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Thirdly how to optimally integrate all treatment aspects including locoregional ones and systemic ones. Based on all this, we can develop and then provide the patients with shared decision making tools.
This entry was posted in Author Interviews, Breast Cancer, NEJM, Radiation Therapy and tagged breast cancer, radiation by Marie Benz MD FAAD. In Belgium the product is sold under the name "Rilatine" and in Brazil and Portugal as "Ritalina".
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Learn directly from medical researchers published in major and specialty medical journals and health care meetings.
Poortmans: Based on the former hypothesis that breast cancer sequentially spreads from breast to lymph nodes and from there to distant organs, up to the eighties it was very custom to perform extended radical surgery and to irradiate extensively locoregional for most patients. Poortmans: We found a decreased risk for development of distant metastases of 3% at 10 years, translated in a 3% overall improved overall disease free survival.
This can be explained by the fact that once distant metastases are found, no further search for local (breast) or regional (lymph nodes) recurrences is performed any more, as this is not relevant anymore for treatment or prognosis. The explanation lies simply in the fact that even after development of distant metastases, patients can live for quite some more years with, however, only very little chance for definitive cure.
Thereby, it becomes more of a challenge to demonstrate benefits of further improving treatment as the same relative improvement will be translated into a lower absolute improvement. While you may freely discuss your troubles, you should not look to the Website for information or advice on such topics. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition.
With the growing interest in systemic treatments to prevent development (= from already present undetectable cancer cells to really visible and threatening metastases) of distant metastases, new information about possible late side effects and our increasing knowledge about the biological behaviour of breast cancer in the eighties and the nineties, the extend of especially locoregional treatment was gradually reduced. However, the spread of distant metastases might occur from cancer involvement of the lymph nodes, explaining why we saw the effect of the lymph node irradiation basically only on the rate of development of distant metastases. Nevertheless, by more effectively preventing the development of distant metastases by improved systemic therapy (or even better by earlier detection with a lower basal rate of distant metastases) the importance of optimizing locoregional control becomes even higher.

In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. For radiation therapy, often the irradiation of the internal mammary lymph nodes was left aside, as this was linked to the delivery of radiation dose to the heart, possibly or probably leading to late side effects.
On the other hand, breast cancer related mortality is significantly improved and we did not see an increase in non breast cancer related causes of death. At the start of the study, about half of the radiation oncology departments did include irradiation of the internal mammary lymph nodes in patients with risk factors, while the other half did not. Overall toxicity was limited with only a significant increase in pulmonary toxicity, however to a low grade in the big majority of those patients.
With Propionate, androgenic side effects seem somewhat less pronounced than with the other Testosterones, probably due to the fact that blood levels do not build up as high. Hereby we had an ideal base for the investigation of the value of treating the non-operated part of the regional lymph nodes. The benefit in overall survival is in a similar order of magnitude than adding for example taxanes to anthracycline-based adjuvant chemotherapy for a similar patient population as ours.

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