title: Accelerated partial breast intensity-modulated radiotherapy in women who have prior breast augmentation.
abstract: OBJECTIVE
  To examine the outcome of breast cancer patients who have prior breast augmentation treated with lumpectomy followed by accelerated partial breast external intensity-modulated radiotherapy (APBIMRT) with image-guided radiotherapy (IGRT).
  
  
  METHODS
  Four patients with previous elective subpectoral breast augmentation were enrolled on this APBIMRT trial. These four patients were treated with 10 equal twice daily 3.85 Gy fractions over 5 consecutive days (total dose of 38.5 Gy) using APBIMRT and IGRT. Patients were assessed for pain and cosmetic outcome (physician and a patient self-assessment).
  
  
  RESULTS
  At last follow-up, two patients reported an excellent cosmetic results (at 2 years and at 8 months, respectively), one reported good cosmetic results (at 2 years), and one reported poor cosmetic results (at 20 months). Physicians rated the cosmetic outcomes as excellent in two (CEL; at 2 years and 8 months, respectively), good in one (CEL; at 20 months) and excellent in one (KTH; at 2 years). Three patients reported no breast/chest wall pain (two at 2 years and one at 1 year) and the fourth reported mild pain (at 20 months). The mean percent volume of ipsilateral breast receiving 100%, 75%, 50%, and 25% of the prescribed dose was 7.28%, 17.55%, 24.33%, and 33.1%, respectively. The mean breast, planning target volume (PTV), and implant volumes were 399.88 cc, 43.55 cc, and 313.36 cc, respectively. The mean breast prosthesis/total volume (breast tissue plus prosthesis) ratio was 44.55%. The mean PTV/ipsilateral breast and PTV/total volume ratios were 11.1% and 6.1%, respectively.
  
  
  CONCLUSIONS
  The results show that a regimen of APBIMRT with IGRT is possible in patients who have prior breast augmentation.
authors.affiliation: Rocky Mountain Cancer Centers, Littleton, CO, USA. charles.leonard@usoncology.com
authors.forename: Charles E
authors.initials: CE
authors.lastname: Leonard
authors.forename: Tim
authors.initials: T
authors.lastname: Johnson
authors.forename: Michael
authors.initials: M
authors.lastname: Tallhamer
authors.forename: Kathryn
authors.initials: K
authors.lastname: Howell
authors.forename: Jane
authors.initials: J
authors.lastname: Kercher
authors.forename: Terese
authors.initials: T
authors.lastname: Kaske
authors.forename: Lora
authors.initials: L
authors.lastname: Barke
authors.forename: Scot
authors.initials: S
authors.lastname: Sedlacek
authors.forename: Tracy
authors.initials: T
authors.lastname: Hobart
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Carter
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty; D008875:Middle Aged; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*