THE USE OF AN INTERCURRENT BOOST IN BREAST CONSERVATIVE THERAPY FOR EARLY STAGE BREAST CANCER

Abstract

T he standard of care for locoregional management of early stage breast cancer became breast-conserving surgery (BCS) followed by a course of whole-breast radiotherapy (Pierce et al.,2005). In general, the majority of in-breast local recurrences occur in the region of the prior lumpectomy site and index quadrantwhether the patient undergoes postoperative breast irradiation or not (Smith et al., 2000). Many clinical trials have demonstrated that the addition of a localized dose to the tumor bed significantly reduces local recurrences and confirmed the concept of dose–response for a specific tumor volume in breast cancer (Timothy, 2005). Although relatively short lived, radiation induced skin reactions are uncomfortable and itchy. It can be painful and are some-times dose-limitingand has been associated with decreased quality of life. Furthermore, severe radiodermatitis necessitates treatment modifications or delays, which may compromise the efficacy of radiotherapy (McQuestion, 2006). Moist desquamation, evidenced by red, exposed dermis and serous oozing, occurs after four to five weeks of therapy as the basal cells are further depleted (Archambeau et al., 1995). The present study aimed to evaluate the ability of planned intrercuurent boost method to decrease occurrence of radiodermatitis in the breast and less treatment interruptions in comparison to the conventional method of giving the boost after finishing whole breast irradiation. Our primary end point was to comparetheplanned intrercuurent boost method with the conventional WBRT method regarding the rate of radiodermatitis, treatment breaks and the average overall treatment time.Our secondary end point was to comparetheplanned intrercuurent boost method with the conventional WBRT method regarding the rate of ipsilateral breast local recurrence.