  Jeffrey M Switchenko⁴  Oliver Riesterer³  Fundagul Andic⁶  Janjira Petsuksiri²  Dana Nickleach⁴  Crispin Hiley¹  Susie A Chen⁵ 

[1] The Institute of Cancer Research and The Royal Marsden National Health Service Foundation Trust, Sutton, Surrey, UK;Radiation Oncology Division, Radiology department, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Rd., Bangkoknoi, Bangkok, Thailand;Department of Radiation Oncology, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland;Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, Emory University, 1365 Clifton Rd. NE, Building B, Atlanta, GA, USA;Department of Radiation Oncology, University of Texas Southwestern Medical Center, 5801 Forest Park Rd., Dallas, TX 75390-9183, USA;Cukurova Universitesi Balcali Hastanesi, Radyasyon Onkolojisi, AD 01330, Saricam, Adana, Turkey;Department of Radiation Oncology, Winship Cancer Institute, Emory University, 1365 Clifton Rd. NE, Rm 1307-A, Atlanta, GA 30322, USA

关键词: Survey;    Breast cancer;    Post mastectomy radiation;    Breast reconstruction;   

Others  :  1154510
DOI  :  10.1186/1748-717X-8-45

 received in 2012-12-10, accepted in 2013-02-17,  发布年份 2013

【 摘 要 】

Purpose

The goal of this study was to explore the perspectives and practice of radiation oncologists who treat breast cancer patients who have had breast reconstruction.

Methods

In 2010, an original electronic survey was sent to all physician members of the American Society of Radiation Oncology, National Cancer Research Institute-Breast Cancer Studies Group in the United Kingdom, Thai Society of Therapeutic Radiology and Oncology, Swiss Society of Radiation Oncology, and Turkish Radiation Oncology Society. We identified factors associated with radiation oncologists who treat breast cancer patients with reconstruction performed prior to radiation and obtained information regarding radiation management of the breast reconstruction.

Results

358 radiation oncologists responded, and 60% of the physicians were from the United States. While 64% of participants agree or strongly agree that breast image affects a woman’s quality of life during radiation, 57% feel that reconstruction challenges their ability to deliver effective breast radiation. Compared with other countries, treatment within the United States was associated with a high reconstruction rate (>/= 50% of mastectomy patients) prior to radiation (p < 0.05). Delayed-immediate reconstruction with a temporary tissue expander was more common in the United States than in other countries (52% vs. 23%, p = 0.01). Among physicians who treat patients with tissue expanders, the majority (60%) prefer a moderately inflated implant with 150-250 cc of fluid rather than a completely deflated (13%) or inflated expander (28%) during radiation. Among radiation oncologists who treat reconstructions, 49% never use bolus and 40% never boost a breast reconstruction. United States physicians were more likely than physicians from other countries to boost or bolus the reconstruction irrespective of the type of reconstruction seen in their clinic patients (p < 0.01).

Conclusions

Great variation in practice is evident from our study of radiation treatment for breast cancer patients with reconstruction. Further research on the impact and delivery of radiation to a reconstructed breast may validate some of the observed practices, highlight the variability in treatment practice, and help create a treatment consensus.

【 授权许可】

   
2013 Chen et al; licensee BioMed Central Ltd.

【 图 表 】

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