TY - JOUR
T1 - American College of Radiology Appropriateness Criteria® on Conservative Surgery and Radiation
T2 - Stages I and II Breast Carcinoma
AU - White, Julia R.
AU - Halberg, Francine E.
AU - Rabinovitch, Rachel
AU - Green, Sheryl
AU - Haffty, Bruce G.
AU - Solin, Lawrence J.
AU - Strom, Eric A.
AU - Taylor, Marie E.
AU - Edge, Stephen B.
PY - 2008/6
Y1 - 2008/6
N2 - Background: During the past 2 decades, breast conservation therapy (BCT) has become firmly established as a standard therapeutic approach for eligible women with early-stage breast cancer. Breast radiation after conservative surgery is an integral component of BCT, resulting in comparable local control and equivalent survival to mastectomy. Successful breast conservation relies on understanding key elements for patient selection, evaluation, treatment contraindications, radiation therapy methods, and integration with systemic therapy. Methods: The Appropriateness Criteria Committee of the American College of Radiology convened an expert panel to examine BCT for early-stage breast cancer. By using a modified Delphi technique to generate consensus, the expert panel responded to questionnaires on 9 clinical cases that address various key elements of breast conservation. A literature review on BCT led to the generation of an evidence table to support the consensus and overview. Results: Consensus for appropriateness criteria for BCT was produced for various clinical scenarios commonly encountered in practice. These topics include radiation oncology management issues related to young patient age, sentinel node biopsy, elderly patients, other histology, positive margins, extensive intraductal component, node-positive breast cancer, genetic breast cancer, partial breast irradiation, and systemic therapy. Radiation methods for BCT are reviewed. Conclusion: The Breast Cancer Panel has generated a consensus of up-to-date guidelines for the appropriate use of radiation for BCT by using a modified Delphi process for the American College of Radiology Appropriateness Criteria.
AB - Background: During the past 2 decades, breast conservation therapy (BCT) has become firmly established as a standard therapeutic approach for eligible women with early-stage breast cancer. Breast radiation after conservative surgery is an integral component of BCT, resulting in comparable local control and equivalent survival to mastectomy. Successful breast conservation relies on understanding key elements for patient selection, evaluation, treatment contraindications, radiation therapy methods, and integration with systemic therapy. Methods: The Appropriateness Criteria Committee of the American College of Radiology convened an expert panel to examine BCT for early-stage breast cancer. By using a modified Delphi technique to generate consensus, the expert panel responded to questionnaires on 9 clinical cases that address various key elements of breast conservation. A literature review on BCT led to the generation of an evidence table to support the consensus and overview. Results: Consensus for appropriateness criteria for BCT was produced for various clinical scenarios commonly encountered in practice. These topics include radiation oncology management issues related to young patient age, sentinel node biopsy, elderly patients, other histology, positive margins, extensive intraductal component, node-positive breast cancer, genetic breast cancer, partial breast irradiation, and systemic therapy. Radiation methods for BCT are reviewed. Conclusion: The Breast Cancer Panel has generated a consensus of up-to-date guidelines for the appropriate use of radiation for BCT by using a modified Delphi process for the American College of Radiology Appropriateness Criteria.
KW - Appropriateness criteria
KW - breast conservation therapy
KW - breast radiation
KW - consensus guideline
KW - early-stage breast cancer
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U2 - 10.1016/j.jacr.2008.02.026
DO - 10.1016/j.jacr.2008.02.026
M3 - Review article
C2 - 18514949
AN - SCOPUS:44349157518
SN - 1546-1440
VL - 5
SP - 701
EP - 713
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 6
ER -