title: Overview on cardiac, pulmonary and cutaneous toxicity in patients treated with adjuvant radiotherapy for breast cancer.
abstract: Conservative management of breast cancer represents the standard treatment for early disease. Breast conserving surgery associated with radiotherapy for stage I-II has been proven to be as equally effective as mastectomy in term of local control, distant disease, and overall survival. The growing minimal invasive surgical approach on the axillary region, and the new breast reconstructive techniques, will probably lead to a significant decrease of the rate of side-effects related to mastectomy. Therefore, the adverse events caused by adjuvant radiation still remain a challenge. Cutaneous, pulmonary and cardiac toxicity represent the main toxicities of adjuvant radiotherapy for breast cancer. Safety profile of radiation is strongly dependent on the multidisciplinary management of the single case (systemic treatment, endocrine therapy, surgery), individual characteristics (i.e., co-morbidities, age, habits), and radiation-related aspects. Radiation techniques development, and facilities implementation concerning organs-at-risk sparing systems (i.e., image-guided radiotherapy, tracking systems, respiratory gating), represent brand new tools for the clinical oncologist, that would certainly minimize toxicity profile in the next future. However, data reported from published literature will greatly help physicians, to give to the patients appropriate counseling regarding the efficacy and potential adverse events of treatments, thus optimizing the informed decision-making process.
authors.affiliation: Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Largo G. A. Brambilla 3, 50134, Florence, Italy. icro.meattini@unifi.it.
authors.forename: Icro
authors.identifier: http://orcid.org/0000-0002-1861-2895
authors.initials: I
authors.lastname: Meattini
authors.affiliation: UOC Oncologia Radioterapica, IRCC Azienda Ospedaliero-Universitaria San Martino IST, Genoa, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Guenzi
authors.affiliation: Unità di Radioterapia, ULSS 12 Veneziana, Mestre, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fozza
authors.affiliation: Radiation Oncology Department, University Hospital of Trieste, Trieste, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Vidali
authors.affiliation: Radiotherapy Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Rovea
authors.affiliation: Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Largo G. A. Brambilla 3, 50134, Florence, Italy.
authors.forename: Fiammetta
authors.initials: F
authors.lastname: Meacci
authors.affiliation: Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Largo G. A. Brambilla 3, 50134, Florence, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livi
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy*; D066126:Cardiotoxicity / Q000209:etiology*; D005260:Female; D006801:Humans; D008168:Lung / Q000528:radiation effects*; D058958:Organs at Risk; D011832:Radiation Injuries / Q000209:etiology; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects* / Q000379:methods; D012867:Skin / Q000528:radiation effects*
keywords: Breast cancer; Cardiac toxicity; Cutaneous toxicity; Pulmonary toxicity; Radiotherapy