BJMO - volume 18, issue 6, october 2024
I. Kindts MD, PhD, A. Baten MD, B. Bussels MD, A. De Caluwé MD, L. Donnay MD, L. Goethals MD, PhD, M. Machiels MD, PhD, V. Remouchamps MD, PhD, L. Veldeman MD, PhD, C. Weltens MD, PhD, P. Poortmans MD, PhD
Primary treatment of preference for a local or locoregional breast cancer is breast-conserving therapy (this is breast-conserving surgery followed by radiation therapy). When a breast cancer recurs, or in case of a second ipsilateral breast cancer, the optimal treatment strategy is less well defined than in the primary setting. Standard of care is salvage mastectomy. However, avoidance of mastectomy, if oncologically safe, has proven to be associated with improved patient satisfaction in terms of cosmetic outcome and quality of life apart from cost and resource implications for healthcare providers. With this manuscript, the Belgian Breast Group of the BeSTRO sets up some basic principles regarding repeat breast-conserving therapy awaiting international guidelines.
(BELG J MED ONCOL 2024;18(6):235-238)
Read moreBJMO - volume 17, issue 6, october 2023
M. Machiels MD, PhD, R. Oulkadi MD, T. Tramm MD, PhD, S.R. Stecklein MD, PhD, N. Somaiah MD, PhD, A. De Caluwé MD, J. Klein MD, PhD, W.T. Tran MD, PhD, R. Salgado MD, PhD
Radiation therapy (RT) has long been fundamental for the curative treatment of breast cancer. While substantial progress has been made in the anatomical and technological precision of RT delivery, and some approaches to de-escalate or omit RT based on clinic-pathologic features have been successful, there remain substantial opportunities to refine individualised RT based on tumour biology. A major area of clinical and research interest is to ascertain the individualised risk of loco-regional recurrence to direct treatment decisions regarding escalation and de-escalation of RT. Patient-tailored treatment with RT is considerably lagging behind compared with the massive progress made in the field of personalised medicine that currently mainly applies to decisions on the use of systemic therapy or targeted agents.
Herein we review select literature surrounding the use of tumour genomic biomarkers and biomarkers of the immune system, including tumour-infiltrating lymphocytes (TILs), within the management of breast cancer, specifically as they relate to progress in moving toward analytically validated and clinically tested biomarkers utilised in RT.
(Belg J Med Oncol 2023;17(6):216–29)
Read moreBJMO - volume 15, issue 2, march 2021
M. Machiels MD, PhD
On May 29th, 2020, M. Machiels defended her PhD thesis entitled ‘Optimising target volume definition and treatment accuracy in oesophageal cancer‘. The research was carried out at the Amsterdam UMC, location AMC under supervision of promotor prof. C.R.N. Rasch, MD, PhD, with dr. M.C.C.M. Hulshof, MD, PhD and Mrs. T. Alderliesten, PhD as co-promoters. Important findings are listed below. Full thesis is available at: http://hdl.handle.net/11245.1/2e692172-00cf-4565-b45c-04d1dffb951a.
(BELG J MED ONCOL 2021;15(2):83-6)
Read moreBJMO - volume 14, issue 4, june 2020
M. Machiels MD, PhD, D. Nevens MD, PhD, K. Erven MD, PhD, G. Buelens MD, C. Billiet MD, PhD, Y. Geussens MD, P. Janssens MD, S. Vanderkam MD, R. Weytjens MD
Whole-breast irradiation, as part of breast-conservation therapy (BCT), has been well-established the last decades. Nonetheless, most local recurrences found after BCT are within or close to the tumour bed. This led to the concept of partial breast irradiation (PBI), delivering the radiation dose to a decreased target volume, thereby lowering exposure to the organs at risk and hence potentially minimizing late adverse effects. This became increasingly important with growing survivorship of patients with early-stage breast cancer over the past decades and the consideration of late adverse effects is gaining more importance. In this review, we will present an overview of the current literature, techniques to deliver PBI and we try to establish whether there is a place for PBI in early-stage breast cancer treatment.
(BELG J MED ONCOL 2020;14(4):140–45)
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