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Overview on cardiac, pulmonary and cutaneous toxicity in patients treated with adjuvant radiotherapy for breast cancer

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Abstract

Conservative management of breast cancer represents the standard treatment for early disease. Breast conserving surgery associated with radiotherapy for stage I-II has been proven to be as equally effective as mastectomy in term of local control, distant disease, and overall survival. The growing minimal invasive surgical approach on the axillary region, and the new breast reconstructive techniques, will probably lead to a significant decrease of the rate of side-effects related to mastectomy. Therefore, the adverse events caused by adjuvant radiation still remain a challenge. Cutaneous, pulmonary and cardiac toxicity represent the main toxicities of adjuvant radiotherapy for breast cancer. Safety profile of radiation is strongly dependent on the multidisciplinary management of the single case (systemic treatment, endocrine therapy, surgery), individual characteristics (i.e., co-morbidities, age, habits), and radiation-related aspects. Radiation techniques development, and facilities implementation concerning organs-at-risk sparing systems (i.e., image-guided radiotherapy, tracking systems, respiratory gating), represent brand new tools for the clinical oncologist, that would certainly minimize toxicity profile in the next future. However, data reported from published literature will greatly help physicians, to give to the patients appropriate counseling regarding the efficacy and potential adverse events of treatments, thus optimizing the informed decision-making process.

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Acknowledgments

This review work got inspired from the Breast Working Party Workshop “Radiotherapy related-toxicity in early breast cancer” presented by the authors during the 23rd National Congress of the “Italian Association of Radiation Oncology” (AIRO), Taormina, October 2013. We also like to thank Ilaria Francesca Furfaro, Tatiana Masoni, and Cinzia Ciabatti (Radiation Oncology Unit, University of Florence, Florence, Italy), involved in the initial paper’s structuring.

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Authors and Affiliations

  1. Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Largo G. A. Brambilla 3, 50134, Florence, Italy

    Icro Meattini, Fiammetta Meacci & Lorenzo Livi

  2. UOC Oncologia Radioterapica, IRCC Azienda Ospedaliero-Universitaria San Martino IST, Genoa, Italy

    Marina Guenzi

  3. Unità di Radioterapia, ULSS 12 Veneziana, Mestre, Italy

    Alessandra Fozza

  4. Radiation Oncology Department, University Hospital of Trieste, Trieste, Italy

    Cristiana Vidali

  5. Radiotherapy Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Turin, Italy

    Paolo Rovea

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  1. Icro Meattini
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  2. Marina Guenzi
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Correspondence to Icro Meattini.

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Meattini, I., Guenzi, M., Fozza, A. et al. Overview on cardiac, pulmonary and cutaneous toxicity in patients treated with adjuvant radiotherapy for breast cancer. Breast Cancer 24, 52–62 (2017). https://doi.org/10.1007/s12282-016-0694-3

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