Radiotherapy for Breast cancer

Radiation oncologist Lasha Goginashvili

 Anatomy

https://www.sciencephoto.com/media/1137057/view/breast-lymph-nodes-illustration
 Statistics

In 2020 2.3 million women diagnosed with breast cancer and

685 000 deaths globally.

https://www.who.int/news-room/fact-sheets/detail/breast-cancer
 Statistics

Perez and Brady`s Principles and Practice of Radiation Oncology) 7th Edition. pg 3966
 Who is at risk?
• Age,
• Gander (Female > male). Approximately 0.5 -1 % of male have BC.
• Obesity
• Harmful use of alcohol
• Childbearing/Parity/Breast-Feeding
• Family history of breast cancer
• History of radiation exposure
• Reproductive history (early menarche and late menopause)
• Tobacco use
• Postmenopausal hormone therapy.
https://www.who.int/news-room/fact-sheets/detail/breast-cancer
 Genetics

BRCA1 BRCA2
• P53
• BRCA1
• BRCA2

Breast Colon and prostate Breast Ovarian

Perez and Brady`s Principles and Practice of Radiation Oncology) 7th Edition. pg 3976 - 3979
 Screening
Age 40 - 70 females

• Consultation of mammologist

• Mammography

• In the case of pathology: Ultrasonography, mass biopsy and

cytology.
 Imaging
Local Spread

• Mammography • CT

• Ultrasonography • Bone scintigraphy

• MRI • PET/CT
 Staging

TNM

Tumor Node Metastasis

 Staging

Clinical staging - is an estimate of the extent of the cancer based on results

of physical exams, imaging tests

Pathological staging - is based on histological examination of tissue

specimens obtained with the aid of biopsy or surgery. It combines the results of
both the clinical staging with the surgical results.
 Staging

American Joint Committee on Cáncer •2017 pg 600 - 602

 Staging

American Joint Committee on Cáncer •2017 pg 600 - 602

 Staging

American Joint Committee on Cáncer •2017 pg 600 - 602

American Joint Committee on Cáncer •2017 pg 600 - 602
 Treatment

• Surgery

• Chemotherapy

• Radiation therapy

Combination
 Treatment

Surgery

• Radical mastectomy

• Radical resection - Breast Conservative Surgery (since 1990)

 Treatment
Neoadjuvant or adjuvant Systemic treatment

• Chemotherapy

• Hormonal therapy

• Immunotherapy
 Treatment
Radiotherapy

• Post-operative

• Radical - rarely
Simulation
Conturing
Conturing
Conturing
Planning
Planning
Deep inspiration breath hold (DIBH)

25
source : National Centre of surgery