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Copenhagen, Denmark
Onsite/Online

ESTRO 2022

Session Item

Breast
Poster (digital)
Clinical
The radiation oncologist’s relevance in the Breast Unit team up-front discussion: our experience
GRAZIA Lazzari , Italy
PO-1224

Abstract

The radiation oncologist’s relevance in the Breast Unit team up-front discussion: our experience
Authors:

GRAZIA Lazzari1, Anna Rita D'Alessandro2, Francesca Cannalire3, Monica Cramarossa4, Roberta D'Andria5, Grazia Marangi6, Giuseppe Melucci7, Salvatore Pisconti8, Giovanni Silvano9

1San Giuseppe Moscati Hospital , Radiation Oncology Unit, Taranto, Italy; 2San Giuseppe Moscati Hospital, Medical Oncology Unit, Taranto, Italy; 3SS Annunziata Hospital , Breast Surgery, Taranto, Italy; 4SS Annunziata Hospital, Breast Surgery, Taranto, Italy; 5SS Annunziata Hospital, Breast Reconstructive Surgery, Taranto, Italy; 6SS Annunziata Hospital, Anatomo-Pathology Unit, Taranto, Italy; 7SS Annunziata Hospital, Breast Unit Senology , Taranto, Italy; 8San Giuseppe Moscati Hospital , Medical Oncology Unit, Taranto, Italy; 9San Giuseppe Moscati Hospital, Radiation Oncology Unit, Taranto, Italy

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Purpose or Objective

The radiation oncologist’s role in the Breast Unit (BU) team got a decisive impact  in  the up-front making decision process in case of several breast cancer (BC) scenarios needing a tailored and organized combination with surgery and radiotherapy in case of  mastectomy or  breast conserving surgery (BCS).

Material and Methods

From 2020-2021 250 breast cancer patients (pts) needing an up-front treatment discussion with radiation oncologist were observed in our BU team. Among them, 70 pts needed a change of  the initial therapeutic program in light of these scenarios: 20 pts with ICD (a) , 15 pts with autoimmune diseases (LES and sclerodermia, b), 5 pts with arm impairment in the affected breast side (c), 30 pts with a response after neoadjuvant chemotherapy followed by mastectomy and chest wall implants with immediate or delayed reconstruction and adjuvant radiotherapy (d).

Results

Totally in 60% of cases the initial decision was changed (42 pts). Mastectomy without adjuvant RT was advised in 20 patients with early BC in case of ICD in the side of affected breast (a), in shoulders impairment (b) while in scenario c adjuvant RT was prescribed after a BCS in non active disease for 8 pts.  In case of mastectomy after neoadjuvant chemotherapy, a delayed chest wall reconstruction with temporary implants was planned in 12 cases showing advanced breast cancers needing adjuvant  RT on chest wall and nodal areas.  

Conclusion

in the BU team discussion the radiation oncologist role is an emerging and relevant protagonist in the up-front tailoring making decision process.