Alternative Breast Boost Methods

By: Megan Kuchenbecker

Why Photon Boosts 10-16 Gy Decreased fibrosis Enhanced local control Deep seeded tumors

https://www.google.com/search?site=&tbm=isch&source=hp&biw=1366&bih=624&q=radiation+breast+fibrosis&oq=radiation+breast+fibrosis&gs_l=img.3...1186.5828.0.6127.25.14.0.6.0.0.429.2251.0j1j4j1j2.8.0....0...1ac.1.48.img..18.7.2004.i3YbI13P1kI&gws_rd=ssl#facrc=_&imgdii=_&imgrc=YY5D-BJHUZlgqM%253A%3BEMF3Lh5Z_GOE1M%3Bhttp%253A%252F%252Fwww.aboutcancer.com%252Fbreast_image_tobias4.jpg%3Bhttp%253A%252F%252Fwww.aboutcancer.com%252Fbre4b.htm%3B258%3B208

Why Not Use Photon Boosts Larger field size Small breast size Shallow tumor

Why Use Simultaneous Boost

2 different volumes to 2 different doses each day

Adenocarcinomas Enhanced local control Decreased treatment time

Why Not Simultaneous Boosts

Few patients fit the criteria Increased acute side effects

https://www.google.com/search?site=&tbm=isch&source=hp&biw=490&bih=639&q=linac&oq=linac&gs_l=img.3..0l10.2035.2961.0.3194.5.5.0.0.0.0.201.718.0j3j1.4.0....0...1ac.1.48.img..1.4.716.77l56vWY34M&gws_rd=ssl#q=radiation%20breast%20fibrosis&tbm=isch&facrc=_&imgdii=_&imgrc=shfnKM-PWp3BLM%253A%3BqCPg_UX-C-gHyM%3Bhttp%253A%252F%252F4.bp.blogspot.com%252F-d-QCEFty82I%252FTZvmDtBKvCI%252FAAAAAAAAHsY%252FmsuzW8oOF8M%252Fs1600%252FRadiation%252Bburn.jpg%3Bhttp%253A%252F%252Fdbrueckman.blogspot.com%252F2011%252F04%252Fmy-breast-cancer-journey.html%3B1600%3B1200

Why Use Interstitial Boosts Noninvasive Breast Brachytherapy

Applicators (NIBB) Decrease toxicity Improve cosmetic outcomes Decreased fibrosis

https://www.google.com/search?q=interstitial+breast+brachytherapy&espv=2&source=lnms&tbm=isch&sa=X&ei=oCPFU5b5E8i-8QGN2oDwAw&ved=0CAYQ_AUoAQ&biw=780&bih=596#q=mammosite+radiation+therapy+system&tbm=isch&facrc=_&imgdii=_&imgrc=1zAL3oPzuyXlOM%253A%3B1hd5qK5wPT498M%3Bhttp%253A%252F%252Fwww.mammosite.com%252Fphysicians%252Fimages%252FRadiationProcedure.jpg%3Bhttp%253A%252F%252Fwww.mammosite.com%252Fphysicians%252Fradiation-therapy%252Fabout-mammosite.cfm%3B300%3B156

Why Not Interstitial Boosts Very invasive Not many cancer centers do this

procedure

Why Use IOERT 18-20Gy using Targeted Intraoperatve

Radiotherapy(Targit) Superb tissue localization Sterilization Decreased side effects Mayo Clinic of Arizona Study

Why not use IOERT Machine cost Expertise needed in OR

Why Don’t We use These Alternatives More Often?

Availability Cost Benefit