Physicians Give a Boost to the Strength of Oncoplastic Surgery and Radiation Therapy

BARRIE, ON - When treating patients with localized breast cancer, RVH Oncologic and Reconstructive Breast Surgeon, Dr. Renee Hanrahan, and RVH Radiation Oncologist, Dr. Adam Gladwish, routinely consider multi-disciplinary approaches, often combining surgical and radiation treatments to the mutual goal of providing the best possible outcome for their patients.

In 2021, RVH treated and cared for 1,450 newly diagnosed breast cancer patients. Breast cancer treatment continues to be unique and individualized to each patient’s diagnosis, often requiring additional considerations and consultation between both surgical and radiation oncology specialties for planning of each cancer treatment plan.

For women who are diagnosed with localized breast cancer, surgery in the form of a lumpectomy or oncoplastic partial mastectomy (OPM) combined with adjuvant whole breast radiation therapy is the standard of care. Boost radiotherapy (BRT) may also be offered as an additional treatment option after surgery, with the intent of reducing the risk of future breast tumour recurrence in patients with high risk features. 

While OPM is increasingly becoming utilized for its favorable oncologic and aesthetic outcomes, this technique leads to additional breast tissue rearrangement, which can have an impact on target definition for BRT. 

Both surgeons and oncologists, alike, have found that there remain unanswered questions as to whether there is a greater propensity to omit BRT as a result of surgical technique, presumably because there is concern regarding accurate target localization for patients. Answering this question has become an important topic, particularly as more women choose OPM as a means to improve surgical outcomes. 

Given the lack of research investigating the relationship between OPM and BRT, Drs. Hanrahan and Gladwish worked together to develop a study in which they comprehensively reviewed the average treatment effect of surgery type on reception of BRT, as well as treatment delays, tumour recurrence, and BRT targeting.
 
The study found that performing lumpectomy or OPM was not associated with differences in the proportion of patients receiving BRT; in fact, the findings suggested that BRT treatment was based on tumor features. In addition, there were no significant differences in time to adjuvant radiotherapy and radiation oncologists did not alter BRT volumes in the context of OPM.

Drs. Hanrahan and Gladwish recently published their findings in the November 2021 edition of the medical journal Cureus, helping guide their colleagues and patients towards the best possible multidisciplinary care outcomes.