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Cosmetic results after breast conserving therapy
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Which factors play a role ? Several RCTs to investigate impact of:
Factor studied
Impact on cosmesis
Conclusion
Hypofx
No change in breast
appearance
Alfa/beta 3.5 Gy
No boost vs low boost
No boost better than boost
Dose-effect relation present
Prone vs Supine
Tendency for better outcome
prone than supine
Due to better dose
homogeneity ?
2D CRT vs IMRT
Only benefit if scored by
physician at 5 yr, and if
patients are selected
Partial breast vs WBRT
Results conflicting
Probably due to DVH
parameters and dose per
fraction; not clear
Hypofx:
Whelan 2008; Haviland 2013, Valle 2017;
Prone vs supine:
Veldeman 2016;
2D CRT vs
IMRT:
Pignol 2016; Mukesh 2014;
No vs low boost:
Vrieling 1999 & 2000, Hau 2013;
Low vs
high boost
: Brouwers in preparation;
PBI vs WBRT:
Polgar 2017, Coles 2017, Peterson 2015