Summary: This article reviews the current status, indication (risk factors for local recurrences), technical aspects, and controversies of boost irradiation to the tumor bed following breast conserving surgery (BCS). BCS and radiotherapy (RT) are early invasive breast cancer treatment methods widely accepted in the last decades. The standard technique of RT after BCS is represented by external beam radiotherapy (EBRT) via tangential fields up to a total dose of 45 to 50 Gy.
Generally accepted criteria for identification of high risk subgroups, in which irradiation boost is recommended, are still being discussed, as are the optimal boost technique and its impact on local tumor control and cosmetic outcome of the treatment. Although the two most frequent boost techniques (electron vs. brachytherapy) provide reduction of local relapse rate, whereas the electron boost provides for better cosmesis. However, these differences performed by experienced personnel at a technically well-equipped workplace are crucial.
Even though guidelines in these topics are being established based on the results of retrospective and recently published prospective trials, some aspects of boost irradiation still remain controversial. The final results of prospective boost trials results with recently developed boost techniques - intraoperative RT (IORT), CT-image based 3D conformal the influence of these methods on local tumor control in breast cancer patients with conservative surgery and RT.
The Role of interstitial HDR brachytherapy boost in the treatment of early breast cancer.
