Breast board Posiboard-2 The Posiboard-2 breast board is a complete solution for the positioning of breast patients. It is made of a low density foam core covered with an ultra thin layer of carbon fiber. This allows the beam to transfer the Posiboard-2 from any angle with minimal attenuation. For arm positioning, several comfortable and adjustable supports are available. To prevent the patient from sliding down, an adjustable bottom stop is integrated. The Posiboard-2 is compact , lightweight and can be positioned on any couch top with the aid of specifically designed couch top fixation pieces. For additional support, a breast mask can be mounted using a quick release system. When the Posiboard-2 is not in use, it is hung on the wall with the supplied wall mount plate. SINMED BV Posiboard-2
Patient with radio-opaque markers on the skin Red crosses (initial position for the scan) are drawn on the skin to check the position of the patient before marking the isocenters of the different fields.
CT Parameters Pilot scan 130 kV - 200 mA Pitch 2.00 Index 4 - Thickness 4
Almost all serious complications of PMRT relate to irradiation of specific nodal fields (e.g., arm oedema from axillary RT, brachial plexus injury from supraclavicular RT, cardiac injury from left-sided IMC RT)
Properly conducted chest-wall RT has little serious morbidity
Increased non-breast-cancer mortality observed in irradiated patients
Significant only in trials started before 1975
< 1975: 6.4% absolute increase in non-BC deaths with RT
>1975: 0.8% absolute increase in non-BC deaths with RT
Randomised trials of the local management of early breast cancer by various types of surgery and/or radiotherapy Meta-analyses: 42,000 women in 79 trials from the year 2000 EBCTCG meeting Richard Peto, Sarah Darby & Paul McGale, on behalf of the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG)
EBCTCG 2000: trials of local therapy 42,000 9,000 9,000 24,000 Women 21,000 79 TOTAL 5000 17 More surgery v RT + less surgery 4000 16 More surgery v less surgery 12,000 46 Radiotherapy (RT) versus no RT Deaths Trials Available for the EBCTCG year 2000 meta-analyses Treatment comparison
Meta-analysis putting together the results from all (old or new) trials of radiotherapy
Shows that breast cancer mortality can be affected by better local disease control
Isolated local recurrence in the trials of any type of radiotherapy (RT) versus no RT Isolated local recurrence Absolute difference in risk of isolated local recurrence: 20%, mostly within the first 5 years.
Breast cancer mortality 15-year breast cancer mortality in the trials of any type of radiotherapy (RT) versus no RT (total: 24,000 women randomised in 46 trials) Absolute difference in risk of death from breast cancer: 4%, mostly after the first 5 years. Little difference in breast cancer mortality during the first 5 years.
EBCTCG local treatment comparisons (NB Absolute 5-year gain in local recurrence risk depends on treatment comparison and on nodal status, N- or N+)
Radiotherapy (RT) vs no radiotherapy (24,000 women)