1932

Abstract

During the early decades of radiation therapy for breast cancer, local control of disease was documented consistently but, enigmatically, an anticipated impact on breast cancer survival was not observed, leading to confusion in our understanding of the natural history of breast cancer and radiation effects. Now, almost 90 years after its first use in breast cancer, technology developments in diagnostic imaging and radiation therapy have elucidated parts of this enigma. The data now available demonstrate a significant impact of radiation therapy on survival as well as disease control and treatment-related mortality, opening a doorway to understanding the powerful impact of radiation therapy on both breast cancer and critical organs. Efforts are focused on leveraging novel techniques to maximize the benefits of radiation for breast cancer patients.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-med-042716-103422
2018-01-29
2024-03-29
Loading full text...

Full text loading...

/deliver/fulltext/med/69/1/annurev-med-042716-103422.html?itemId=/content/journals/10.1146/annurev-med-042716-103422&mimeType=html&fmt=ahah

Literature Cited

  1. Rayter Z. 1.  2003. History of breast cancer. Medical Therapy of Breast Cancer Z Raytor, J Mansi 1–36 Cambridge, UK: Cambridge Univ. Press [Google Scholar]
  2. Slater JM. 2.  2012. From X-rays to ion beams: a short history of radiation therapy. Ion Beam Therapy: Fundamentals, Technology, Clinical Applications 3203–6 U Linz Berlin/Heidelberg: Springer [Google Scholar]
  3. Bedwinek J. 3.  1993. Breast conserving surgery and irradiation: the importance of demarcating the excision cavity with surgical clips. Int. J. Radiat. Oncol. Biol. Phys. 26:675–79 [Google Scholar]
  4. Recht A, Siddon RL, Kaplan WD. 4.  et al. 1988. Three-dimensional internal mammary lymphoscintigraphy: implications for radiation therapy treatment planning for breast carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 14:477–81 [Google Scholar]
  5. Tapley ND, Spanos WJ Jr., Fletcher GH. 5.  et al. 1982. Results in patients with breast cancer treated by radical mastectomy and postoperative irradiation with no adjuvant chemotherapy. Cancer 49:1316–19 [Google Scholar]
  6. Ragaz J, Olivotto IA, Spinelli JJ. 6.  et al. 2005. Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. J. Natl. Cancer Inst. 97:116–26 [Google Scholar]
  7. Overgaard M, Hansen PS, Overgaard J. 7.  et al. 1997. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial. N. Engl. J. Med. 337:949–55 [Google Scholar]
  8. Overgaard M, Jensen MB, Overgaard J. 8.  et al. 1999. Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomised trial. Lancet 353:1641–48 [Google Scholar]
  9. Clarke M, Collins R, Darby S. 9.  et al. 2005. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366:2087–106 [Google Scholar]
  10. Cuzick J, Stewart H, Rutqvist L. 10.  et al. 1994. Cause-specific mortality in long-term survivors of breast cancer who participated in trials of radiotherapy. J. Clin. Oncol. 12:447–53 [Google Scholar]
  11. Darby SC, Ewertz M, McGale P. 11.  et al. 2013. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N. Engl. J. Med. 368:987–98 [Google Scholar]
  12. van den Bogaard VA, Ta BD, van der Schaaf A. 12.  et al. 2017. Validation and modification of a prediction model for acute cardiac events in patients with breast cancer treated with radiotherapy based on three-dimensional dose distributions to cardiac substructures. J. Clin. Oncol. 35:1171–78 [Google Scholar]
  13. Henson KE, McGale P, Taylor C. 13.  et al. 2013. Radiation-related mortality from heart disease and lung cancer more than 20 years after radiotherapy for breast cancer. Br. J. Cancer 108:179–82 [Google Scholar]
  14. Whelan TJ, Olivotto IA, Parulekar WR. 14.  et al. 2015. Regional nodal irradiation in early-stage breast cancer. N. Engl. J. Med. 373:307–16 [Google Scholar]
  15. Poortmans PM, Collette S, Kirkove C. 15.  et al. 2015. Internal mammary and medial supraclavicular irradiation in breast cancer. N. Engl. J. Med. 373:317–27 [Google Scholar]
  16. Hennequin C, Bossard N, Servagi-Vernat S. 16.  et al. 2013. Ten-year survival results of a randomized trial of irradiation of internal mammary nodes after mastectomy. Int. J. Radiat. Oncol. Biol. Phys. 86:860–66 [Google Scholar]
  17. Chang JS, Park W, Kim YB. 17.  et al. 2013. Long-term survival outcomes following internal mammary node irradiation in stage II–III breast cancer: results of a large retrospective study with 12-year follow-up. Int. J. Radiat. Oncol. Biol. Phys. 86:867–72 [Google Scholar]
  18. Thorsen LB, Offersen BV, Dano H. 18.  et al. 2016. DBCG-IMN: a population-based cohort study on the effect of internal mammary node irradiation in early node-positive breast cancer. J. Clin. Oncol. 34:314–20 [Google Scholar]
  19. Bentel G, Marks LB, Hardenbergh P. 19.  et al. 1999. Variability of the location of internal mammary vessels and glandular breast tissue in breast cancer patients undergoing routine CT-based treatment planning. Int. J. Radiat. Oncol. Biol. Phys. 44:1017–25 [Google Scholar]
  20. Saito AI, Lightsey J, Li JG. 20.  et al. 2009. Accuracy of breast cancer axillary lymph node treatment plans based on 2-dimensional imaging: what we should know before interpreting 2-dimensional treatment-planning era studies. Am. J. Clin. Oncol. 32:387–95 [Google Scholar]
  21. Pereira DC, Ramos RP, do Nascimento MZ. 21.  2014. Segmentation and detection of breast cancer in mammograms combining wavelet analysis and genetic algorithm. Comput. Methods Programs Biomed. 114:88–101 [Google Scholar]
  22. White J, Tai A, Arthur D. 22.  et al. 2017. Radiation Therapy Oncology Group. Breast cancer atlas for radiation therapy planning: consensus definitions https://www.rtog.org/LinkClick.aspx?fileticket=vzJFhPaBipE=. Accessed May 7, 2017
  23. 23. Radiation Therapy Oncology Group. 2016. Breast contouring RADCOMP consortium, v.3. https://www.rtog.org/LinkClick.aspx?fileticket=eVB451KQ83M%3d&tabid=429. Accessed May 7, 2017
  24. Nielsen MH, Berg M, Pedersen AN. 24.  et al. 2013. Delineation of target volumes and organs at risk in adjuvant radiotherapy of early breast cancer: national guidelines and contouring atlas by the Danish Breast Cancer Cooperative Group. Acta Oncol 52:703–10 [Google Scholar]
  25. Verhoeven K, Weltens C, Remouchamps V. 25.  et al. 2015. Vessel based delineation guidelines for the elective lymph node regions in breast cancer radiation therapy—PROCAB guidelines. Radiother. Oncol. 114:11–16 [Google Scholar]
  26. Jethwa KR, Kahila MM, Hunt KN. 26.  et al. 2017. Delineation of internal mammary nodal target volumes in breast cancer radiation therapy. Int. J. Radiat. Oncol. Biol. Phys. 97:762–69 [Google Scholar]
  27. Guan H, Dong YL, Ding LJ. 27.  et al. 2015. Morphological factors and cardiac doses in whole breast radiation for left-sided breast cancer. Asian Pac. J. Cancer Prev. 16:2889–94 [Google Scholar]
  28. Kubasov IV. 28.  1990. [The potassium ion yield from the frog muscle studied using a contact ion-selective electrode]. Fiziol Zh SSSR Im I M Sechenova 76:1550–56 Russian [Google Scholar]
  29. Sardar P, Kundu A, Chatterjee S. 29.  et al. 2017. Long-term cardiovascular mortality after radiotherapy for breast cancer: a systematic review and meta-analysis. Clin. Cardiol. 40:73–81 [Google Scholar]
  30. Hjelstuen MH, Mjaaland I, Vikstrom J. 30.  et al. 2012. Radiation during deep inspiration allows loco-regional treatment of left breast and axillary-, supraclavicular- and internal mammary lymph nodes without compromising target coverage or dose restrictions to organs at risk. Acta Oncol 51:333–44 [Google Scholar]
  31. Dincoglan F, Beyzadeoglu M, Sager O. 31.  et al. 2013. Dosimetric evaluation of critical organs at risk in mastectomized left-sided breast cancer radiotherapy using breath-hold technique. Tumori 99:76–82 [Google Scholar]
  32. Lymberis SC, deWyngaert JK, Parhar P. 32.  et al. 2012. Prospective assessment of optimal individual position (prone versus supine) for breast radiotherapy: volumetric and dosimetric correlations in 100 patients. Int. J. Radiat. Oncol. Biol. Phys. 84:902–9 [Google Scholar]
  33. Griem KL, Fetherston P, Kuznetsova M. 33.  et al. 2003. Three-dimensional photon dosimetry: a comparison of treatment of the intact breast in the supine and prone position. Int. J. Radiat. Oncol. Biol. Phys. 57:891–99 [Google Scholar]
  34. Wurschmidt F, Stoltenberg S, Kretschmer M. 34.  et al. 2014. Incidental dose to coronary arteries is higher in prone than in supine whole breast irradiation. A dosimetric comparison in adjuvant radiotherapy of early stage breast cancer. Strahlenther. Onkol. 190:563–68 [Google Scholar]
  35. Sethi RA, No HS, Jozsef G. 35.  et al. 2012. Comparison of three-dimensional versus intensity-modulated radiotherapy techniques to treat breast and axillary level III and supraclavicular nodes in a prone versus supine position. Radiother. Oncol. 102:74–81 [Google Scholar]
  36. Stegman LD, Beal KP, Hunt MA. 36.  et al. 2007. Long-term clinical outcomes of whole-breast irradiation delivered in the prone position. Int. J. Radiat. Oncol. Biol. Phys. 68:73–81 [Google Scholar]
  37. 37. National Comprehensive Cancer Network. 2017. NCCN Clinical Practice Guidelines in Oncology. Breast cancer. Version 2.2017. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed May 7, 2017
  38. Popescu CC, Olivotto IA, Beckham WA. 38.  et al. 2010. Volumetric modulated arc therapy improves dosimetry and reduces treatment time compared to conventional intensity-modulated radiotherapy for locoregional radiotherapy of left-sided breast cancer and internal mammary nodes. Int. J. Radiat. Oncol. Biol. Phys. 76:287–95 [Google Scholar]
  39. Webb S. 39.  2009. Volumetric-modulated arc therapy: its role in radiation therapy. http://medicalphysicsweb.org/cws/article/opinion/39542. Accessed May 7, 2017
  40. Johansen S, Cozzi L, Olsen DR. 40.  2009. A planning comparison of dose patterns in organs at risk and predicted risk for radiation induced malignancy in the contralateral breast following radiation therapy of primary breast using conventional, IMRT and volumetric modulated arc treatment techniques. Acta Oncol 48:495–503 [Google Scholar]
  41. Boman E, Rossi M, Haltamo M. 41.  et al. 2016. A new split arc VMAT technique for lymph node positive breast cancer. Phys. Med. 32:1428–36 [Google Scholar]
  42. Donovan E, Bleakley N, Denholm E. 42.  et al. 2007. Randomised trial of standard 2D radiotherapy (RT) versus intensity modulated radiotherapy (IMRT) in patients prescribed breast radiotherapy. Radiother. Oncol. 82:254–64 [Google Scholar]
  43. Mulliez T, Veldeman L, van Greveling A. 43.  et al. 2013. Hypofractionated whole breast irradiation for patients with large breasts: a randomized trial comparing prone and supine positions. Radiother. Oncol. 108:203–8 [Google Scholar]
  44. Barnett GC, Wilkinson JS, Moody AM. 44.  et al. 2011. The Cambridge Breast Intensity-modulated Radiotherapy Trial: patient- and treatment-related factors that influence late toxicity. Clin. Oncol. 23:662–73 [Google Scholar]
  45. Livi L, Meattini I, Marrazzo L. 45.  et al. 2015. Accelerated partial breast irradiation using intensity-modulated radiotherapy versus whole breast irradiation: 5-year survival analysis of a phase 3 randomised controlled trial. Eur. J. Cancer 51:451–63 [Google Scholar]
  46. Pignol JP, Truong P, Rakovitch E. 46.  et al. 2016. Ten years results of the Canadian breast intensity modulated radiation therapy (IMRT) randomized controlled trial. Radiother. Oncol. 121:414–19 [Google Scholar]
  47. Buwenge M, Cammelli S, Ammendolia I. 47.  et al. 2017. Intensity modulated radiation therapy for breast cancer: current perspectives. Breast Cancer 9:121–26 [Google Scholar]
  48. Ares C, Khan S, Macartain AM. 48.  et al. 2010. Postoperative proton radiotherapy for localized and locoregional breast cancer: potential for clinically relevant improvements?. Int. J. Radiat. Oncol. Biol. Phys. 76:685–97 [Google Scholar]
  49. Xu N, Ho MW, Li Z. 49.  et al. 2014. Can proton therapy improve the therapeutic ratio in breast cancer patients at risk for nodal disease?. Am. J. Clin. Oncol. 37:568–74 [Google Scholar]
  50. MacDonald SM, Patel SA, Hickey S. 50.  et al. 2013. Proton therapy for breast cancer after mastectomy: early outcomes of a prospective clinical trial. Int. J. Radiat. Oncol. Biol. Phys. 86:484–90 [Google Scholar]
  51. Cuaron JJ, Chon B, Tsai H. 51.  et al. 2015. Early toxicity in patients treated with postoperative proton therapy for locally advanced breast cancer. Int. J. Radiat. Oncol. Biol. Phys. 92:284–91 [Google Scholar]
  52. Bradley JA, Dagan R, Ho MW. 52.  et al. 2016. Initial report of a prospective dosimetric and clinical feasibility trial demonstrates the potential of protons to increase the therapeutic ratio in breast cancer compared with photons. Int. J. Radiat. Oncol. Biol. Phys. 95:411–21 [Google Scholar]
  53. Tommasino F, Durante M, D'Avino V. 53.  et al. 2017. Model-based approach for quantitative estimates of skin, heart, and lung toxicity risk for left-side photon and proton irradiation after breast-conserving surgery. Acta Oncol 56:730–36 [Google Scholar]
  54. Taylor CW, Wang Z, Macaulay E. 54.  et al. 2015. Exposure of the heart in breast cancer radiation therapy: a systematic review of heart doses published during 2003 to 2013. Int. J. Radiat. Oncol. Biol. Phys. 93:845–53 [Google Scholar]
/content/journals/10.1146/annurev-med-042716-103422
Loading
/content/journals/10.1146/annurev-med-042716-103422
Loading

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error