Omission of Axillary Dissection Following Nodal Downstaging With Neoadjuvant Chemotherapy.

Importance: Data on oncological outcomes after omission of axillary lymph node dissection (ALND) in patients with breast cancer that downstages from node positive to negative with neoadjuvant chemotherapy are sparse. Additionally, the best axillary surgical staging technique in this scenario is unknown.

Objective: To investigate oncological outcomes after sentinel lymph node biopsy (SLNB) with dual-tracer mapping or targeted axillary dissection (TAD), which combines SLNB with localization and retrieval of the clipped lymph node.

Proton Partial Breast Irradiation: Detailed Description of Acute Clinico-Radiologic Effects.

Accelerated partial breast irradiation (APBI) with protons results in a very different acute effect profile than standard whole breast irradiation. We reviewed our initial experience with proton APBI and felt that a detailed description of these effects were needed to permit a common tool to compare experience with this developing technology. Sixty sequential patients treated with proton APBI on a prospective protocol were evaluated and 43 patients with a minimum six-month follow-up underwent detailed photographic and radiologic analysis.

A 10-Year Experience with Mastectomy and Tissue Expander Placement to Facilitate Subsequent Radiation and Reconstruction.

Background: An integrated approach to skin sparing mastectomy with tissue expander placement followed by radiotherapy and delayed reconstruction was initiated in our institution in 2002. The purpose of this study was to assess the surgical outcomes of this strategy.

Methods: Between September 2002 and August 2013, a total of 384 reconstructions had a tissue expander placed at the time of mastectomy and subsequently underwent radiotherapy.

Proton partial breast irradiation in the supine position: Treatment description and reproducibility of a multibeam technique.

Purpose: Proton-accelerated partial breast irradiation (APBI) is early in its developmental phase without standardized treatment parameters. We report an approach to multibeam proton APBI using a universally available supine setup and deliberate beam arrangement strategy to limit the total area of skin receiving a full dose while being robust for interfraction variation.

Methods And Materials: Thirty-three American Society for Radiation Oncology consensus-suitable/cautionary APBI candidates were treated using a passively scattered proton beam between 2010 and 2014 to 34 Gy relative biological effectiveness in 10 fractions twice daily.

Radio-chemotherapy in anal cancer: Institutional experience at a large radiation oncology center in Chile.

Aim: In this article the aim is to provide a concise narrative review and inform the institutional experience at a referral center in Chile with the use of radio-chemotherapy in anal cancer.

Background: Cancer of the anus and anal canal is mainly a loco-regional disease. For years the standard of care has been concomitant radio-chemotherapy, which permits organ preservation and better local control than alternative surgical procedures.