658 / 1082
S642
ESTRO 36 2017
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Conclusion
Despite adjuvant RNI, patients remain at risk of RNR. RNI
fields can be optimized, as in our cohort 34 nodes (39%)
were marginal, occurring in areas not adequately covered
by the prescribed dose. However, 68% of SCF and 50% of
axillary relapses were still ‘in-field’, suggesting that
either our prescribed dose to these areas was not
adequate to control disease, or that these patients were
at a high risk of systemic relapse. Use of the RTOG atlas
did not provide improved coverage. The anatomical data
from this cohort will be used to generate an atlas of nodal
relapse that can assist in defining optimal radiotherapy
volumes for RNI. Whether inclusion of such regions will
alter relapse patterns and event rates is unknown.
EP-1196 Possible use of genetic tests: let’s consider
the opinion of patients
S. Gay
1
, F. Palorini
1
, M. De Santis
2
, S. Frasca
2
, C. West
3
,
T. Rattay
4
, T. Rancati
1
, R. Valdagni
2
, L. Lozza
2
1
Fondazione IRCCS Istituto Nazionale dei Tumori,
Prostate Cancer Program, Milan, Italy
2
Fondazione IRCCS Istituto Nazionale dei Tumori,
Radiation Oncology 1, Milan, Italy
3
University of Manchester, University of Manchester,
Manchester, United Kingdom
4
Christie Hospital, Christie Hospital, Manchester, United
Kingdom
Purpose or Objective
More than half of all women undergoing breast cancer
radiotherapy (RT) are anxious about possible changes to
appearance of their breast, often causing negative
perception of RT.
Aim of this work was to explore patients’ views on a
potential predictive genetic test that should provide an
individual risk probability for toxicity after RT. First, to
establish, before any such test is implemented in clinical
practice, if such a decision-making tool is acceptable and
appropriate for breast cancer pts. Finally, to understand
if it would have conditioned the decision-making process
with respect the treatment choice (RT + lumpectomy vs
mastectomy alone).
Material and Methods
11 breast cancer pts undergone semi-structured
interviews after RT completion. Interviews were
conducted by a radiotherapist and a radiotherapy
technician.
Thematic analysis was used to analyze the transcripts and
identify key themes. Coding was employed to detect
common topics and identify sub-themes.
Results
Characteristic of the
11 pts are reported in figure.
Saturation of themes was reached and 6 themes and
relative sub-themes were identified.
1) Comprehension & impressions about benefits of the
test: pts well understand the aim of the test, a few pts
see in this test a tool for improving RT plans depending on
individual predisposition to toxicity, but they do not
consider it as a tool to independently choose mastectomy
or RT. Nevertheless, they think that the test might make
them more confident about treatment since it gives
additional information.
2) Preliminary preparation to RT and its side effects: the
majority of pts felt prepared to RT even if preparation
does not always cancel fear. Many women consider
important to have the largest and reliable information.
Knowing in advance also negative experiences (about
toxicity) is a plus point: women want to be aware about
the path they are going to follow.
3) Side effects & hypotheses about protective factors:
women propose physical/psychological conditions that
would have protected them from strong morbidity, as skin
color, use of cream, positive attitude, beloved people,
visualization techniques.
4) Thoughts about mastectomy vs RT: mastectomy is felt
as a very invasive treatment when compared to RT side
effects, furthermore, RT toxicity is felt not so serious as a
not suitably treated cancer.
5) Emotions: anxiety and fear are insistent feelings, but
they are barely connected to genetic test’s result and to
the consequent storing of genetic information.
6) Importance of Human Relationships: trust and gratitude
versus Hospital/Physician are conditions often more
relavant for the treatment choice than the response of a