J Bedwinek1. 1. Cancer Care Center, St. Joseph Hospital, St. Louis, MO 63122.
Abstract
PURPOSE: To determine whether or not the surgical scar and surgical induration are suitable landmarks for localizing the boost field in the treatment of patients undergoing breast conservation surgery and irradiation. METHODS AND MATERIALS: Thirty-five patients had surgical clips placed in the excision cavity at the time of tumor excision. The boost field locations for these patients were determined by encompassing the surgical induration with a minimum 2 cm margin or, when there was no induration, by encompassing the incision scar with a 3 cm margin. Simulator radiographs were taken with the boost field margins marked with solder wire. RESULTS: The simulator radiographs showed that the excision cavity clips were at or outside the boost field margins in 19 patients, 54% of the entire group. An unexpected finding was that, in six of the 23 patients with the surgical scar 2 cm medial or lateral to the areola, the excision cavity clips were inadequately covered by tangential fields even though the fields appeared to be adequate based on external landmarks. CONCLUSION: (a) This study suggests that the skin incision and surgical induration are not reliable landmarks for boost field localization. (b) Without surgical clips, part of the excision cavity would have underdosed by the tangential fields in 23% of patients with medial or lateral surgical scars.
PURPOSE: To determine whether or not the surgical scar and surgical induration are suitable landmarks for localizing the boost field in the treatment of patients undergoing breast conservation surgery and irradiation. METHODS AND MATERIALS: Thirty-five patients had surgical clips placed in the excision cavity at the time of tumor excision. The boost field locations for these patients were determined by encompassing the surgical induration with a minimum 2 cm margin or, when there was no induration, by encompassing the incision scar with a 3 cm margin. Simulator radiographs were taken with the boost field margins marked with solder wire. RESULTS: The simulator radiographs showed that the excision cavity clips were at or outside the boost field margins in 19 patients, 54% of the entire group. An unexpected finding was that, in six of the 23 patients with the surgical scar 2 cm medial or lateral to the areola, the excision cavity clips were inadequately covered by tangential fields even though the fields appeared to be adequate based on external landmarks. CONCLUSION: (a) This study suggests that the skin incision and surgical induration are not reliable landmarks for boost field localization. (b) Without surgical clips, part of the excision cavity would have underdosed by the tangential fields in 23% of patients with medial or lateral surgical scars.
Authors: Maria C De Santis; Luigia Nardone; Barbara Diletto; Roberta Canna; Michela Dispinzieri; Lorenza Marino; Laura Lozza; Vincenzo Valentini Journal: Br J Radiol Date: 2016-07-25 Impact factor: 3.039
Authors: Amparo González Sanchis; Luis Brualla González; Carlos Fuster Diana; Jose Carlos Gordo Partearroyo; Andres Garcia-Vilanova Comas; Jose Luis Lopez Torrecilla; Joan Roselló Ferrando Journal: Clin Transl Oncol Date: 2012-07-25 Impact factor: 3.405
Authors: I Chitapanarux; M Muttarak; W Na-Chiangmai; H Trakultivakorn; A Somwangprasert; P Kamnerdsupaphon; E Tharavichitkul; V Sukthomya; V Lorvidhaya; A Watcharawipha Journal: Biomed Imaging Interv J Date: 2009-07-01