title: Use of boost radiotherapy in oncoplastic breast-conserving surgery - a systematic review.
abstract: BACKGROUND
  The use of local boost radiotherapy to the tumour bed has been demonstrated in randomised-controlled trials to reduce local recurrence rates following breast-conserving surgery (BCS) and is the standard of care. Oncoplastic BCS techniques with parenchymal rearrangement present new challenges to the localisation of the tumour bed and therefore delivery of local boost radiotherapy. The aim of this review was to evaluate the reporting of boost radiotherapy in the oncoplastic BCS literature.
  
  
  METHODS
  Pubmed, Ovid MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews were searched for studies reporting oncoplastic BCS using volume displacement techniques.
  
  
  RESULTS
  24 studies met the inclusion criteria (n = 1933 patients). Use of boost radiotherapy was reported in 11 studies, in 2 of which it was for the treatment of incomplete or close margins, and marking of the tumour bed was only reported in 8 studies. None of the studies reported the number of patients where the tumour bed could not be localised.
  
  
  CONCLUSIONS
  The use of local boost radiotherapy and tumour bed marking was not reported in the majority of studies of oncoplastic BCS. Future studies need to provide detailed information regarding the use of boost radiotherapy and difficulties determining the target volume so that current radiotherapy approaches can be reviewed and improved for these advanced techniques.
authors.affiliation: Department of Surgery, Western Infirmary, Dumbarton Road, Glasgow G11 6NT, Scotland, UK; Canniesburn Plastic Surgery Unit Jubilee Building, Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK. Electronic address: markschaverien@fastmail.fm.
authors.forename: M V
authors.initials: MV
authors.lastname: Schaverien
authors.forename: S
authors.initials: S
authors.lastname: Stallard
authors.forename: D
authors.initials: D
authors.lastname: Dodwell
authors.forename: J C
authors.initials: JC
authors.lastname: Doughty
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007432:Intraoperative Period; D016462:Mammaplasty / Q000379:methods; D015412:Mastectomy, Segmental / Q000379:methods; D018365:Neoplasm, Residual; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant; D058028:Research Report / Q000592:standards*
keywords: Boost radiotherapy; Breast-conserving surgery; Oncoplastic breast surgery; Review