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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 8/2015

Open Access 01-08-2015 | Original Article

DEGRO practical guidelines for radiotherapy of breast cancer V

Therapy for locally advanced and inflammatory breast cancer, as well as local therapy in cases with synchronous distant metastases

Authors: Prof. Dr. med. Wilfried Budach, Christiane Matuschek, Edwin Bölke, Jürgen Dunst, Petra Feyer, Rainer Fietkau, Wulf Haase, Wolfgang Harms, Marc D. Piroth, Marie-Luise Sautter-Bihl, Felix Sedlmayer, Rainer Souchon, Frederick Wenz, Rolf Sauer, Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO)

Published in: Strahlentherapie und Onkologie | Issue 8/2015

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Abstract

Aim

The purpose of this work is to give practical guidelines for radiotherapy of locally advanced, inflammatory and metastatic breast cancer at first presentation.

Methods

A comprehensive survey of the literature using the search phrases “locally advanced breast cancer”, “inflammatory breast cancer”, “breast cancer and synchronous metastases”, “de novo stage IV and breast cancer”, and “metastatic breast cancer” and “at first presentation” restricted to “clinical trials”, “randomized trials”, “meta-analysis”, “systematic review”, and “guideline” was performed and supplemented by using references of the respective publications. Based on the German interdisciplinary S3 guidelines, updated in 2012, this publication addresses indications, sequence to other therapies, target volumes, dose, and fractionation of radiotherapy.

Results

International and national guidelines are in agreement that locally advanced, at least if regarded primarily unresectable and inflammatory breast cancer should receive neoadjuvant systemic therapy first, followed by surgery and radiotherapy. If surgery is not amenable after systemic therapy, radiotherapy is the treatment of choice followed by surgery, if possible. Surgery and radiotherapy should be administered independent of response to neoadjuvant systemic treatment. In patients with a de novo diagnosis of breast cancer with synchronous distant metastases, surgery and radiotherapy result in considerably better locoregional tumor control. An improvement in survival has not been consistently proven, but may exist in subgroups of patients.

Conclusion

Radiotherapy is an important part in the treatment of locally advanced and inflammatory breast cancer that should be given to all patients regardless to the intensity and effect of neoadjuvant systemic treatment and the extent of surgery. Locoregional radiotherapy in patients with primarily distant metastatic disease should be prescribed on an individual basis.
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Metadata
Title
DEGRO practical guidelines for radiotherapy of breast cancer V
Therapy for locally advanced and inflammatory breast cancer, as well as local therapy in cases with synchronous distant metastases
Authors
Prof. Dr. med. Wilfried Budach
Christiane Matuschek
Edwin Bölke
Jürgen Dunst
Petra Feyer
Rainer Fietkau
Wulf Haase
Wolfgang Harms
Marc D. Piroth
Marie-Luise Sautter-Bihl
Felix Sedlmayer
Rainer Souchon
Frederick Wenz
Rolf Sauer
Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO)
Publication date
01-08-2015
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 8/2015
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-015-0843-1

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