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Comparison of Helical Tomotherapy and Direct Tomotherapy in Bilateral Whole Breast Irradiation in a Case of Bilateral Synchronous Grade 1 and Stage 1 Breast Cancer

Patient: Female, 60 Final Diagnosis: Complete remission Symptoms: None Medication: — Clinical Procedure: Radiotherapy Specialty: Oncology OBJECTIVE: Rare disease BACKGROUND: Synchronous bilateral breast cancer is rare. A case is presented where whole breast irradiation (WBI) was planned after breast...

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Autores principales: Lancellotta, Valentina, Iacco, Martina, Perrucci, Elisabetta, Zucchetti, Claudio, Dipilato, Anna Concetta, Falcinelli, Lorenzo, Palumbo, Isabella, Aristei, Cynthia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627865/
https://www.ncbi.nlm.nih.gov/pubmed/28935854
http://dx.doi.org/10.12659/AJCR.905245
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author Lancellotta, Valentina
Iacco, Martina
Perrucci, Elisabetta
Zucchetti, Claudio
Dipilato, Anna Concetta
Falcinelli, Lorenzo
Palumbo, Isabella
Aristei, Cynthia
author_facet Lancellotta, Valentina
Iacco, Martina
Perrucci, Elisabetta
Zucchetti, Claudio
Dipilato, Anna Concetta
Falcinelli, Lorenzo
Palumbo, Isabella
Aristei, Cynthia
author_sort Lancellotta, Valentina
collection PubMed
description Patient: Female, 60 Final Diagnosis: Complete remission Symptoms: None Medication: — Clinical Procedure: Radiotherapy Specialty: Oncology OBJECTIVE: Rare disease BACKGROUND: Synchronous bilateral breast cancer is rare. A case is presented where whole breast irradiation (WBI) was planned after breast conserving surgery in a patient with synchronous bilateral breast cancer. A comparison was made between the feasibility of helical tomotherapy and direct tomotherapy. CASE REPORT: A 60-year-old woman was found to have bilateral breast nodules on routine mammographic screening, resulting in bilateral lumpectomy and sentinel lymph node biopsy. Histopathology showed a 6 mm diameter invasive ductal carcinoma in the right breast (Grade 1, hormone receptor positive, HER2 negative) and an 8mm diameter tubular carcinoma in the left breast (Grade 1, hormone receptor positive, HER2 negative). Lymph node biopsy and histology, chest X-ray, abdominal ultrasound scan, and bone scintigraphy were negative for metastases (both tumors were Stage 1). Adjuvant therapy with commenced with anastrozole, but no chemotherapy was given. Clinical target volumes (CTVs) were contoured on computed tomography (CT) images. For planning target volumes (PTVs), CTVs were expanded by 1 cm in all directions, except for the medial 5 mm. Since dose constraints to organs at risk (OARs) were beyond established limits, CTVs were expanded by 5 mm. For PTVs, OAR doses and homogeneity indices for helical tomotherapy and direct tomotherapy were compared. Helical tomotherapy provided better target volume coverage and OAR sparing than direct tomotherapy. CONCLUSIONS: In a case of bilateral synchronous Stage 1 and Grade 1 breast cancer, helical tomotherapy appeared more suitable than direct tomotherapy.
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spelling pubmed-56278652017-10-12 Comparison of Helical Tomotherapy and Direct Tomotherapy in Bilateral Whole Breast Irradiation in a Case of Bilateral Synchronous Grade 1 and Stage 1 Breast Cancer Lancellotta, Valentina Iacco, Martina Perrucci, Elisabetta Zucchetti, Claudio Dipilato, Anna Concetta Falcinelli, Lorenzo Palumbo, Isabella Aristei, Cynthia Am J Case Rep Articles Patient: Female, 60 Final Diagnosis: Complete remission Symptoms: None Medication: — Clinical Procedure: Radiotherapy Specialty: Oncology OBJECTIVE: Rare disease BACKGROUND: Synchronous bilateral breast cancer is rare. A case is presented where whole breast irradiation (WBI) was planned after breast conserving surgery in a patient with synchronous bilateral breast cancer. A comparison was made between the feasibility of helical tomotherapy and direct tomotherapy. CASE REPORT: A 60-year-old woman was found to have bilateral breast nodules on routine mammographic screening, resulting in bilateral lumpectomy and sentinel lymph node biopsy. Histopathology showed a 6 mm diameter invasive ductal carcinoma in the right breast (Grade 1, hormone receptor positive, HER2 negative) and an 8mm diameter tubular carcinoma in the left breast (Grade 1, hormone receptor positive, HER2 negative). Lymph node biopsy and histology, chest X-ray, abdominal ultrasound scan, and bone scintigraphy were negative for metastases (both tumors were Stage 1). Adjuvant therapy with commenced with anastrozole, but no chemotherapy was given. Clinical target volumes (CTVs) were contoured on computed tomography (CT) images. For planning target volumes (PTVs), CTVs were expanded by 1 cm in all directions, except for the medial 5 mm. Since dose constraints to organs at risk (OARs) were beyond established limits, CTVs were expanded by 5 mm. For PTVs, OAR doses and homogeneity indices for helical tomotherapy and direct tomotherapy were compared. Helical tomotherapy provided better target volume coverage and OAR sparing than direct tomotherapy. CONCLUSIONS: In a case of bilateral synchronous Stage 1 and Grade 1 breast cancer, helical tomotherapy appeared more suitable than direct tomotherapy. International Scientific Literature, Inc. 2017-09-22 /pmc/articles/PMC5627865/ /pubmed/28935854 http://dx.doi.org/10.12659/AJCR.905245 Text en © Am J Case Rep, 2017 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Lancellotta, Valentina
Iacco, Martina
Perrucci, Elisabetta
Zucchetti, Claudio
Dipilato, Anna Concetta
Falcinelli, Lorenzo
Palumbo, Isabella
Aristei, Cynthia
Comparison of Helical Tomotherapy and Direct Tomotherapy in Bilateral Whole Breast Irradiation in a Case of Bilateral Synchronous Grade 1 and Stage 1 Breast Cancer
title Comparison of Helical Tomotherapy and Direct Tomotherapy in Bilateral Whole Breast Irradiation in a Case of Bilateral Synchronous Grade 1 and Stage 1 Breast Cancer
title_full Comparison of Helical Tomotherapy and Direct Tomotherapy in Bilateral Whole Breast Irradiation in a Case of Bilateral Synchronous Grade 1 and Stage 1 Breast Cancer
title_fullStr Comparison of Helical Tomotherapy and Direct Tomotherapy in Bilateral Whole Breast Irradiation in a Case of Bilateral Synchronous Grade 1 and Stage 1 Breast Cancer
title_full_unstemmed Comparison of Helical Tomotherapy and Direct Tomotherapy in Bilateral Whole Breast Irradiation in a Case of Bilateral Synchronous Grade 1 and Stage 1 Breast Cancer
title_short Comparison of Helical Tomotherapy and Direct Tomotherapy in Bilateral Whole Breast Irradiation in a Case of Bilateral Synchronous Grade 1 and Stage 1 Breast Cancer
title_sort comparison of helical tomotherapy and direct tomotherapy in bilateral whole breast irradiation in a case of bilateral synchronous grade 1 and stage 1 breast cancer
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627865/
https://www.ncbi.nlm.nih.gov/pubmed/28935854
http://dx.doi.org/10.12659/AJCR.905245
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