Reevaluation of Postradiotherapy Seroma Changes in Locally Advanced Breast Cancer

While the use of high effective doses may clearly contribute to improved local control outcomes, adverse effects of irradiation should also be considered to maintain patient's quality of life.In the millennium era, there have been several advances in technology which improved the delivery of irradiation.Molecular imaging methods, automatic segmentation techniques, Image Guided RT (IGRT), Intensity Modulated RT (IMRT), stereotactic RT, and adaptive RT (ART) have been introduced for facilitating optimal radiotherapeutic management of patients .Admittedly, best therapeutic results could be obtained through close collaboration among related disciplines for cancer management.Tumor boards bring together surgical oncologists, radiation oncologists, medical oncologists, imaging, and other relevant specialists to discuss about patient, tumor, and treatment characteristics to find out the management strategy for individualized optimal management.From the standpoint of radiation oncology, optimal target volume determination and normal tissue sparing are among the critical considerations for optimal radiotherapeutic management.While definition of larger target volumes may result in excessive radiation induced toxicity, determination of smaller treatment volumes may eventually lead to treatment failure.Within this context, efforts to improve target definition may translate into improved radiotherapeutic results AbstractObjective: In this study, we evaluated posttreatment volume changes for locally advanced breast cancer.Materials and methods: Primary goal of this study has been to evaluate volume change of seroma for locally advanced breast cancer.We have carried out a comparative analysis of treatment volume changes by CT simulation images with integration of MRI.While we primarily focused on evaluation of incorporated multimodality imaging for treatment volume determination, we also assessed critical organ contouring along with interobserver and intraobserver variations.Ground truth target volume has been utilized for comparative analysis, and it was determined by board certified radiation oncologists after detailed evaluation of all imaging and relevant data with thorough colleague peer review and consensus.Results: Seroma target volume was used as the reference for comparative evaluation, and 20% decreasing in seroma was revealed after radiotherapy with the use of MRI in our selected group of patients with locally advanced breast cancer.Conclusion: Multimodality imaging may be suggested to improve seroma target changes in patients with locally advanced breast cancer despite the need for further supporting evidence.