Use of a Tumor Bed Boost in the Radiotherapy after Oncoplastic Breast Conserving Surgery

Use of a radiotherapy (RT) tumor bed boost in addition to whole breast irradiation (WBI) after oncoplastic breast conserving surgery (OBCS) can be very challenging due to the massive tissue displacements. The aim of our study is to present relevant RT data regarding the use of a boost RT in patients who underwent OBCS and received adjuvant RT at Neolife Medical Center Bucharest. Materials and Methods: 12 patients treated with intensity modulated radiotherapy (IMRT), after OBCS, using conventional or hypofractionated schedules, between 10/2018 and 12/2020 were included in the study. Pre- and postoperative CT images and surgical clips when available were used for tumor bed (TB) localization and definition of the boost volume. Results: One or more risk factors associated with local recurrence (age under 51 years, high grade tumors, associated ductal carcinoma in situ) were present in 10 patients. Boost RT was delivered in 3 patients. Conclusions: TB localization for the boost RT is difficult without an appropriate marking. Surgical clips and communication between the surgeon and the radiation oncologist are essential for treatment success.