EP-1185: Post-operative Irradiation after Nipple-Sparing or Skin-Sparing Mastectomy: An International Survey
Bibliographic record
Abstract
Purpose or ObjectiveThe risk of breast failure after breast-conserving treatment is two-fold higher in invasive carcinoma with positive surgical margins than in free margins, (between 12 and 34% at ten years) (1).A new resection is recommended, with risk of fair cosmetic result, or mastectomy.With close margin total dose should be higher to avoid local recurrence.Twenty years ago, we started with a high dose rate (HDR) boost after whole breast irradiation in cases with close or positive margin.We review the long-term outcome in these high risk cases Material and Methods Between 12.1996 and 12.2011, 248 patients were included, with a median age of 55 .Mean FU 127 months.By T stage 179 T1, 62 T2 and 6 T3.By margin status, 120 was positive, 76 close until 2mm, 52 close >2mm and <5mm.All of them were treated with whole breast irradiation (WBI) 50Gy plus HDR boost with 3 fractions of 4.4Gy to 85% isodose in two days, with rigid needles.The contour of CTV was decided by clinical assessment, no CT planning was used.Chemotherapy was used in 52%, and hormonal treatment in 76%.Survival was calculated by Kaplan Meyer method. ResultsIn the whole population, actuarial breast failure at 10 and 15 years was 6.5% and 11.6%.With positive margin: 6.8% and 14.8%, with close margin ≤2mm: 9.8% and 9.8%, with margin >2mm <5mm, 2% and 2%.By age, in 90 patients aged 50 or younger, was 11.9% and 17.8%, between 51-70, 3.8% and 8.2%, and no failures over 70.In young women under 50 with positive margin, breast recurrence was 13.1% and 24% at 10 and 15 years.By T stage, no differences between T1 and T2, no failures in T3.No differences if margin was due to invasive carcinoma or DCIS, in G3, or depending on hormonal receptors.Fibrosis or induration were registered in 26.7%, breast edema 6.5%, volume reduction 6.5%, telangiectasia 3.4%, hyperpigmentation 2.1%.Cosmetic outcome was excellent/good in 85.8%. ConclusionLong-term breast control of patients with positive or close surgical margin using WBI plus a HDR boost is similar to that achieved with free margins in the EORTC 22881-10882 trial, in all groups of age, but in young women with positive margin where a new resection is recommended.This approach is useful to avoid a second intervention, in women over 50 with positive surgical margin, or with close margins in all ages.(1) Guinot JL, et al.Breast-conservative surgery with close or positive margins: can the breast be preserved with highdose-rate brachytherapy boost?Int
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".