Breast (Apr 2025)
The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy
- Meritxell Arenas,
- Yasemin Bölükbaşı,
- Liesbeth J. Boersma,
- Birgitte Offersen,
- Vassilis Kouloulias,
- Isabella Palumbo,
- Lurdes Trigo,
- Laura Lozza,
- Fabio Marazzi,
- Marco Trovo,
- Sofia Rivera,
- Orit Kaidar-Person,
- Charlotte Coles,
- Icro Meattini,
- Vincenzo Valentini,
- Cynthia Aristei,
- Philip Poortmans,
- Simona Borghesi,
- Antonella Ciabattoni,
- Pierfrancesco Franco,
- Marco Krengli,
- David Krug,
- Maria Cristina Leonardi,
- Valeria Masiello,
- Angel Montero Luis,
- Valerio Nardone,
- Sara Pedretti,
- Elisabetta Perrucci,
- Ivica Ratosa,
- Trine Tramm
Affiliations
- Meritxell Arenas
- Radiation Oncology Department, Hospital Universitari Sant Joan de Reus, Faculty of Medicine, University of Rovira i Virgili, Spain; Corresponding author. Radiation Oncology Department, Hospital Universitari Sant Joan de Reus, Faculty of Medicine, University of Rovira i Virgili, Avda Josep laporte, sn, 43200, Reus, Spain.
- Yasemin Bölükbaşı
- Faculty of Medicine, University of Koc Radiation Oncology Department, Türkiye
- Liesbeth J. Boersma
- Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Birgitte Offersen
- Department of Experimental Clinical Oncology, Department of Oncology, Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
- Vassilis Kouloulias
- Department of Clinical Radiation Oncology, National and Kapodistrian University of Athens, ATTIKON University Hospital, Greece
- Isabella Palumbo
- Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia and Perugia General Hospital, Perugia, Italy
- Lurdes Trigo
- Department of Brachytherapy, Instituto Português de Oncologia do Porto Francisco Gentil, E.P.E, Portugal
- Laura Lozza
- Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumouri, Milan, Italy
- Fabio Marazzi
- Radiation Oncology, Fondazione Policlinico Gemelli IRCCS, Roma, Italy
- Marco Trovo
- Department of Radiation Oncology, Azienda Sanitaria Universitaria Integrata UD, Udine, Italy
- Sofia Rivera
- Gustave Roussy, Radiotherapy Departement, Paris-Saclay University, F-94805, VILLEJUIF France
- Orit Kaidar-Person
- Sheba Medical Center, Ramat Gan, Israel; Tel Aviv University, Tel Aviv, Israel
- Charlotte Coles
- Department of Oncology, University of Cambridge, UK
- Icro Meattini
- Department of Experimental and Clinical Biomedical Sciences M Serio, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
- Vincenzo Valentini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Universit'a Cattolica del Sacro Cuore e Fondazione Policlinico Gemelli IRCSS Roma, Italy
- Cynthia Aristei
- Section of Radiation Therapy, University of Perugia and Perugia General Hospital, Italy
- Philip Poortmans
- Department of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk, Antwerp, Belgium
- Simona Borghesi
- Antonella Ciabattoni
- Pierfrancesco Franco
- Marco Krengli
- David Krug
- Maria Cristina Leonardi
- Valeria Masiello
- Angel Montero Luis
- Valerio Nardone
- Sara Pedretti
- Elisabetta Perrucci
- Ivica Ratosa
- Trine Tramm
- Journal volume & issue
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Vol. 80
p. 103881
Abstract
At the Fifth Assisi Think Tank Meeting (ATTM) on breast cancer, one key topic was the role of tumor bed boost in invasive breast cancer and ductal carcinoma in situ. The need for a tumor bed boost after whole breast irradiation is controversial. A literature review assessed boost indications, target volume definition, techniques, dose fractionation, and ongoing trials. Findings indicated that while a boost halves the risk of local recurrence at 10 years, it also leads to worsened cosmetic outcomes and increased fibrosis without improving overall survival. Therefore, we would recommend to omit the boost if the estimated reduction in local recurrence at 10 years is less than 3 %, and to apply shared decision-making with patients, if the boost is expected to reduce the local recurrence rate with >3 % at 10 years. Future research will focus on identifying patient subgroups that can safely omit the boost and improving boost volume precision.
