Radiotherapy of the breast: Targeting physics and biology

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Radiotherapy of the breastTargeting physics and
biology

• J. Bernier MD, PDChairman, Department of
  Radio-OncologyOncology Institute of Southern
  SwitzerlandCH-6504 Bellinzona Switzerland

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Adjuvant local treatment will be influenced by -
shifts in management algorithms - further
developments in irradiation technology
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Early Breast Cancer
Partial vs Whole Breast Irradiation
Efficacy Quality of life Socio-economi
c aspects PBI Intra-operative
radiotherapy Peri-operative, high-dose rate
brachytherapy High-conformality external
radiotherapy WBI Intensity-modulated
radiotherapy (IMRT) Hadrontherapy
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The Post-Mastectomy Dillemma

• In patients at intermediate-risk
• (1-3 pathologically positive nodes)
• Priority to prospective studies allowing a
  determination of the real impact of
  local-regional irradiation on survival.

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Targeted Therapies

• Molecular signatures
• identification of patients with poor-prognosis
  tumors
• requiring more aggressive local treatments
  (high- dose/high-precision RT)
• Pathologic and bio-molecular features
• Addition of biological modifiers of tumor cell
  response to RT