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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Impact of Axillary Lymph Node Dissection on Breast Skin Thickening During and After Radiotherapy for Breast Cancer</title><author><name sortKey="Torres, Mylin A" sort="Torres, Mylin A" uniqKey="Torres M" first="Mylin A." last="Torres">Mylin A. Torres</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Yang, Xiaofeng" sort="Yang, Xiaofeng" uniqKey="Yang X" first="Xiaofeng" last="Yang">Xiaofeng Yang</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Noreen, Samantha" sort="Noreen, Samantha" uniqKey="Noreen S" first="Samantha" last="Noreen">Samantha Noreen</name><affiliation><nlm:aff id="A3">Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Chen, Hao" sort="Chen, Hao" uniqKey="Chen H" first="Hao" last="Chen">Hao Chen</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A4">Provision Center for Proton Therapy, Knoxville, Tennessee, USA</nlm:aff></affiliation></author><author><name sortKey="Han, Tatiana" sort="Han, Tatiana" uniqKey="Han T" first="Tatiana" last="Han">Tatiana Han</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Henry, Simone" sort="Henry, Simone" uniqKey="Henry S" first="Simone" last="Henry">Simone Henry</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Mister, Donna" sort="Mister, Donna" uniqKey="Mister D" first="Donna" last="Mister">Donna Mister</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Andic, Fundagal" sort="Andic, Fundagal" uniqKey="Andic F" first="Fundagal" last="Andic">Fundagal Andic</name><affiliation><nlm:aff id="A5">Department of Radiation Oncology, Cukurova University School of Medicine, Adana, Turkey</nlm:aff></affiliation></author><author><name sortKey="Long, Qi" sort="Long, Qi" uniqKey="Long Q" first="Qi" last="Long">Qi Long</name><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Liu, Tian" sort="Liu, Tian" uniqKey="Liu T" first="Tian" last="Liu">Tian Liu</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27055397</idno><idno type="pmc">4973142</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973142</idno><idno type="RBID">PMC:4973142</idno><idno type="doi">10.1016/j.ijrobp.2016.01.030</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">003684</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003684</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Impact of Axillary Lymph Node Dissection on Breast Skin Thickening During and After Radiotherapy for Breast Cancer</title><author><name sortKey="Torres, Mylin A" sort="Torres, Mylin A" uniqKey="Torres M" first="Mylin A." last="Torres">Mylin A. Torres</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Yang, Xiaofeng" sort="Yang, Xiaofeng" uniqKey="Yang X" first="Xiaofeng" last="Yang">Xiaofeng Yang</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Noreen, Samantha" sort="Noreen, Samantha" uniqKey="Noreen S" first="Samantha" last="Noreen">Samantha Noreen</name><affiliation><nlm:aff id="A3">Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Chen, Hao" sort="Chen, Hao" uniqKey="Chen H" first="Hao" last="Chen">Hao Chen</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A4">Provision Center for Proton Therapy, Knoxville, Tennessee, USA</nlm:aff></affiliation></author><author><name sortKey="Han, Tatiana" sort="Han, Tatiana" uniqKey="Han T" first="Tatiana" last="Han">Tatiana Han</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Henry, Simone" sort="Henry, Simone" uniqKey="Henry S" first="Simone" last="Henry">Simone Henry</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Mister, Donna" sort="Mister, Donna" uniqKey="Mister D" first="Donna" last="Mister">Donna Mister</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Andic, Fundagal" sort="Andic, Fundagal" uniqKey="Andic F" first="Fundagal" last="Andic">Fundagal Andic</name><affiliation><nlm:aff id="A5">Department of Radiation Oncology, Cukurova University School of Medicine, Adana, Turkey</nlm:aff></affiliation></author><author><name sortKey="Long, Qi" sort="Long, Qi" uniqKey="Long Q" first="Qi" last="Long">Qi Long</name><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author><author><name sortKey="Liu, Tian" sort="Liu, Tian" uniqKey="Liu T" first="Tian" last="Liu">Tian Liu</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Winship Cancer Institute, Emory University, Atlanta, GA, USA</nlm:aff></affiliation></author></analytic><series><title level="j">International journal of radiation oncology, biology, physics</title><idno type="ISSN">0360-3016</idno><idno type="eISSN">1879-355X</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title><p id="P1">This prospective study was conducted to determine predictors of epidermal thickening during and after whole breast radiotherapy (XRT) using objective measurements acquired with ultrasound.</p></sec><sec id="S2"><title>Methods and Materials</title><p id="P2">Following breast conserving surgery, 70 women received a definitive course of whole breast XRT (50 Gy plus boost). Prior to XRT, at week 6 of XRT, and 6 weeks post XRT, subjects underwent objective ultrasound measurements of epidermal thickness over the lumpectomy cavity and all four quadrants of the treated breast. A skin thickness ratio (STRA) was then generated normalizing for corresponding measurements taken of the untreated breast.</p></sec><sec id="S3"><title>Results</title><p id="P3">Baseline measurements indicated that 87% of patients had skin thickening in the treated versus untreated breast (mean increase of 27%, SD of 0.29) prior to XRT. The STRA increased significantly by week 6 of XRT (mean 25% (SD .46) and continued to increase significantly 6 weeks post XRT (mean 33% (SD .46) above baseline measurements (p<0.001 for both timepoints). In multivariable analysis, breast volume (p=0.003) and surgical evaluation of the axilla with full lymph node dissection (p<0.05) predicted for more severe changes in STRA 6 weeks after XRT compared with baseline. STRA measurements correlated with physician ratings of skin toxicity according to RTOG grading criteria.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">This is one of the first studies to objectively document that lymph node surgery impacts XRT-induced skin thickening in breast cancer patients. Surgical evaluation of the axilla with a complete lymph node dissection was associated with the most severe XRT-induced skin changes following XRT completion. These results may inform future studies aimed at minimizing side effects of XRT and surgery, particularly when surgical lymph node assessments may not alter breast cancer management or outcome.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7603616</journal-id><journal-id journal-id-type="pubmed-jr-id">4036</journal-id><journal-id journal-id-type="nlm-ta">Int J Radiat Oncol Biol Phys</journal-id><journal-id journal-id-type="iso-abbrev">Int. J. Radiat. Oncol. Biol. Phys.</journal-id><journal-title-group><journal-title>International journal of radiation oncology, biology, physics</journal-title></journal-title-group><issn pub-type="ppub">0360-3016</issn><issn pub-type="epub">1879-355X</issn></journal-meta><article-meta><article-id pub-id-type="pmid">27055397</article-id><article-id pub-id-type="pmc">4973142</article-id><article-id pub-id-type="doi">10.1016/j.ijrobp.2016.01.030</article-id><article-id pub-id-type="manuscript">NIHMS776361</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>The Impact of Axillary Lymph Node Dissection on Breast Skin Thickening During and After Radiotherapy for Breast Cancer</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Torres</surname><given-names>Mylin A.</given-names></name><degrees>M.D.</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Yang</surname><given-names>Xiaofeng</given-names></name><degrees>Ph.D.</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Noreen</surname><given-names>Samantha</given-names></name><degrees>B.A.</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Chen</surname><given-names>Hao</given-names></name><degrees>Ph.D.</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Han</surname><given-names>Tatiana</given-names></name><degrees>B.A.</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Henry</surname><given-names>Simone</given-names></name><degrees>B.A.</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Mister</surname><given-names>Donna</given-names></name><degrees>B.A.</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Andic</surname><given-names>Fundagal</given-names></name><degrees>M.D.</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Long</surname><given-names>Qi</given-names></name><degrees>Ph.D.</degrees><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Liu</surname><given-names>Tian</given-names></name><degrees>Ph.D.</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA</aff><aff id="A2"><label>2</label>Winship Cancer Institute, Emory University, Atlanta, GA, USA</aff><aff id="A3"><label>3</label>Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA</aff><aff id="A4"><label>4</label>Provision Center for Proton Therapy, Knoxville, Tennessee, USA</aff><aff id="A5"><label>5</label>Department of Radiation Oncology, Cukurova University School of Medicine, Adana, Turkey</aff><author-notes><corresp id="FN1"><underline>Corresponding Author:</underline> Mylin A. Torres, MD, Emory University, Department of Radiation Oncology, 1365 Clifton Rd NE, Room 1307A, Atlanta, GA 30322. Telephone: (404) 778-3473; Fax: (404) 778-5520; <email>matorre@emory.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>27</day><month>4</month><year>2016</year></pub-date><pub-date pub-type="epub"><day>23</day><month>1</month><year>2016</year></pub-date><pub-date pub-type="ppub"><day>1</day><month>6</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>6</month><year>2017</year></pub-date><volume>95</volume><issue>2</issue><fpage>590</fpage><lpage>596</lpage><pmc-comment>elocation-id from pubmed: 10.1016/j.ijrobp.2016.01.030</pmc-comment>
<abstract><sec id="S1"><title>Purpose</title><p id="P1">This prospective study was conducted to determine predictors of epidermal thickening during and after whole breast radiotherapy (XRT) using objective measurements acquired with ultrasound.</p></sec><sec id="S2"><title>Methods and Materials</title><p id="P2">Following breast conserving surgery, 70 women received a definitive course of whole breast XRT (50 Gy plus boost). Prior to XRT, at week 6 of XRT, and 6 weeks post XRT, subjects underwent objective ultrasound measurements of epidermal thickness over the lumpectomy cavity and all four quadrants of the treated breast. A skin thickness ratio (STRA) was then generated normalizing for corresponding measurements taken of the untreated breast.</p></sec><sec id="S3"><title>Results</title><p id="P3">Baseline measurements indicated that 87% of patients had skin thickening in the treated versus untreated breast (mean increase of 27%, SD of 0.29) prior to XRT. The STRA increased significantly by week 6 of XRT (mean 25% (SD .46) and continued to increase significantly 6 weeks post XRT (mean 33% (SD .46) above baseline measurements (p<0.001 for both timepoints). In multivariable analysis, breast volume (p=0.003) and surgical evaluation of the axilla with full lymph node dissection (p<0.05) predicted for more severe changes in STRA 6 weeks after XRT compared with baseline. STRA measurements correlated with physician ratings of skin toxicity according to RTOG grading criteria.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">This is one of the first studies to objectively document that lymph node surgery impacts XRT-induced skin thickening in breast cancer patients. Surgical evaluation of the axilla with a complete lymph node dissection was associated with the most severe XRT-induced skin changes following XRT completion. These results may inform future studies aimed at minimizing side effects of XRT and surgery, particularly when surgical lymph node assessments may not alter breast cancer management or outcome.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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