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1.Poortmans Introduction 		1
Accelerated Partial Breast Irradiation 		1
Slide Number 2 		2
Slide Number 3 		3
Advanced Multidisc. TC in Breast Cancer 		4
Accelerated Partial Breast Irradiation 		5
Accelerated Partial Breast Irradiation 		6
Accelerated Partial Breast Irradiation 		7
Slide Number 8 		8
Slide Number 9 		9
Slide Number 10 		10
Slide Number 11 		11
Accelerated Partial Breast Irradiation 		12
Accelerated Partial Breast Irradiation 		13
Accelerated Partial Breast Irradiation 		14
Accelerated Partial Breast Irradiation 		15
Accelerated Partial Breast Irradiation 		16
Accelerated Partial Breast Irradiation 		17
Multidisciplinary Breast Cancer Course 		18
Accelerated Partial Breast Irradiation 		19
Accelerated Partial Breast Irradiation 		20
Accelerated Partial Breast Irradiation 		21
Slide Number 22 		22
2.breast cancer estro 		23
Imaging for early Stage Breast Cancer 		23
Questions :New imaging techniques ? 		24
(New) Imaging Techniques 		25
Breast Cancer Screening 		26
Slide Number 5 		27
Slide Number 6 		28
Breast Ultrasound ? 		29
Performances of screening breast ultrasound 		30
Slide Number 9 		31
How to improve screening? Tomosynthesis 		32
Principles 		33
Slide Number 12 		34
Slide Number 13 		35
Results: DBT and Screening 		36
Cancer detection rate /1000 Screening testEuropean countries 		37
Recall rate/1000 Screening test:Europe 		38
Tomosynthesis : Non indications 		39
How to improve Breast Cancer staging? 		40
Breast MRI 		41
Slide Number 20 		42
Accuracy of Breast MRI Staging 		43
In case of suspicious Breast MRI? 		44
Slide Number 23 		45
Slide Number 24 		46
DCIS : MRI Staging? 		47
DCIS : MRI Staging? 		48
MRI and DCIS: controversies 		49
Slide Number 28 		50
Alternative to MRI : Contrast-Mammography 		51
Slide Number 30 		52
55 yo, distorsion left breast US: not conclusive 		53
Slide Number 32 		54
Slide Number 33 		55
Clinical Performance : CESM vs MG 		56
CESM vs MRI 		57
Conclusion 		58
3.ESTRO 13 novembre 2016 		59
Slide Number 1 		59
Plan 		60
What do pathologists predict?(or try to…) 		61
Slide Number 4 		62
Slide Number 5 		63
Slide Number 6 		64
Slide Number 7 		65
Slide Number 8 		66
Predictive biomarkers 		67
Slide Number 10 		68
Slide Number 11 		69
Ki67/Mib1 		70
Towards a simplified taxonomy of breast cancer? « definition of intrinsic subtypes has proven efficient in defining prognosis for breast cancer patients » 		71
Slide Number 14 		72
Slide Number 15 		73
ADJUVANT - Résultats 		74
Slide Number 17 		75
Slide Number 18 		76
Slide Number 19 		77
Slide Number 20 		78
Slide Number 21 		79
Slide Number 22 		80
Slide Number 23 		81
Slide Number 24 		82
Slide Number 25 		83
Slide Number 26 		84
Slide Number 27 		85
Slide Number 28 		86
Slide Number 29 		87
Slide Number 30 		88
4.Poortmans Background 		89
Slide Number 1 		89
The basics behind the rise of APBI 		90
Slide Number 3 		91
The basics behind the rise of APBI: background 		92
Slide Number 5 		93
Slide Number 6 		94
Slide Number 7 		95
Slide Number 8 		96
Slide Number 9 		97
Slide Number 10 		98
Slide Number 11 		99
Slide Number 12 		100
Slide Number 13 		101
Slide Number 14 		102
Slide Number 15 		103
Slide Number 16 		104
Slide Number 17 		105
Slide Number 18 		106
Slide Number 19 		107
Slide Number 20 		108
Slide Number 21 		109
Slide Number 22 		110
The basics behind the rise of APBI: background 		111
Slide Number 24 		112
Slide Number 25 		113
Slide Number 26 		114
Slide Number 27 		115
Slide Number 28 		116
Slide Number 29 		117
Slide Number 30 		118
Slide Number 31 		119
Slide Number 32 		120
Slide Number 33 		121
Slide Number 34 		122
Slide Number 35 		123
Slide Number 36 		124
Slide Number 37 		125
6.Target contouring_Strnad 2016_closed cavity_final 		126-127
Target definition in partial breast irradiation GEC-ESTRO consensus 		126-127
3 pillars of APBI 		128-129
GEC-ESTRO guidelines for target definition in breast brachytherapy 		130-131
GEC-ESTRO guidelines for target definition in breast brachytherapy 		132-133
GEC-ESTRO guidelines for target definition in breast brachytherapy 		134-135
What we can use? 		136-137
Slide Number 7 		138-139
. Mammography before surgery 		140-141
Mammography before surgery 		142-143
Ultrasound before surgery 		144-145
Slide Number 11 		146-147
Slide Number 12 		148-149
Slide Number 13 		150-151
Surgical report 		152-153
GEC-ESTRO guidelines for target definition in breast brachytherapy 		154-155
Basic informations 		156-157
Slide Number 17 		158-159
Slide Number 18 		160-161
Resection margin and residual disease 		162-163
Resection margin and residual disease 		164-165
Resection margin and residual disease 		166-167
Resection margin and residual disease 		168-169
Slide Number 23 		170-171
Slide Number 24 		172-173
Slide Number 25 		174-175
Slide Number 26 		176-177
Slide Number 27 		178-179
Slide Number 28 		180-181
Slide Number 29 		182-183
Slide Number 30 		184-185
Slide Number 31 		186-187
Slide Number 32 		188-189
Slide Number 33 		190-191
Slide Number 34 		192-193
Slide Number 35 		194-195
Slide Number 36 		196-197
Slide Number 37 		198-199
Slide Number 38 		200-201
Slide Number 39 		202-203
Slide Number 40 		204-205
Slide Number 41 		206-207
Slide Number 42 		208-209
Slide Number 43 		210-211
Slide Number 44 		212-213
Recommendations for daily routine 		214-215
3 pillars of APBI 		216-217
7.Target volume delineation with open cavity_Major 		218
Slide Number 1 		218
Techniques for tumor bed localisation in APBI 		219
Quantification of contour comparisons 		220
Slide Number 4 		221
Slide Number 5 		222
Slide Number 6 		223
Slide Number 7 		224
Slide Number 8 		225
Slide Number 9 		226
Slide Number 10 		227
Slide Number 11 		228
Slide Number 12 		229
Slide Number 13 		230
Slide Number 14 		231
Slide Number 15 		232
Slide Number 16 		233
Conclusions from the contouring study 		234
Slide Number 18 		235
Recommendations for cavity contouring 		236
Slide Number 20 		237
Slide Number 21 		238
Slide Number 22 		239
Recommendations for cavity contouring 		240
Slide Number 24 		241
Recommendations for cavity contouring 		242
Slide Number 26 		243
Seroma with no distinct border 		244
What to include in seroma delineation 		245
Recommendations for cavity contouring 		246
Slide Number 30 		247
How to draw contour near clips 		248
Slide Number 32 		249
CTV (=PTV) definition from the cavity 		250
CTV (=PTV) definition from the cavity 		251
Slide Number 35 		252
Slide Number 36 		253
8.APBI position in 2016 		254
The position of APBI in current daily practice in 2016 		254
Learning objectives 		255
What do we have in France? 		256
What do we have in France? 		257
Guidelines for APBI in France 		258
National evaluation of intraoperative APBI 		259
National evaluation of intraoperative APBI 		260
National evaluation of intraoperative APBI 		261
National Institute for health and Care Excellence 		262
To what extend has APBI been introduced in your country ? 		263
APBI, who is doing what in France? 		264
INTRABEAM 		265
Electron beam (IORT Sein) 		266
Breast brachytherapy (GERICO 03) 		267
APBI by External Beam Radotherapy (SHARE) 		268
SHARE 		269
SHARE 		270
SHARE 		271
PAPBI 		272
Increased homogeneity in contouring 		273
High dose irradiated volume is removed 		274
PAPBI: First results 		275
Who is doing what in the audience? 		276
Success and limiting factors in France 		277
What is the major limiting factor you face? 		278
Conclusion 		279
Thank you for your attention 		280
9.FINAL Comparison techniques BVO FINAL 		281
Slide Number 1 		281
Overview 		282
Multi-catheter interstitial brachytherapy 		283
Technique 		284
Slide Number 5 		285
Slide Number 6 		286
Slide Number 7 		287
Multi-catheter interstitial brachytherapy 		288
Multi-catheter interstitial brachytherapyPROS and CONS 		289
Balloon-based techniques: MammoSite, Axxent, Contura 		290
Balloon-based techniques: MammoSite, Axxent, Contura 		291
Balloon-based techniques: MammoSite, Axxent, Contura 		292
Slide Number 13 		293
Hybrid Brachytherapy devices 		294
Hybrid Brachytherapy devices 		295
MammoSite, Axxent, Contura, SAVI and ClearPathPROS and CONS 		296
NIBB, noninvasive image-guided breast brachytherapy 		297
NIBB, noninvasive image-guided breast brachytherapy 		298
NIBB, noninvasive image-guided breast brachytherapy 		299
NIBB, noninvasive image-guided breast brachytherapy 		300
3D Conformal External Beam RT 		301
3D Conformal External Beam RT : PROS and CONS 		302
Intra-Operative RT Techniques 		303
Intrabeam 		304
Intrabeam 		305
Mobetron 		306
Novac-7 		307
Intra-Operative RT Techniques: PROS and CONS 		308
Comparison of MammoSite and Interstitial Brachytherapy, example 		309
Comparison of MammoSite and Interstitial Brachytherapy, example 		310
Comparison: 3D CRT, prone and supine helical tomotherapy and interstitial BT 		311
Comparison: 3D CRT, prone and supine helical tomotherapy and interstitial BT 		312
Slide Number 33 		313
Slide Number 34 		314
Slide Number 35 		315
Why difficult to compare interstitial BT to other techniques? 		316
Comparison of 4 different external beam RT techniques:3D CRT, IMRT, helical Tomotherapy, proton beam therapy 		317
Slide Number 38 		318
Comparison of 4 different external beam RT techniques:3D CRT, IMRT, helical Tomotherapy, proton beam therapy 		319
Comparison of 4 different external beam RT techniques:3D CRT, IMRT, helical Tomotherapy, proton beam therapy 		320
Comparison of effective target volume between MammoSite and 3D CRT 		321
Comparison of effective target volume between MammoSite and 3D CRT 		322
Characteristics of IORT systems 		323
Comparison of cost-efficacy 		324
Example on the most expensive technique, 28 fr 		325
Comparison of cost-efficacy 		326
Slide Number 47 		327
Slide Number 48 		328
Conclusions 		329
10.Basic characteristics_physicist point of view_Major 		330
Slide Number 1 		330
Slide Number 2 		331
Slide Number 3 		332
Slide Number 4 		333
Slide Number 5 		334
Slide Number 6 		335
Slide Number 7 		336
Slide Number 8 		337
Slide Number 9 		338
Slide Number 10 		339
Slide Number 11 		340
Slide Number 12 		341
Slide Number 13 		342
Slide Number 14 		343
Slide Number 15 		344
Slide Number 16 		345
Slide Number 17 		346
Slide Number 18 		347
Slide Number 19 		348
Slide Number 20 		349
Slide Number 21 		350
Slide Number 22 		351
Slide Number 23 		352
Slide Number 24 		353
Slide Number 25 		354
Slide Number 26 		355
Slide Number 27 		356
Slide Number 28 		357
Slide Number 29 		358
Slide Number 30 		359
Slide Number 31 		360
Slide Number 32 		361
Slide Number 33 		362
Slide Number 34 		363
Slide Number 35 		364
Slide Number 36 		365
Slide Number 37 		366
Slide Number 38 		367
Slide Number 39 		368
Slide Number 40 		369
Slide Number 41 		370
Slide Number 42 		371
Slide Number 43 		372
Slide Number 44 		373
Slide Number 45 		374
Slide Number 46 		375
Slide Number 47 		376
Slide Number 48 		377
Slide Number 49 		378
Slide Number 50 		379
Slide Number 51 		380
Slide Number 52 		381
Slide Number 53 		382
Slide Number 54 		383
11.Poortmans Wrap up from 13 November 		384
Multidisciplinary management of Breast Cancer 		384
France (French Republic) 		385
France (French Republic) 		386
Slide Number 4 		387
Slide Number 5 		388
Slide Number 6 		389
Imaging for early Stage Breast Cancer 		390
How to improve screening? Tomosynthesis 		391
Breast MRI 		392
In case of suspicious Breast MRI? 		393
Alternative to MRI : Contrast-Mammography 		394
CESM vs MRI 		395
Conclusion 		396
Slide Number 14 		397
What do pathologists predict?(or try to…) 		398
Slide Number 16 		399
Towards a simplified taxonomy of breast cancer? « definition of intrinsic subtypes has proven efficient in defining prognosis for breast cancer patients » 		400
Slide Number 18 		401
Slide Number 19 		402
Slide Number 21 		403
Slide Number 22 		404
The basics behind the rise of APBI 		405
Slide Number 24 		406
Slide Number 25 		407
Slide Number 26 		408
Slide Number 27 		409
Slide Number 28 		410
Slide Number 29 		411
Slide Number 30 		412
Slide Number 31 		413
Target definition in partial breast irradiation GEC-ESTRO consensus 		414
3 pillars of APBI 		415
Slide Number 34 		416
Slide Number 35 		417
Slide Number 36 		418
Recommendations for daily routine 		419
3 pillars of APBI 		420
Slide Number 39 		421
Techniques for tumor bed localisation in APBI 		422
Slide Number 41 		423
Conclusions from the contouring study 		424
Slide Number 43 		425
Recommendations for cavity contouring 		426
Recommendations for cavity contouring 		427
Recommendations for cavity contouring 		428
Recommendations for cavity contouring 		429
CTV (=PTV) definition from the cavity 		430
Slide Number 49 		431
The position of APBI in current daily practice in 2016 		432
Learning objectives 		433
Conclusion 		434
Slide Number 53 		435
Comparison: 3D CRT, prone and supine helical tomotherapy and interstitial BT 		436
Slide Number 55 		437
Slide Number 56 		438
Slide Number 57 		439
Techniques: PROS and CONS 		440
Slide Number 59 		441
Slide Number 60 		442
Conclusions 		443
Slide Number 62 		444
Slide Number 63 		445
Slide Number 64 		446
Slide Number 65 		447
Slide Number 66 		448
Slide Number 67 		449
Slide Number 68 		450
Slide Number 69 		451
Slide Number 70 		452
Slide Number 71 		453
Slide Number 72 		454
Accelerated Partial Breast Irradiation 		455
12.Poortmans Risk factors 		456
Risk factors for local recurrence 		456
Slide Number 2 		457
Slide Number 3 		458
Slide Number 4 		459
Slide Number 5 		460
Slide Number 6 		461
Slide Number 7 		462
Slide Number 8 		463
Slide Number 9 		464
Slide Number 10 		465
Slide Number 11 		466
Slide Number 12 		467
Slide Number 13 		468
Slide Number 14 		469
Slide Number 15 		470
Slide Number 16 		471
Slide Number 17 		472
Slide Number 18 		473
Slide Number 19 		474
Slide Number 20 		475
Slide Number 21 		476
Slide Number 22 		477
Slide Number 23 		478
Slide Number 24 		479
Slide Number 25 		480
Slide Number 26 		481
Slide Number 27 		482
Slide Number 28 		483
Slide Number 29 		484
Slide Number 30 		485
Slide Number 31 		486
Slide Number 32 		487
Slide Number 33 		488
Slide Number 34 		489
Slide Number 35 		490
Slide Number 36 		491
Slide Number 37 		492
Slide Number 38 		493
Slide Number 39 		494
Slide Number 40 		495
Slide Number 41 		496
Slide Number 42 		497
Slide Number 43 		498
Slide Number 44 		499
Slide Number 45 		500
Slide Number 46 		501
Slide Number 47 		502
Slide Number 48 		503
Slide Number 49 		504
Slide Number 50 		505
Slide Number 51 		506
13.ESTRO APBI 2016 Criteria 		507
Slide Number 1 		507
Rationale for selecting patients 		508
Slide Number 3 		509
Slide Number 4 		510
Slide Number 5 		511
Slide Number 6 		512
Slide Number 7 		513
Slide Number 8 		514
Slide Number 9 		515
Slide Number 10 		516
Slide Number 11 		517
Slide Number 12 		518
Slide Number 13 		519
Proportion of patients eligible for APBI according to clinical trial eligibility and consensus guidelines (between 2010 and 2012) 		520
Slide Number 15 		521
Update of ASTRO statement 		522
Update of ASTRO statement 		523
Slide Number 18 		524
Slide Number 19 		525
Slide Number 20 		526
Slide Number 21 		527
Update of ASTRO statement. Age 		528
Slide Number 23 		529
Slide Number 24 		530
Slide Number 25 		531
RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation(Mc Cormick B et al, JCO 2015) 		532
Update of ASTRO statement. DCIS 		533
Slide Number 28 		534
Slide Number 29 		535
Update of ASTRO statement. No change 		536
Slide Number 31 		537
Update of ASTRO statement. IORT 		538
Slide Number 33 		539
Slide Number 34 		540
Slide Number 35 		541
Slide Number 36 		542
MRI and PBI 		543
MR Imaging for selection of patients for partial breast irradiation: A systematic review and meta-analysisDi Leo G et al, Radiology, 2015 		544
Slide Number 39 		545
Slide Number 40 		546
18.ESTRO APBI Technique & Results 2016 		547
Slide Number 1 		547
APBI: Intraoperative irradiation 		548
Slide Number 3 		549
Using motorized Mobetron motions to soft-dock for treatment 		550
Slide Number 5 		551
Slide Number 6 		552
2D Dose distrubution 		553
Slide Number 8 		554
Slide Number 9 		555
Slide Number 10 		556
ELIOT delivery 		557
Slide Number 12 		558
ClinicalTrials.gov Identifier NCT01849133 		559
Slide Number 14 		560
Slide Number 15 		561
Slide Number 16 		562
Slide Number 17 		563
Slide Number 18 		564
A phase I/II trial in an Asian population 		565
Slide Number 20 		566
Barros AC et al, Int J Breast Cancer 2014 		567
Hanna SA et al, IJROBP 2014 		568
Slide Number 23 		569
Slide Number 24 		570
Slide Number 25 		571
Slide Number 26 		572
In vivo dosimetry 		573
Slide Number 28 		574
Primary and Secondary OutcomeNumber of Events 		575
Slide Number 30 		576
TARGIT-R: North America experienceValente SA et al, Ann Surg Oncol 2016 		577
Meta-Analysis on IORTZhang Li et al, Medicine 2015 		578
Slide Number 33 		579
Slide Number 34 		580
Slide Number 35 		581
Slide Number 36 		582
Slide Number 37 		583
Meta-Analysis on IORTZhang Li et al, Medicine 2015 		584
Slide Number 39 		585
Slide Number 40 		586
Slide Number 41 		587
Slide Number 42 		588
Slide Number 43 		589
Permanent Seed Implant 		590
Slide Number 45 		591
Slide Number 46 		592
19.Technical approaches IOERT Philippson Simon 		593
Technical approaches, patient selection and clinical results in electron APBI: The experience and results from more than 800 patients treated at the Institut Jules BordetC. Philippson & S. SimonInstitut Jules Bordet, Brussels, Belgium 		593
Plan 		594
Introduction 		595
Inclusion criteria 		596
Surgical technique 		597
Surgical technique 		598
Surgical technique 		599
Surgical technique 		600
Surgical technique 		601
Surgical technique 		602
Surgical technique 		603
Surgical technique 		604
Surgical technique 		605
Surgical technique 		606
Specific technique 		607
Specific technique-Target volume 		608
Advantages & disavantages of IOERT 		609
Jules Bordet Experience 		610
Jules Bordet Experience 		611
Jules Bordet Experience 		612
Jules Bordet Experience 		613
Jules Bordet Experience 		614
Jules Bordet Experience 		615
Jules Bordet Experience 		616
Jules Bordet Experience 		617
Jules Bordet Experience 		618
Jules Bordet Experience 		619
Jules Bordet Experience 		620
Jules Bordet Experience 		621
Jules Bordet Experience 		622
Results 		623
Results 		624
Results 		625
Results 		626
Results 		627
Results 		628
Results 		629
Results 		630
Results 		631
Results 		632
Results 		633
Conclusions 		634
Conclusions 		635
Technical Considerations 		636
Technical Considerations 		637
Technical Considerations 		638
Technical Considerations 		639
Technical Considerations 		640
Technical Considerations 		641
Technical Considerations 		642
Technical Considerations 		643
Technical Considerations 		644
Technical Considerations 		645
Technical Considerations 		646
Technical Considerations 		647
Technical Considerations 		648
Technical Considerations 		649
Technical Considerations 		650
Technical Considerations 		651
Technical Considerations 		652
Technical Considerations 		653
Technical Considerations 		654
Technical Considerations 		655
Technical Considerations 		656
Technical Considerations 		657
Technical Considerations 		658
Technical Considerations 		659
Technical Considerations 		660
Technical Considerations 		661
Technical Considerations 		662
Technical Considerations 		663
Technical Considerations 		664
Technical Considerations 		665
Technical Considerations 		666
Technical Considerations 		667
Technical Considerations 		668
Technical Considerations 		669
Technical Considerations 		670
Technical Considerations 		671
Technical Considerations 		672
Technical Considerations 		673
Slide Number 82 		674
20.APBI _Strnad REVIEW_ESTRO_Paris 2016 		676-677
Accelerated Partial Breast Irradiation – RESULTS OF BRACHYTHERAPY in 2016 		676-677
Techniques 		678-679
Techniques 		680-681
Multicatheter – interstitial Brachytherapy for APBI 		682-683
FACTS 		684-685
MYTHS 		686-687
MYTHS 		688-689
MYTHS 		690-691
MYTHS 		692-693
MYTHS 		694-695
FACTS 		696-697
FACTS 		698-699
FACTS 		700-701
FACTS 		702-703
FACTS 		704-705
RESULTS 		706-707
Slide Number 17 		708-709
Results of APBI studies using suboptimal patient selection criteria 		710-711
Slide Number 19 		712-713
APBI – current methods of brachytherapy 		714-715
APBI using Multicatheter Brachytherapy 		716-717
Results of APBI using brachytherapy 		718-719
APBI using multicatheter brachytherapy: largest „retrospective analasis“ 		720-721
APBI using multicatheter brachytherapy: largest „retrospective analasis“ 		722-723
APBI using multicatheter brachytherapy: largest „retrospective analasis“ 		724-725
APBI using multicatheter brachytherapy: largest „Match pair analysis“ 		726-727
APBI using multicatheter brachytherapy: largest „Match pair analysis“ 		728-729
APBI using multicatheter brachytherapy: largest „Phase II trial“ 		730-731
APBI using multicatheter brachytherapy: largest „Phase II trial“ 		732-733
APBI using multicatheter brachytherapy – Phase III trial 		734-735
Slide Number 31 		736-737
Slide Number 32 		738-739
Slide Number 33 		740-741
5-Y. LOCAL RECURRENCE RATE 		742-743
5-Y. DISEASE-FREE SURVIVAL 		744-745
5-Y. OVERALL SURVIVAL 		746-747
LATE SIDE EFFECTS 		748-749
LATE SIDE EFFECTS 		750-751
CONCLUSION 		752-753
CONCLUSION 		754-755
Balloon – Mammosite-System – advantages and disadvantages 		756-757
Other Balloon-Systems – advantages and disadvantages 		758-759
Balloon – Mammosite-System 		760-761
Balloon – Mammosite-System 		762-763
Balloon – Mammosite-System 		764-765
SAVI-System 		766-767
SAVI-System 		768-769
SAVI-System 		770-771
APBI 2016 – SUMMARY 		772-773
21.Physics for intraop_endocavitary_interstitial_Major 		774
Slide Number 1 		774
Slide Number 2 		775
Slide Number 3 		776
Slide Number 4 		777
Slide Number 5 		778
Slide Number 6 		779
Slide Number 7 		780
Slide Number 8 		781
Slide Number 9 		782
Slide Number 10 		783
Slide Number 11 		784
Slide Number 12 		785
Slide Number 13 		786
Slide Number 14 		787
Slide Number 15 		788
Slide Number 16 		789
Slide Number 17 		790
Slide Number 18 		791
Slide Number 19 		792
Slide Number 20 		793
Slide Number 21 		794
Slide Number 22 		795
Slide Number 23 		796
Slide Number 24 		797
Slide Number 25 		798
Slide Number 26 		799
Slide Number 27 		800
Slide Number 28 		801
Slide Number 29 		802
Slide Number 30 		803
Slide Number 31 		804
Slide Number 32 		805
Slide Number 33 		806
Slide Number 34 		807
Slide Number 35 		808
Slide Number 36 		809
Slide Number 37 		810
Slide Number 38 		811
Slide Number 39 		812
Slide Number 40 		813
Slide Number 41 		814
Slide Number 42 		815
Slide Number 43 		816
Slide Number 44 		817
Slide Number 45 		818
Slide Number 46 		819
Slide Number 47 		820
Slide Number 48 		821
Slide Number 49 		822
Slide Number 50 		823
Slide Number 51 		824
Slide Number 52 		825
Slide Number 53 		826
Slide Number 54 		827
Slide Number 55 		828
Slide Number 56 		829
Slide Number 57 		830
Slide Number 58 		831
Slide Number 59 		832
Slide Number 60 		833
Slide Number 61 		834
Slide Number 62 		835
Slide Number 63 		836
Slide Number 64 		837
Slide Number 65 		838
Slide Number 66 		839
Slide Number 67 		840
Slide Number 68 		841
Slide Number 69 		842
Slide Number 70 		843
Slide Number 71 		844
Summary 		845
Slide Number 73 		846
23.Cosmetic outcome after APBI 		847
Slide Number 1 		847
Agenda 		848
Slide Number 3 		849
Cosmetic outcome ELIOT 		850
Slide Number 5 		851
Slide Number 6 		852
Slide Number 7 		853
Slide Number 8 		854
Slide Number 9 		855
Slide Number 10 		856
Slide Number 11 		857
Cosmetic outcome external beam RT 		858
Slide Number 13 		859
Slide Number 14 		860
Slide Number 15 		861
Slide Number 16 		862
Slide Number 17 		863
Slide Number 18 		864
Slide Number 19 		865
Slide Number 20 		866
Slide Number 21 		867
First results from the clinically controlled randomized DBCG PBI trial 		868
CONSORT diagram, DBCG PBI trial 		869
Breast induration 		870
Breast induration 		871
Slide Number 26 		872
Breast induration 		873
Slide Number 28 		874
Breast dyspigmentation 		875
Breast dyspigmentation 		876
3 yr scar, edema, telangiectasia 		877
Global cosmetic outcome 		878
Global cosmetic outcome 		879
Slide Number 34 		880
Slide Number 35 		881
Slide Number 36 		882
Slide Number 37 		883
Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial 		884
Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial 		885
Slide Number 40 		886
Slide Number 41 		887
Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial 		888
Slide Number 43 		889
Slide Number 44 		890
Slide Number 45 		891
Slide Number 46 		892
Slide Number 47 		893
Slide Number 48 		894
Slide Number 49 		895
Slide Number 50 		896
Slide Number 51 		897
Slide Number 52 		898
Conclusion on cosmetic outcome 		899
24.Poortmans Wrap up from 14 November 		900
Multidisciplinary management of Breast Cancer 		900
France (French Republic) 		901
France (French Republic) 		902
Slide Number 4 		903
Risk factors for local recurrence 		904
Slide Number 6 		905
Slide Number 7 		906
Slide Number 8 		907
Slide Number 9 		908
Slide Number 10 		909
Slide Number 11 		910
Slide Number 12 		911
Slide Number 13 		912
Rationale for selecting patients 		913
Slide Number 15 		914
Slide Number 16 		915
Update of ASTRO statement 		916
Update of ASTRO statement 		917
Update of ASTRO statement. Age 		918
Update of ASTRO statement. DCIS 		919
Update of ASTRO statement. IORT 		920
Slide Number 22 		921
APBI: Intraoperative irradiation 		922
Slide Number 24 		923
Technical approaches, patient selection and clinical results in electron APBI: The experience and results from more than 800 patients treated at the Institut Jules BordetC. Philippson & S. SimonInstitut Jules Bordet, Brussels, Belgium 		924
Conclusions 		925
Conclusions 		926
Technical Considerations 		927
Accelerated Partial Breast Irradiation – RESULTS OF BRACHYTHERAPY in 2016 		928
Techniques 		929
CONCLUSION 		930
CONCLUSION 		931
APBI 2016 – SUMMARY 		932
Slide Number 34 		933
Slide Number 35 		934
Slide Number 36 		935
Summary 		936
Slide Number 38 		937
Slide Number 39 		938
Accelerated Partial Breast Irradiation 		939
25.3D CRT techniques and results FINAL 		940
Slide Number 1 		940
Overview 		941
3D CRT for APBI 		942
3D CRT for APBI 		943
3D CRT in prone position 		944
3D CRT in prone position 		945
General about 3D CRT APBI 		946
Slide Number 8 		947
Slide Number 9 		948
Is there a role for VMAT and DIBH in APBI? 		949
Is there a role for VMAT and DIBH in APBI? 		950
Is there a role for VMAT and DIBH in APBI? 		951
What is the risk of major coronary event or heart death at these dose levels? 		952
Is there a role for VMAT and DIBH in APBI? 		953
Techniques, change in seroma after surgery 		954
Techniques, change in seroma after surgery 		955
Techniques, change in seroma after surgery 		956
Slide Number 18 		957
Randomized APBI studies using 3D CRT according to ClinicalTrials.gov Oct 14th, 2016 		958
Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial 		959
Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial 		960
Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial 		961
Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial 		962
Slide Number 24 		963
Slide Number 25 		964
Slide Number 26 		965
Slide Number 27 		966
Slide Number 28 		967
Slide Number 29 		968
Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial 		969
Slide Number 31 		970
Slide Number 32 		971
Slide Number 33 		972
Slide Number 34 		973
Slide Number 35 		974
Slide Number 36 		975
Slide Number 37 		976
Slide Number 38 		977
Slide Number 39 		978
Slide Number 40 		979
Why the difference btw RAPID and IRMA? 		980
But do we have practice changing studies? 		981
Slide Number 43 		982
Slide Number 44 		983
Slide Number 45 		984
Slide Number 46 		985
Slide Number 47 		986
Slide Number 48 		987
Slide Number 49 		988
Slide Number 50 		989
Slide Number 51 		990
Slide Number 52 		991
Slide Number 53 		992
Slide Number 54 		993
Slide Number 55 		994
Slide Number 56 		995
Slide Number 57 		996
First results from the clinically controlled randomized DBCG PBI trial 		997
Aim and hypothesis of the DBCG PBI trial 		998
Local recurrences? 		999
Randomization DBCG PBI 		1000
Endpoints 		1001
Slide Number 63 		1002
RT technique 		1003
Statistical assumptions 		1004
Statistical assumptions 		1005
Baseline data 		1006
CONSORT diagram 		1007
Baseline data, N=839 		1008
Slide Number 70 		1009
Slide Number 71 		1010
Slide Number 72 		1011
Slide Number 73 		1012
Slide Number 74 		1013
Recurrence, other malignancy and death 		1014
Conclusion Import Low / DBCG PBI 		1015
UK consensus statement: PBI 		1016
Slide Number 78 		1017
Slide Number 79 		1018
Slide Number 80 		1019
Slide Number 81 		1020
Slide Number 82 		1021
Long-term outcomes of proton beam RT,Study from Massachusetts General Hospital, Boston 		1022
Long-term outcomes of proton beam RT,Study from Massachusetts General Hospital, Boston 		1023
Long-term outcomes of proton beam RTResults 		1024
Slide Number 86 		1025
Long-term outcomes of proton beam RT,Study from Massachusetts General Hospital, Boston 		1026
APBI and prior breast augmentation? 		1027
APBI and prior breast augmentation? 		1028
External beam for PBI 		1029
26.Physics for EBRT_3D-CRT_IMRT_IGRT_Major 		1030
Slide Number 1 		1030
Slide Number 2 		1031
Slide Number 3 		1032
Slide Number 4 		1033
Slide Number 5 		1034
Slide Number 6 		1035
Slide Number 7 		1036
Slide Number 8 		1037
Slide Number 9 		1038
Slide Number 10 		1039
Slide Number 11 		1040
Slide Number 12 		1041
Slide Number 13 		1042
Slide Number 14 		1043
Slide Number 15 		1044
Slide Number 16 		1045
Slide Number 17 		1046
Slide Number 18 		1047
Slide Number 19 		1048
Slide Number 20 		1049
Slide Number 21 		1050
Slide Number 22 		1051
Slide Number 23 		1052
Slide Number 24 		1053
Slide Number 25 		1054
Slide Number 26 		1055
Slide Number 27 		1056
Slide Number 28 		1057
Slide Number 29 		1058
Slide Number 30 		1059
Slide Number 31 		1060
Slide Number 32 		1061
Slide Number 33 		1062
Slide Number 34 		1063
Slide Number 35 		1064
Slide Number 36 		1065
Slide Number 37 		1066
Slide Number 38 		1067
Slide Number 39 		1068
Slide Number 40 		1069
Slide Number 41 		1070
Slide Number 42 		1071
Slide Number 43 		1072
Slide Number 44 		1073
Slide Number 45 		1074
Slide Number 46 		1075
Slide Number 47 		1076
Slide Number 48 		1077
Slide Number 49 		1078
Slide Number 50 		1079
Slide Number 51 		1080
Slide Number 52 		1081
Slide Number 53 		1082
Slide Number 54 		1083
Slide Number 55 		1084
Slide Number 56 		1085
Slide Number 57 		1086
Slide Number 58 		1087
Slide Number 59 		1088
Slide Number 60 		1089
Slide Number 61 		1090
Slide Number 62 		1091
Slide Number 63 		1092
Slide Number 64 		1093
Slide Number 65 		1094
Slide Number 66 		1095
Slide Number 67 		1096
Slide Number 68 		1097
Slide Number 69 		1098
Slide Number 70 		1099
Slide Number 71 		1100
Slide Number 72 		1101
Slide Number 73 		1102
Slide Number 74 		1103
Slide Number 75 		1104
Slide Number 76 		1105
Summary 		1106
Slide Number 78 		1107
28.Poortmans TV delineation and outcome after oncoplastic surgery 		1108
Target volume delineation & outcome 		1108
Slide Number 2 		1109
Slide Number 3 		1110
Slide Number 4 		1111
Slide Number 5 		1112
Slide Number 6 		1113
Slide Number 7 		1114
Slide Number 8 		1115
Slide Number 9 		1116
Slide Number 10 		1117
Slide Number 11 		1118
Slide Number 12 		1119
Slide Number 13 		1120
Slide Number 14 		1121
Slide Number 15 		1122
Slide Number 16 		1123
Slide Number 17 		1124
Slide Number 18 		1125
Slide Number 19 		1126
Slide Number 20 		1127
Slide Number 21 		1128
Slide Number 22 		1129
Slide Number 23 		1130
Slide Number 24 		1131
Slide Number 25 		1132
Slide Number 26 		1133
Slide Number 27 		1134
Slide Number 28 		1135
Slide Number 29 		1136
Slide Number 30 		1137
Slide Number 31 		1138
Slide Number 32 		1139
Slide Number 33 		1140
Slide Number 34 		1141
Slide Number 35 		1142
Slide Number 36 		1143
Slide Number 37 		1144
Slide Number 38 		1145
Slide Number 39 		1146
Slide Number 40 		1147
How can oncoplastic surgery and APBI be combined: 		1148
Slide Number 42 		1149
Slide Number 43 		1150
Slide Number 44 		1151
Slide Number 45 		1152
Slide Number 46 		1153
Slide Number 47 		1154
Slide Number 48 		1155
Slide Number 49 		1156
Slide Number 50 		1157
Slide Number 51 		1158
Slide Number 52 		1159
Slide Number 53 		1160
Slide Number 54 		1161
29.APBI _Strnad PRO ESTRO_Paris 2016_short2 		1162-1163
3 pillars of APBI 		1162-1163
3 pillars of APBI 		1164-1165
Slide Number 3 		1166-1167
3 pillars of APBI 		1168-1169
APBI – current methods 		1170-1171
APBI Phase 3 trials using external beam radiation 		1172-1173
APBI Phase 3 trials using external beam radiation 		1174-1175
APBI Phase 3 trials using external beam radiation 		1176-1177
IMPORT LOW 		1178-1179
Breast induration 		1180-1181
APBI Phase 3 trial using of IORT with Linac 		1182-1183
APBI Phase 3 trial using IORT with Intrabeam (50 kV – Röntgen-machine) 		1184-1185
Slide Number 13 		1186-1187
5-Y. DISEASE-FREE SURVIVAL 		1188-1189
CONCLUSION 		1190-1191
Partial Breast Irradiation 2016 –FACTS ~ Summary 		1192-1193
3 pillars of APBI 		1194-1195
Slide Number 18 		1196-1197
Slide Number 19 		1198-1199
PATIENTS CHARACTERISTICS 		1200-1201
SUBGROUPS ACCORDING GEC-ESTRO RECOMMENDATION 		1202-1203
SUBGROUPS ACCORDING ASTRO RECOMMENDATION 		1204-1205
SUBGROUPS ACCORDING GEC-ESTRO or ASTRO RECOMMENDATION 		1206-1207
5-Y. LOCAL RECURRENCE RATE 		1208-1209
Slide Number 25 		1210-1211
Slide Number 26 		1212-1213
5-Y. LOCAL RECURRENCE RATE 		1214-1215
5-Y. DISEASE-FREE SURVIVAL 		1216-1217
5-Y. OVERALL SURVIVAL 		1218-1219
CONCLUSION I. 		1220-1221
CONCLUSION II. 		1222-1223
CONCLUSION II. 		1224-1225
CONCLUSION 		1226-1227
30.Debate critical to APBINY 		1228
Slide Number 1 		1228
Overview 		1229
Slide Number 3 		1230
Do we know the ”true nature” of breast cancer 		1231
Slide Number 5 		1232
Slide Number 6 		1233
Slide Number 7 		1234
Slide Number 8 		1235
Slide Number 9 		1236
MVA using DM, BCM and all-cause mortality as endpoint 		1237
Slide Number 11 		1238
These are the only data with long-term follow up indicating the influence from subtypes on local recurrence & BCM 		1239
Slide Number 13 		1240
Overall conclusions from the DBCG studies on age effects 		1241
Fractionation 		1242
Theories of fractionationNominal standard dose 		1243
Ellis´ NSD model 		1244
Ellis´ NSD model in breast cancer 		1245
Ellis´ NSD model in breast cancer 		1246
Ellis´ NSD model 		1247
Slide Number 21 		1248
Slide Number 22 		1249
LQ modela solid model or….? 		1250
LQ model 		1251
2 Gy strategy 		1252
Slide Number 26 		1253
Take home message:By using hypofractionation the therapeutic ratio allways falls 		1254
Randomized APBI studies using 3D CRT according to ClinicalTrials.gov Oct 2016 		1255
Slide Number 29 		1256
Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial 		1257
Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial 		1258
ELIOT, included patient characteristics 		1259
ELIOT, 5-year event rates 		1260
ELIOT, IBTR 		1261
ELIOT, factors associated with IBTR 		1262
ELIOT, aspects 		1263
TARGIT A 		1264
Slide Number 38 		1265
TARGIT A 		1266
TARGIT A 		1267
Cochrane review comparing APBI with standard RT 		1268
Cochrane review comparing APBI with standard RT 		1269
Cochrane review comparing APBI with standard RT 		1270
Slide Number 44 		1271
Slide Number 45 		1272
Slide Number 46 		1273
Slide Number 47 		1274
Slide Number 48 		1275
Comments from the authors and the editorial 		1276
If you treat patients with APBI outside trial you must think you know what is going to happen….. 		1277
….. So you may need to prepare for a surprice! 		1278
Slide Number 52 		1279
What may happen if you are not restrictive? 		1280
31.adjuvant treatment for early breast cancer 		1281
Slide Number 1 		1281
Slide Number 2 		1282
Slide Number 3 		1283
Slide Number 4 		1284
Long-term recurrence risks after use of endocrine therapy for only 5 years Relevance of breast tumour characteristics 		1285
Slide Number 6 		1286
MA.17R Trial Design <br />AI x 5 yrs - Following Prior 5 years of AI - preceded or not by Tamoxifen 		1287
Slide 15 		1288
Slide 16 		1289
Slide 18 		1290
Slide 21 		1291
Conclusion MA17R: extended AI 		1292
Slide Number 13 		1293
Slide Number 14 		1294
Slide Number 15 		1295
Slide Number 16 		1296
Slide Number 17 		1297
Slide Number 18 		1298
Slide Number 19 		1299
Slide Number 20 		1300
Slide Number 21 		1301
ADJUVANT - Résultats 		1302
Slide Number 23 		1303
Slide Number 24 		1304
Slide Number 25 		1305
Slide Number 26 		1306
Slide Number 27 		1307
Slide Number 28 		1308
Slide Number 29 		1309
Slide Number 30 		1310
Slide Number 31 		1311
Slide Number 32 		1312
Slide Number 33 		1313
Slide Number 34 		1314
Slide Number 35 		1315
Slide Number 36 		1316
Slide Number 37 		1317
Slide Number 38 		1318
Slide Number 39 		1319
Slide Number 40 		1320
Slide Number 41 		1321
Dose-dense ? 		1322
Slide Number 43 		1323
Slide Number 44 		1324
Slide Number 45 		1325
Slide Number 46 		1326
Slide Number 47 		1327
33.External beam planning 		1328
External Beam Radiotherapy 		1328
Positioning 		1329
Breathing Control 		1330
Active breathing coordinator 		1331
Catalyst 		1332
RPM 		1333
vmDIBH 		1334
vmDIBH 		1335
6 Degrees of freedom Couches 		1336
Contouring OAR 		1337
Treatment Planning 		1338
BEV’s 		1339
Treatment Plan 		1340
VMAT 		1341
Treatment plan 		1342
Constraints 		1343
Constraints 		1344
Image guidance: which modality? 		1345
Image guidance 		1346
Image-guidance for whole breast (+/- nodes) 		1347
Daily kV imaging 		1348
MV vs kV imaging 		1349
MV image guidance 		1350
Other possible improvements 		1351
Using clips for registration: an interesting alternative 		1352
Contouring Clips 		1353
Clips in DRR 		1354
Clips in DRR 		1355
Clips match PA (kV) 		1356
Clips match Lat (kV) 		1357
Clips vs Bony anatomy match 		1358
Slide Number 32 		1359
Conclusions 		1360
35.Morbidity and APBI BO FINAL 		1361
Slide Number 1 		1361
Slide Number 2 		1362
Important radiation related late morbidities 		1363
Definitions 		1364
Grading of late loco-regional morbidity 		1365
Fibrosis 		1366
Dyspigmentation 		1367
Telangiectasia 		1368
Scar 		1369
Edema 		1370
Life-threatening late radiation-induced morbidity 		1371
Second solid Non-Breast Cancer 		1372
HR of Second Solid Cancer comparing RT treated with non-RT treated 		1373
Second Cancer by Time since Treatment 		1374
Dose Response relation of Second Lung cancer after Radiotherapy for Breast Cancer; Treatment lag ≥ 5 years 		1375
Meta-analysis on second cancers after Radiotherapy for Breast Cancer: 762,468 Breast Cancer Patients 		1376
Endpoint: All Second Non-Breast Cancers 		1377
Endpoint: Second Esophagus Cancer Overall RR 		1378
Endpoint: Second Esophagus Cancer by time since BC diagnosis 		1379
Endpoint: Second Thyroid Cancer Overall RR 		1380
Endpoint: Second Thyroid cancer by time since BC diagnosis 		1381
Endpoint: Second Sarcomas 		1382
Endpoint: Second Lung Cancer Overall RR 		1383
Endpoint: Second Lung Cancer by time since BC diagnosis 		1384
Group of second cancers at high dose sites:Esophagus, pleura, lung, bones & connective tissues. Latency 5 years following BC diagnosis, by surgery type 		1385
Slide Number 26 		1386
Slide Number 27 		1387
RT Dose Distribution in Sagittal Section of Breast 		1388
Slide Number 29 		1389
The radiobiology of late morbiditya paradigm shift in recent years 		1390
Target-cell hypothesis 		1391
Target-cell hypothesis Late effect was a direct consequence of cell killing 		1392
Slide Number 33 		1393
Slide Number 34 		1394
Intra- and inter-patient variation 		1395
Intra- and inter-patient variation 		1396
Intra- and inter-patient variation 		1397
Inter-patient variability in radiotherapy response 		1398
Problems finding the holy grail 		1399
Slide Number 40 		1400
RAPPERRadiogenomics: Assessment of Polymorphisms for Predicting the Effects of Radiotherapy 		1401
Slide Number 42 		1402
GWAS and the RAPPER study 		1403
GWAS and the RAPPER study 		1404
Prediction and Prevention 		1405
An example 		1406
Prediction 		1407
Prediction 		1408
Independent prospective validation of predictivegene expression signature in fibroblasts irradiated in vitro 		1409
Slide Number 50 		1410
Ingenuity pathway analysis 		1411
Molecular pathology 		1412
Slide Number 53 		1413
Slide Number 54 		1414
Therapy of RIF 		1415
Slide Number 56 		1416
Slide Number 57 		1417
Slide Number 58 		1418
Slide Number 59 		1419
Genome-wide association studies 		1420
Biology and caveats-predisposing factors for late effects 		1421
Slide Number 62 		1422
Protocol proposal 		1423
Pentoxifylline 		1424
Pharmacological effects 		1425
Clinical studies 		1426
Slide Number 67 		1427
Slide Number 68 		1428
Inclusion criteria 		1429
Endpoints 		1430
Power estimation 		1431
Thank you for your attentionInterested in cooperation: nicolaj@oncology.au.dk 		1432
36.Poortmans Wrap up from 15 November 		1433
Multidisciplinary management of Breast Cancer 		1433
France (French Republic) 		1434
France (French Republic) 		1435
France (French Republic) 		1436
France (French Republic) 		1437
Slide Number 6 		1438
Slide Number 7 		1439
Overview 		1440
Slide Number 9 		1441
First results from the clinically controlled randomized DBCG PBI trial 		1442
External beam for PBI 		1443
Slide Number 12 		1444
Summary 		1445
Target volume delineation & outcome 		1446
Slide Number 15 		1447
Slide Number 16 		1448
Slide Number 17 		1449
Slide Number 18 		1450
Slide Number 19 		1451
Slide Number 20 		1452
Slide Number 21 		1453
Slide Number 22 		1454
Slide Number 23 		1455
Slide Number 24 		1456
CONCLUSION I. 		1457
CONCLUSION II. 		1458
CONCLUSION II. 		1459
CONCLUSION 		1460
Slide Number 29 		1461
Slide Number 30 		1462
Overview 		1463
Slide Number 32 		1464
3 pillars of APBI 		1465
Slide Number 34 		1466
Slide Number 35 		1467
Slide Number 36 		1468
Slide Number 37 		1469
Important radiation related late morbidities 		1470
Inter-patient variability in radiotherapy response 		1471
Problems finding the holy grail 		1472
Therapy of RIF 		1473
Slide Number 42 		1474
Accelerated Partial Breast Irradiation 		1475
37.Poortmans Local treatment for breast- always less, where is the limit - Interaction between local and systemic treatments 		1476
Local treatment for breast: always less, where is the limit? 		1476
Slide Number 2 		1477
Slide Number 3 		1478
Slide Number 4 		1479
Slide Number 5 		1480
Slide Number 6 		1481
Slide Number 7 		1482
Slide Number 8 		1483
Slide Number 9 		1484
Slide Number 13 		1485
Slide Number 14 		1486
Slide Number 15 		1487
Slide Number 16 		1488
Slide Number 17 		1489
Slide Number 18 		1490
Slide Number 19 		1491
Slide Number 20 		1492
Slide Number 21 		1493
Slide Number 22 		1494
Slide Number 23 		1495
Slide Number 24 		1496
Slide Number 25 		1497
Slide Number 26 		1498
Slide Number 27 		1499
Slide Number 28 		1500
Slide Number 29 		1501
Slide Number 30 		1502
Slide Number 31 		1503
Slide Number 32 		1504
Slide Number 33 		1505
Slide Number 34 		1506
Slide Number 35 		1507
Slide Number 36 		1508
Slide Number 37 		1509
Slide Number 38 		1510
Slide Number 39 		1511
Slide Number 40 		1512
Slide Number 41 		1513
Slide Number 42 		1514
Slide Number 43 		1515
Slide Number 44 		1516
Slide Number 45 		1517
Slide Number 46 		1518
Slide Number 47 		1519
Slide Number 48 		1520
Slide Number 49 		1521
Slide Number 50 		1522
Slide Number 51 		1523
Slide Number 52 		1524
Slide Number 53 		1525
Slide Number 54 		1526
Slide Number 55 		1527
Slide Number 56 		1528
Slide Number 57 		1529
Local treatment for breast: always less, where is the limit? 		1530
Slide Number 59 		1531
Slide Number 60 		1532
Slide Number 61 		1533
Slide Number 62 		1534
Slide Number 63 		1535
Slide Number 64 		1536
Slide Number 65 		1537
Slide Number 66 		1538
Slide Number 67 		1539
Slide Number 68 		1540
Slide Number 69 		1541
Slide Number 70 		1542
Slide Number 71 		1543
Slide Number 72 		1544
Slide Number 73 		1545
Slide Number 74 		1546
Slide Number 75 		1547
Slide Number 76 		1548
Slide Number 77 		1549
Slide Number 78 		1550
Slide Number 79 		1551
Slide Number 80 		1552
Slide Number 81 		1553
Slide Number 82 		1554
Slide Number 83 		1555
Slide Number 84 		1556
38.Side effects 		1557
How to avoid side effects? 		1557
Slide Number 2 		1558
To characterize the dose to skin how would you define the dose? 		1559
What thickness (d) would you use to define the skin as an organ? 		1560
Slide Number 5 		1561
Which volume dose would you use to characterize the skin dose? 		1562
Slide Number 7 		1563
Slide Number 8 		1564
Slide Number 9 		1565
Slide Number 10 		1566
Slide Number 11 		1567
Slide Number 12 		1568
Slide Number 13 		1569
Slide Number 14 		1570
Slide Number 15 		1571
Slide Number 16 		1572
Slide Number 17 		1573
Slide Number 18 		1574
Slide Number 19 		1575
Which technique do you think spares better the heart? 		1576
Slide Number 21 		1577
Which technique do you think spares better the heart? 		1578
Slide Number 23 		1579
Which technique do you think spares better the heart? 		1580
Slide Number 25 		1581
Which technique do you think spares better the heart? 		1582
Slide Number 27 		1583
Which technique do you think spares better the heart? 		1584
Slide Number 29 		1585
Which technique do you think spares better the heart? 		1586
Slide Number 31 		1587
Which technique do you think spares better the heart? 		1588
Slide Number 33 		1589
Which technique do you think spares better the heart? 		1590
Slide Number 35 		1591
Slide Number 36 		1592
Which technique do you think spares better the heart? 		1593
Slide Number 38 		1594
Slide Number 39 		1595
Which technique do you think spares better the heart? 		1596
Slide Number 41 		1597
Which technique do you think spares better the heart? 		1598
Slide Number 43 		1599
Which technique do you think spares better the heart? 		1600
Slide Number 45 		1601
39.Salvage APBI ESTRO Paris 2016_final 		1602-1603
Second breast conserving therapy 		1602-1603
Salvage-Brachytherapie 		1604-1605
Salvage-Brachytherapie 		1606-1607
Local treatment for In-Breast Recurrence? 		1608-1609
In-Breast Recurrence 		1610-1611
In-Breast Recurrence 		1612-1613
In-Breast Recurrence 		1614-1615
In-Breast Recurrence 		1616-1617
Slide Number 9 		1618-1619
Slide Number 10 		1620-1621
Slide Number 11 		1622-1623
Slide Number 12 		1624-1625
In-Breast Recurrence 		1626-1627
Material & Methods – Patient features 		1628-1629
Tumour characteristics 		1630-1631
Material & Methods – Patient features 		1632-1633
Material & Methods – Patient features 		1634-1635
Technical features of brachytherapy 		1636-1637
Clinical outcome 		1638-1639
Actuarial rate of 2nd local recurrence 		1640-1641
Results 		1642-1643
Actuarial rate of distant metastasis 		1644-1645
Results 		1646-1647
Prognostic factors for 2nd LR (uni- & multivariate analysis) 		1648-1649
Prognostic factors for DM (uni- & multivariate analysis) 		1650-1651
Prognostic factors for DFS (uni- & multivariate analysis) 		1652-1653
Summary of results (Multivariate analysis) 		1654-1655
Incidence of late side-effects 		1656-1657
Value of late side-effects 		1658-1659
Cosmetic results 		1660-1661
Summary 		1662-1663
Selection criteria for salvage breast conserving therapy 		1664-1665
Ongoing and future projects 		1666-1667
… and SUMMARY of all these FACTS ?? 		1668-1669
SUMMARY 		1670-1671
Conclusions 		1672-1673
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