a "muance" to consider if contemplating APBI (accelerated partial breast irradiation)

[Lani]

it is important to consider that if the tumor bed is medial (toward the midline of the body rather than towards the armpit) that there might not be (so much of or even an) advantage with regards to how much radiation the lungs and/or heart are exposed to


5 November 2007

Partial breast irradiation exposes normal tissue

MedWire News: Women who undergo partial breast irradiation (PBI) for breast cancer may receive as much exposure to the heart and lungs as those who receive standard whole breast irradiation (WBI), say US researchers.

But PBI, compared with WBI, can spare significant cardiac tissue in patients with lateralized tumor beds, the researchers note.

"We suspect there are fundamental differences in the amount of exposure to radiation a patient has using these techniques, but no one has ever looked at how much normal tissue is spared," said Laura Vallow (Mayo Clinic, Jacksonville, Florida) at the recent 2007 meeting of The American Society for Therapeutic Radiology and Oncology in Los Angeles, USA.

She added: "We are interested in the finer points of treatment planning, with the ultimate goal of making treatment more tolerable with less radiation exposure."

In the first phase of the study, the researchers enrolled 25 women with early stage breast cancer and devised computer generated radiotherapy plans for WBI and 3-D conformal PBI.

As reported at the meeting the volumes of the ipsilateral lung receiving 2.36, 4.60, 8.80, and 16.40 Gy doses were 29.7, 21.9, 12.0, and 5.8%, respectively, in PBI plans and 26.5, 17.8, 12.2, and 8.2%, respectively, in WBI plans.

"Patients are getting more exposure overall to their lungs with partial breast irradiation but less lung tissue is irradiated to higher doses compared to whole breast irradiation," Vallow summarises.

In the second phase of the study, the researchers enrolled 14 women who had undergone lumpectomy in their left breast and calculated radiation to normal heart tissue.

They found that PBI and WBI delivered about the same amount of radiation to the heart of women whose tumors were located in the middle of the breast. In women whose tumors were closer to the armpit, however, PBI spared most of the heart tissue, exposing just 2.4% at 2.5 Gy, compared with 13.5% for WBI at the same dose.

"The hope is that a short course of radiotherapy will be as effective as the much longer course, and that this could lead to increased use of breast conservation over mastectomy," Vallow said.

Vallow et al claim that by calculating these "nuances of tissue exposure" they can improve the effectiveness of PBI, which could lead to an increase in conservative treatment.

"Many women may be opting for a mastectomy instead of a lumpectomy in order to avoid weeks and weeks of radiation treatment," Vallow says.

"If the results of both methods are equivalent, then perhaps some of these women will choose less drastic surgery."



49th annual meeting of The American Society for Therapeutic Radiology and Oncology; Los Angeles, USA: 28 October - 1 November 2007

http://www.redjournal.org/

[Lani]

perhaps "muance" is a new noise made by Chinese hamsters while lactating!

[Andrea Barnett Budin]

I was going to look up the word muance, as it was in quotes and seemed so authoritative! Thanks Lani for saving me the trouble...

I must ask. I can't contain myself any longer. I have been reading your posts for over a year, always w/great interest. They are informative and thought-provoking always... And there are nearly 1700 of them!

However, I see you do not have a SIGNATURE or a PROFILE, Lani. I don't even know if you are a female, or if you have bc, let alone HER2+ gene. I would have PMd you, but neither that or sending an email are an option for under your member name. Would you be willing to share w/your Sisters and Brothers a bit of who you are, as we all do?

You have great medical understanding that's for sure. Is it through personal experience? Please forgive my being so forward as to ask these questions. As I said, I would have done it privately if I could have, but this is the only way to contact you. I would guess others would be interested in knowing more about our Lani cohort...
Andi

[Lani]

and you open up a can of worms.

I wish to remain incognito. I have my (very good) reasons and they are personal.

My wishing to remain anonymous does not impact the quality(for what it's worth and I hope that is considerable)/quantity(more than 1700 posts as an unconscionable(sp?)number of my posts were lost in the hacking of this site) of my input.

I hold no expertise in the area ; the breadth, extent of my reading, however, are evident.

Does not knowing the personal history of a long-dead painter, sculptor, author or composer keep you from being able to access, gain benefit from their work?

Rather than works of art I produce information (or as I call it ammunition and sources of hope).

I enjoy so much the articles posted by hopeful, RhondaH, et al as their joy in finding new "ammunition" is almost palpable in their postings, as well as their generosity/enjoyment involved in the posting.
I genuinely sing their praises.

The phantom "propellerhead" (TOM'S TERM FOR ME) poster

[SoCalGal]

Hi Lani,
I am also very curious like Andi. I figure that you have your reasons...I must admit that while reading Andi's message to you, I realized that I've invented a "Lani" in my mind - I picture this person whenever I read your posts. Maybe another time I'll describe the person I imagine. Right now, I'm sounding crazier than I intended. lol.

Thanks for all that you do - it means the world to so many of us. You have helped me many times. I hope someday to know more about you!
xo Flori

[Andrea Barnett Budin]

Okay Lani, I respect your need to live in camouflage. But please don't shy away from humor. It is very healing. And brings such joy to others!

I chose to pose my long held question to you when you were in a good mood, hoping for the best opportunity to make contact w/the real you.

Please keep on posting. Keep on arming us. And keep on laughing w/us. When you are ready, please take your disguise off (as per your incognito comment).

The more we learn abut one another, the closer w/all feel. Surely many of us have revealed intimate details of not only our medical history but private feelings and the scars that came both w/them and because of our experience. We each learn much from one anothers sharing. We grow. We feel validated. We feel supported. And armed in different and empowering ways... We are a family, I feel. I have genuine affection for those who join me on this board.

With all due respect and an ongoing desire to know the source of the accumulation of so much medical awareness...

Like Flori, we each have our vision of what Lani looks like and hold a fantasy of what Lani is all about ... You know me -- I'm all out there, open, honest and reaching out...
Andi