The Impact of an Incidental Dose on Axillary Tumor Control and Toxicity in Localized Breast Cancer: A Retrospective Analysis
Purpose: The dosimetric analysis of the incidental axillary dose delivered to axillary lymph node levels I–III by different techniques of whole breast irradiation and the analysis of prognostic factors of axillary recurrence of breast cancer. Methods: We perform a retrospective analysis that include...
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| Published in: | Cancers Vol. 14; no. 3; p. 807 |
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| Main Authors: | , , , , , , |
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| Language: | English |
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04.02.2022
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| ISSN: | 2072-6694, 2072-6694 |
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| Abstract | Purpose: The dosimetric analysis of the incidental axillary dose delivered to axillary lymph node levels I–III by different techniques of whole breast irradiation and the analysis of prognostic factors of axillary recurrence of breast cancer. Methods: We perform a retrospective analysis that includes 171 patients with localized breast carcinoma irradiated at Centre Paul Strauss. To be included in the study, patients had to have a histological confirmation of breast cancer diagnosis, surgical treatment without axillary lymph node dissection (ALND), whole breast irradiation without axillary irradiation by a specific field, and a treatment plan available. Results: Three patients had lymph node recurrence. There was no significant correlation between the maximal or mean dose delivered at the three axillary levels and the risk of axillary lymph node recurrence. There was no significant correlation between the irradiation technique and the risk of axillary lymph node recurrence. Two patients, both in the HT group, had lymphoedema. There was significantly more lymphoedema in the HT group than in the ST and IMRT groups (p < 0.048). The mean dose in level II was significantly higher in the group of patients with lymphoedema (3.45 Gy (1.08; 9.62) vs. 23.4 Gy (23.1; 23.6)) (p < 0.02). Conclusion: The irradiation technique has an influence on the incidental dose delivered to the axillary area, but has no influence on the risk of axillary recurrence. The risk of lymphoedema could be related to the use of HT and the mean dose delivered at level II. |
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| AbstractList | The dosimetric analysis of the incidental axillary dose delivered to axillary lymph node levels I-III by different techniques of whole breast irradiation and the analysis of prognostic factors of axillary recurrence of breast cancer.PURPOSEThe dosimetric analysis of the incidental axillary dose delivered to axillary lymph node levels I-III by different techniques of whole breast irradiation and the analysis of prognostic factors of axillary recurrence of breast cancer.We perform a retrospective analysis that includes 171 patients with localized breast carcinoma irradiated at Centre Paul Strauss. To be included in the study, patients had to have a histological confirmation of breast cancer diagnosis, surgical treatment without axillary lymph node dissection (ALND), whole breast irradiation without axillary irradiation by a specific field, and a treatment plan available.METHODSWe perform a retrospective analysis that includes 171 patients with localized breast carcinoma irradiated at Centre Paul Strauss. To be included in the study, patients had to have a histological confirmation of breast cancer diagnosis, surgical treatment without axillary lymph node dissection (ALND), whole breast irradiation without axillary irradiation by a specific field, and a treatment plan available.Three patients had lymph node recurrence. There was no significant correlation between the maximal or mean dose delivered at the three axillary levels and the risk of axillary lymph node recurrence. There was no significant correlation between the irradiation technique and the risk of axillary lymph node recurrence. Two patients, both in the HT group, had lymphoedema. There was significantly more lymphoedema in the HT group than in the ST and IMRT groups (p < 0.048). The mean dose in level II was significantly higher in the group of patients with lymphoedema (3.45 Gy (1.08; 9.62) vs. 23.4 Gy (23.1; 23.6)) (p < 0.02).RESULTSThree patients had lymph node recurrence. There was no significant correlation between the maximal or mean dose delivered at the three axillary levels and the risk of axillary lymph node recurrence. There was no significant correlation between the irradiation technique and the risk of axillary lymph node recurrence. Two patients, both in the HT group, had lymphoedema. There was significantly more lymphoedema in the HT group than in the ST and IMRT groups (p < 0.048). The mean dose in level II was significantly higher in the group of patients with lymphoedema (3.45 Gy (1.08; 9.62) vs. 23.4 Gy (23.1; 23.6)) (p < 0.02).The irradiation technique has an influence on the incidental dose delivered to the axillary area, but has no influence on the risk of axillary recurrence. The risk of lymphoedema could be related to the use of HT and the mean dose delivered at level II.CONCLUSIONThe irradiation technique has an influence on the incidental dose delivered to the axillary area, but has no influence on the risk of axillary recurrence. The risk of lymphoedema could be related to the use of HT and the mean dose delivered at level II. The dosimetric analysis of the incidental axillary dose delivered to axillary lymph node levels I-III by different techniques of whole breast irradiation and the analysis of prognostic factors of axillary recurrence of breast cancer. We perform a retrospective analysis that includes 171 patients with localized breast carcinoma irradiated at Centre Paul Strauss. To be included in the study, patients had to have a histological confirmation of breast cancer diagnosis, surgical treatment without axillary lymph node dissection (ALND), whole breast irradiation without axillary irradiation by a specific field, and a treatment plan available. Three patients had lymph node recurrence. There was no significant correlation between the maximal or mean dose delivered at the three axillary levels and the risk of axillary lymph node recurrence. There was no significant correlation between the irradiation technique and the risk of axillary lymph node recurrence. Two patients, both in the HT group, had lymphoedema. There was significantly more lymphoedema in the HT group than in the ST and IMRT groups ( < 0.048). The mean dose in level II was significantly higher in the group of patients with lymphoedema (3.45 Gy (1.08; 9.62) vs. 23.4 Gy (23.1; 23.6)) ( < 0.02). The irradiation technique has an influence on the incidental dose delivered to the axillary area, but has no influence on the risk of axillary recurrence. The risk of lymphoedema could be related to the use of HT and the mean dose delivered at level II. Purpose: The dosimetric analysis of the incidental axillary dose delivered to axillary lymph node levels I–III by different techniques of whole breast irradiation and the analysis of prognostic factors of axillary recurrence of breast cancer. Methods: We perform a retrospective analysis that includes 171 patients with localized breast carcinoma irradiated at Centre Paul Strauss. To be included in the study, patients had to have a histological confirmation of breast cancer diagnosis, surgical treatment without axillary lymph node dissection (ALND), whole breast irradiation without axillary irradiation by a specific field, and a treatment plan available. Results: Three patients had lymph node recurrence. There was no significant correlation between the maximal or mean dose delivered at the three axillary levels and the risk of axillary lymph node recurrence. There was no significant correlation between the irradiation technique and the risk of axillary lymph node recurrence. Two patients, both in the HT group, had lymphoedema. There was significantly more lymphoedema in the HT group than in the ST and IMRT groups (p < 0.048). The mean dose in level II was significantly higher in the group of patients with lymphoedema (3.45 Gy (1.08; 9.62) vs. 23.4 Gy (23.1; 23.6)) (p < 0.02). Conclusion: The irradiation technique has an influence on the incidental dose delivered to the axillary area, but has no influence on the risk of axillary recurrence. The risk of lymphoedema could be related to the use of HT and the mean dose delivered at level II. Simple SummaryThe incidental axillary dose varies according to the whole breast irradiation technique. However, this dose has not been shown to be a prognostic factor for locoregional recurrence. The objectives of our retrospective study are to dosimetrically evaluate the incidental axillary dose according to the different irradiation techniques and the risk factors of axillary recurrence. We confirmed that the irradiation technique has an influence on the incidental dose delivered to the axillary area, but has no influence on the risk of axillary recurrence. The risk of lymphoedema could be related to the use of high tangential beams and the mean dose delivered at level II.AbstractPurpose: The dosimetric analysis of the incidental axillary dose delivered to axillary lymph node levels I–III by different techniques of whole breast irradiation and the analysis of prognostic factors of axillary recurrence of breast cancer. Methods: We perform a retrospective analysis that includes 171 patients with localized breast carcinoma irradiated at Centre Paul Strauss. To be included in the study, patients had to have a histological confirmation of breast cancer diagnosis, surgical treatment without axillary lymph node dissection (ALND), whole breast irradiation without axillary irradiation by a specific field, and a treatment plan available. Results: Three patients had lymph node recurrence. There was no significant correlation between the maximal or mean dose delivered at the three axillary levels and the risk of axillary lymph node recurrence. There was no significant correlation between the irradiation technique and the risk of axillary lymph node recurrence. Two patients, both in the HT group, had lymphoedema. There was significantly more lymphoedema in the HT group than in the ST and IMRT groups (p < 0.048). The mean dose in level II was significantly higher in the group of patients with lymphoedema (3.45 Gy (1.08; 9.62) vs. 23.4 Gy (23.1; 23.6)) (p < 0.02). Conclusion: The irradiation technique has an influence on the incidental dose delivered to the axillary area, but has no influence on the risk of axillary recurrence. The risk of lymphoedema could be related to the use of HT and the mean dose delivered at level II. |
| Author | Pflumio, Carole Noël, Georges Hild, Carole Schmitt, Martin Chambrelant, Isabelle Hong Chheang, Parigna Petit, Thierry |
| AuthorAffiliation | 2 Radiotherapy Department, Khmer Soviet Friendship Hospital, Yuthapol Khemarak Phoumin Blvd, Phnom Penh 12306, Cambodia; p.hongchheang@icans.eu 1 Radiotherapy Department, Strasbourg Europe Cancer Institute, 17 Rue Albert Calmette, 67200 Strasbourg, France; ma.schmitt@icans.eu (M.S.); i.chambrelant@icans.eu (I.C.) 3 Medical Oncology Department, Strasbourg Europe Cancer Institute, 17 Rue Albert Calmette, 67200 Strasbourg, France; c.pflumio@icans.eu (C.P.); t.petit@icans.eu (T.P.) 4 Breast Surgery Department, Strasbourg Europe Cancer Institute, 17 Rue Albert Calmette, 67200 Strasbourg, France; c.hild@icans.eu |
| AuthorAffiliation_xml | – name: 1 Radiotherapy Department, Strasbourg Europe Cancer Institute, 17 Rue Albert Calmette, 67200 Strasbourg, France; ma.schmitt@icans.eu (M.S.); i.chambrelant@icans.eu (I.C.) – name: 3 Medical Oncology Department, Strasbourg Europe Cancer Institute, 17 Rue Albert Calmette, 67200 Strasbourg, France; c.pflumio@icans.eu (C.P.); t.petit@icans.eu (T.P.) – name: 4 Breast Surgery Department, Strasbourg Europe Cancer Institute, 17 Rue Albert Calmette, 67200 Strasbourg, France; c.hild@icans.eu – name: 2 Radiotherapy Department, Khmer Soviet Friendship Hospital, Yuthapol Khemarak Phoumin Blvd, Phnom Penh 12306, Cambodia; p.hongchheang@icans.eu |
| Author_xml | – sequence: 1 givenname: Martin orcidid: 0000-0002-3969-6610 surname: Schmitt fullname: Schmitt, Martin – sequence: 2 givenname: Isabelle orcidid: 0000-0002-8102-771X surname: Chambrelant fullname: Chambrelant, Isabelle – sequence: 3 givenname: Parigna surname: Hong Chheang fullname: Hong Chheang, Parigna – sequence: 4 givenname: Carole surname: Pflumio fullname: Pflumio, Carole – sequence: 5 givenname: Carole surname: Hild fullname: Hild, Carole – sequence: 6 givenname: Thierry surname: Petit fullname: Petit, Thierry – sequence: 7 givenname: Georges orcidid: 0000-0003-4952-5572 surname: Noël fullname: Noël, Georges |
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| Keywords | axillary lymph node dosimetric analysis radiotherapy intensity-modulated radiotherapy three-dimensional radiotherapy breast carcinoma |
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| Snippet | Purpose: The dosimetric analysis of the incidental axillary dose delivered to axillary lymph node levels I–III by different techniques of whole breast... The dosimetric analysis of the incidental axillary dose delivered to axillary lymph node levels I-III by different techniques of whole breast irradiation and... Simple SummaryThe incidental axillary dose varies according to the whole breast irradiation technique. However, this dose has not been shown to be a prognostic... |
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| SubjectTerms | Body mass index Breast cancer Breast carcinoma Cancer therapies Dosimetry Fractions Lumpectomy Lymph nodes Lymphatic system Lymphedema Mastectomy Metastasis Patients Radiation therapy Risk factors Software Statistical analysis Toxicity Tumors |
| Title | The Impact of an Incidental Dose on Axillary Tumor Control and Toxicity in Localized Breast Cancer: A Retrospective Analysis |
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