Abstract
While adjuvant treatments of early breast cancers (BCs) had significantly improved patients’ overall survival, some of them will still develop locoregional relapses and/or severe late radio-induced toxicities. Here, we propose to review how to personalize locoregional treatment by identifying patients at high and low risk of locoregional relapse, patients at risk of late radio-induced side effects. We will, therefore, discuss how to enhance BC radiosensitivity. Finally, we will address how personalized radiotherapy could be implemented in prospective clinical trials.
Highlights
In France, incidence of early breast cancer (BC) is 54,062 in 2015
Those results are consistent with others reported in the literature such as Braunstein and colleagues’ study [7]: among 2,233 BC patients treated from 1998 to 2007, a total of 69 local relapse were observed with a median follow-up of 106 months
postmastectomy radiotherapy (PMRT) significantly decreased locoregional relapses (LRR) risk in both clinical trials with a hazard ratio (HR) at 0.35 in the British Columbia and HR at 0.30 in the Danish Breast Cancer Group (DBCG)-82b trials, respectively
Summary
In France, incidence of early breast cancer (BC) is 54,062 in 2015 (data from FRANCIM, French network of cancer registries). Adjuvant treatments of early stage BC had significantly improved patients’ overall survival (OS) over time. In the last two decades, biological tumor analysis permitted to classify BC prognostic outcomes according to molecular classification: luminal (positive estrogen and/or progesterone receptors—ER/PgR), triple negative (negative ER/PgR/negative Her2), and Her overexpression phenotypes (positive Her2) [1, 2]. Since the introduction of BC molecular classification, systemic therapies are tailored according to BC heterogeneity (biomarkers as ER/PgR, Her, Ki67) and aggressiveness (histological subtypes, histological grade, and tumor stage). Different methods have been developed to help clinicians in BC management as prognostic tools We propose to review which BC population would be at high risk of locoregional relapse, the trends of radiosensitization in BC, and how to identify patients at risk of late radio-induced side effects
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