RESUMEN
The French National Cancer Institute (INCa) and Société française de sénologie et pathologie mammaire (SFSPM), in collaboration with a multidisciplinary experts group, have published the French national clinical practice guidelines on a selection of 11 currently debated questions regarding the management of invasive breast cancer. Those guidelines are based on a comprehensive analysis of the current published evidence dealing with those issues, secondly reviewed by 100 reviewers. Radiotherapy was concerned by five of the 11 questions: indications for the boost after whole gland irradiation; hypofractionated radiotherapy; partial breast irradiation; indications for mammary internal nodes irradiation, and indications of radiotherapy after neo-adjuvant chemotherapy.
Asunto(s)
Neoplasias de la Mama/radioterapia , Antineoplásicos/uso terapéutico , Mama/patología , Neoplasias de la Mama/patología , Fraccionamiento de la Dosis de Radiación , Femenino , Fibrosis , Francia , Humanos , Ganglios Linfáticos/efectos de la radiación , Mastectomía , Mastectomía Segmentaria , Terapia Neoadyuvante , Invasividad Neoplásica , Recurrencia Local de Neoplasia/prevención & control , Órganos en Riesgo , Radioterapia Adyuvante , Factores de RiesgoRESUMEN
Whole breast irradiation delivering an equivalent dose of 50 Gy in 5 weeks, followed by a 10 to 16 Gy-boost to the tumor bed is the standard of care after breast-conserving surgery for early-breast cancer. Accelerated partial breast irradiation (APBI) is currently under investigations in large multi-institutional, prospective, randomized trials to objectively address the critical endpoints of treatment efficacy, toxicity and cosmesis. Patient's selection for this new approach is crucial to individualise treatments and define the subgroups of patients who will really benefit from APBI in terms of quality of life without decreasing long-term results of the disease control and cosmesis. In this review, we will discuss the patients' profiles selection for APBI regarding their general and tumor criteria. The differences between APBI techniques either performed intra or post operatively will be also discussed.
