PURPOSE: After breast-conserving surgery, a seroma often forms in the surgical cavity. If not drained, it may affect the volume of tumor bed requiring a boost after whole-breast radiation therapy (WBRT). Our objective was to evaluate the change in seroma volume that occurs during WBRT, before boost planning. METHODS AND MATERIALS: A retrospective review was performed of women receiving breast-conserving therapy with evidence of seroma at the time of WBRT planning. Computed tomography (CT) simulation was performed before WBRT and before the tumor bed boost. All patients received either a hypofractionated (42.4 Gy/16 fraction + 9.6 Gy/4 fraction boost) or standard fractionated (50.4 Gy/28 fraction + 10 Gy/5 fraction boost) regimen. Seroma volumes were contoured and compared on CT at the time of WBRT simulation and tumor bed boost planning. RESULTS: Twenty-four patients with evidence of seroma were identified and all patients received WBRT without drainage of the seroma. Mean seroma volume before WBRT and at boost planning were significantly different at 65.7 cm(3) (SD, 50.5 cm(3)) and 35.6 cm(3) (SD, 24.8 cm(3)), respectively (p < 0.001). Mean and median reduction in seroma volume during radiation were 39.6% (SD, 23.8%) and 46.2% (range, 10.7-76.7%), respectively. Fractionation schedule was not correlated with change in seroma volume. Length of time from surgery to start of radiation therapy showed an inverse correlation with change in seroma volume (Pearson correlation r = -0.53, p < 0.01). CONCLUSIONS: The volume of seroma changes significantly during WBRT. Consequently, the accuracy of breast boost planning is likely affected, as is the volume of normal breast tissue irradiated. CT-based boost planning before boost irradiation is suggested to ensure appropriate coverage.
PURPOSE: After breast-conserving surgery, a seroma often forms in the surgical cavity. If not drained, it may affect the volume of tumor bed requiring a boost after whole-breast radiation therapy (WBRT). Our objective was to evaluate the change in seroma volume that occurs during WBRT, before boost planning. METHODS AND MATERIALS: A retrospective review was performed of women receiving breast-conserving therapy with evidence of seroma at the time of WBRT planning. Computed tomography (CT) simulation was performed before WBRT and before the tumor bed boost. All patients received either a hypofractionated (42.4 Gy/16 fraction + 9.6 Gy/4 fraction boost) or standard fractionated (50.4 Gy/28 fraction + 10 Gy/5 fraction boost) regimen. Seroma volumes were contoured and compared on CT at the time of WBRT simulation and tumor bed boost planning. RESULTS: Twenty-four patients with evidence of seroma were identified and all patients received WBRT without drainage of the seroma. Mean seroma volume before WBRT and at boost planning were significantly different at 65.7 cm(3) (SD, 50.5 cm(3)) and 35.6 cm(3) (SD, 24.8 cm(3)), respectively (p < 0.001). Mean and median reduction in seroma volume during radiation were 39.6% (SD, 23.8%) and 46.2% (range, 10.7-76.7%), respectively. Fractionation schedule was not correlated with change in seroma volume. Length of time from surgery to start of radiation therapy showed an inverse correlation with change in seroma volume (Pearson correlation r = -0.53, p < 0.01). CONCLUSIONS: The volume of seroma changes significantly during WBRT. Consequently, the accuracy of breast boost planning is likely affected, as is the volume of normal breast tissue irradiated. CT-based boost planning before boost irradiation is suggested to ensure appropriate coverage.
Authors: José Luis Guinot; M Isabel Tortajada; María Carrascosa; Vicente Crispín; Ana Otero; Belén Ríos; Eleonor Rivin; Miguel Santos; Pablo Soler; Leoncio Arribas Journal: Clin Transl Oncol Date: 2012-02 Impact factor: 3.405
Authors: SooYoon Sung; Joo Hwan Lee; Jong Hoon Lee; Sung Hwan Kim; Yoo-Kang Kwak; Sea-Won Lee; Ye Won Jeon; Young Jin Suh Journal: J Breast Cancer Date: 2016-12-23 Impact factor: 3.588
Authors: Minh Tam Truong; Ariel E Hirsch; Nataliya Kovalchuk; Muhammad M Qureshi; Antonio Damato; Bradley Schuller; Nectaria Vassilakis; Michael Stone; David Gierga; John Willins; Lisa A Kachnic Journal: J Appl Clin Med Phys Date: 2013-03-04 Impact factor: 2.102