Our Summary

This study examines a new approach to radiation therapy for breast cancer patients. Normally, after a patient has had breast-conserving surgery, they will undergo radiation therapy using electrons, which is applied to the area where the tumor was removed. However, this method can’t be optimized to protect organs that are near the treatment area, and may not effectively cover the entirety of the area that needs treatment.

The researchers studied a method called modulated electron bolus (MEB), which is a kind of material that can be placed over the skin to help shape the radiation beam, making it more precise. They used a 3D-printed version of this material, and compared the results to traditional methods of radiation therapy.

The study was carried out with 27 patients who had left-sided breast cancer. The researchers created three plans for each patient - one using a traditional approach, one using electrons without the bolus, and one using MEB. They then compared how these different plans affected the organs near the treatment area (the left lung, heart, left anterior descending artery and ribs), and how well they covered the area that needed treatment.

The results showed that using MEB significantly reduced the amount of radiation received by the nearby organs, and it improved the coverage of the treatment area by 14.3%. The dose to the heart and left lung was reduced, while the maximum dose to the left anterior descending artery and the ribs decreased by 6.2% and 4.5% respectively.

In simple terms, the study suggests that MEB, which can be made with a 3D printer, is a better option for radiation therapy after breast-conserving surgery as it protects nearby organs from unnecessary radiation and improves the precision of the treatment.

FAQs

  1. What is the purpose of using a modulated electron bolus (MEB) in radiotherapy for breast cancer patients?
  2. How does the use of MEB affect the radiation dose to organs-at-risk and the conformity of planning target volume (PTV)?
  3. Can 3D printing be used in the creation of a modulated electron bolus?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumpectomy is to follow up with radiation therapy, as it can help reduce the risk of cancer recurrence. Radiation therapy with modulated electron bolus (MEB) may be used to improve treatment outcomes and reduce radiation dose to nearby organs. By using MEB, patients may experience better conformity of treatment volume and lower doses to critical structures such as the lungs, heart, and ribs. Be sure to discuss all treatment options with your healthcare team to determine the best approach for your individual case.

Suitable For

Patients who are typically recommended lumpectomy include those with early-stage breast cancer, small tumors, and those who wish to preserve as much of their breast tissue as possible. Lumpectomy is often considered for patients who have a tumor that is easily removable and has not spread to other parts of the body. It is also recommended for patients who are not good candidates for mastectomy or who prefer breast-conserving surgery. Additionally, patients who have a strong desire to maintain the appearance of their breast may also be recommended lumpectomy.

Timeline

Before lumpectomy:

  • Patient undergoes diagnostic imaging (e.g. mammogram, ultrasound, MRI) to determine the size and location of the tumor
  • Patient may undergo a biopsy to confirm the presence of cancer
  • Treatment options are discussed with the patient, including lumpectomy
  • Pre-operative appointments and tests are scheduled, including blood work and possibly a chest x-ray
  • Patient may meet with a radiation oncologist to discuss post-operative radiotherapy options

After lumpectomy:

  • Patient is monitored closely for any signs of complications following surgery
  • Pathology report is reviewed to determine if the entire tumor was removed and if any further treatment is needed
  • If post-operative radiotherapy is recommended, a treatment plan is created
  • Patient undergoes radiotherapy treatment, which may include modulated electron bolus to improve PTV conformity and reduce dose to adjacent OARs
  • Follow-up appointments are scheduled to monitor the patient’s recovery and overall health
  • Patient may undergo regular imaging scans and blood tests to check for any signs of cancer recurrence.

What to Ask Your Doctor

  1. What is a lumpectomy and why is it being recommended for me?
  2. What are the potential risks and benefits of undergoing a lumpectomy?
  3. How should I prepare for the lumpectomy procedure?
  4. What can I expect during the recovery period after the lumpectomy?
  5. Will I need any additional treatments, such as radiation therapy, after the lumpectomy?
  6. What are the potential long-term effects or complications of a lumpectomy?
  7. How often will I need follow-up appointments or screenings after the lumpectomy?
  8. Are there any lifestyle changes or precautions I should take after the lumpectomy?
  9. How will the lumpectomy affect the appearance and function of my breast?
  10. Are there any alternative treatment options to consider instead of a lumpectomy?

Reference

Authors: Lee VWY, Liu ACH, Cheng KW, Chiang CL, Lee VH. Journal: Med Dosim. 2023 Spring;48(1):37-43. doi: 10.1016/j.meddos.2022.10.001. Epub 2022 Nov 3. PMID: 36336582