ESTRO Multidisciplinary Management of Breast Cancer 2017

Cosmetic results after breast conserving therapy

• Which factors play a role ? Several RCTs to investigate impact of:

Factor studied

Impact on cosmesis

Conclusion

Hypofx

No change in breast appearance

No boost vs low boost

No boost better than boost

Prone vs Supine

Tendency for better outcome prone than supine Only benefit if scored by physician at 5 yr, and if patients are selected

2D CRT vs IMRT

Partial breast vs WBRT

Results conflicting

Hypofx: Whelan 2008; Haviland 2013; Prone vs supine: Veldeman 2016; 2D CRT vs IMRT: Pignol 2016; Mukesh 2014; No vs low boost: Vrieling 1999 & 2000, Hau 2013; Low vs high boost : Brouwers in preparation; PBI vs WBRT: Polgar 2017, Coles 2017, Peterson 2015