In This Issue
Preoperative MRI in Breast Cancer Management
Long-term APBI Outcomes are Favorable
Planning APBI Treatment for Patients with Pacemakers
BrachyBytes Editorial Advisory Board
Deanna Attai, M.D.
Robert Kuske, M.D.
Jay Reiff, Ph.D.
Dan Scanderbeg, Ph.D.
Catheryn Yashar, M.D.
Vic Zannis, M.D.
BEST Forum
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Preoperative MRI in Breast Cancer Management

Victor J. Zannis, MD, FACSVictor J. Zannis, MD, FACS

The use of preoperative breast MRI for newly diagnosed breast cancer patients remains a complex and controversial topic in the breast cancer community. Supporters of the routine use of MRI argue that it improves surgical planning, reduces re-excision rates and lowers the risk of recurrence – all of which could lead to an improvement in overall survival rates.

Opponents, on the other hand, point out that these benefits have not been demonstrated in the available data. In addition to the lack of evidence that MRI improves survival, they argue that the higher cost, additional biopsies, increased patient anxiety, and the potential link between MRI and unnecessary mastectomies are sufficient justification to use the modality sparingly.

Breast surgeon Victor J. Zannis, MD, FACS discusses this controversial topic, including how he utilizes MRI in his own practice and the role it should play in the patient selection process for accelerated partial breast irradiation (APBI). Read more

ASCO BCS: Long-term APBI Outcomes are Favorable

from Radiation Oncology Insider

Long-term outcomes of breast cancer patients participating in a clinical trial evaluating the effectiveness of accelerated partial-breast irradiation (APBI) continue to be favorable, according to a presentation at the American Society of Clinical Oncology‘s (ASCO) Breast Cancer Symposium (BCS) in September.

Radiation Therapy Oncology Group (RTOG) 9517 is a phase I/II trial that began enrolling patients with stage I and II breast cancer in 1997. Its objective was to evaluate the local control rate, overall survival, complication rates, and cosmetic results of patients treated with multicatheter breast brachytherapy following breast conservation surgery. A total of 98 patients treated at six cancer treatment facilities enrolled in the clinical trial. Read article

Planning APBI Treatment for Patients with Pacemakers

from Radiation Oncology Insider

Dayee Jacob, senior medical physicist at Christiana Care Health System, describes how he prepared a treatment plan for the first two patients with pacemakers at Christiana’s Helen F. Graham Cancer Center who were candidates for breast conservation surgery and APBI treatment. By using the SAVI applicator, the Christiana team was able to successfully deliver treatment without requiring surgical relocation of the pacemakers prior to radiotherapy. Read articleFor more on Christiana Care Health System’s pioneering use of APBI with the SAVI applicator in patients with pacemakers, read this Q&A with Dayee Jacob and radiation oncologist Jon Strasser from November 2011.