ESTRO 2022

Session Item

Breast

Session Code: 6006

Session Type: Poster (digital)

Track: Clinical

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

GRAZIA Lazzari , Italy

Presentation Number: PO-1224

Abstract

Abstract Title:

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.