Notes

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Coronavirus disease 2019 (COVID-19) has put a strain on regular healthcare worldwide. In the Netherlands, the national screening programs, including for breast cancer, were halted temporarily. This posed a challenge to breast cancer care, because ∼40% of cases are detected through national screening. Therefore, the aim of the present study was to evaluate the effects of the COVID-19 pandemic on the surgical care of patients with breast cancer in the Netherlands.

The present multicenter retrospective cohort study investigated the effects of COVID-19 on patients with breast cancer who had undergone surgery from March 9 to May 17, 2020. The primary endpoints were the number of surgical procedures performed during the study period, tumor characteristics, surgery type, and route of referral. The secondary endpoint was the incidence of postoperative complications during the study period.

A total of 217 consecutive patients with breast cancer requiring surgery were included. We found an overall decrease in the number of patients with breast cancer who were undergoing surgery. The most significant decline was seen in surgery for T1-T2 and N0 tumors. A decline in the number of referrals from both the national screening program and general practitioners was observed. click here The incidence of postoperative complications remained stable during the study period.

The temporary halt of the national screening program for breast cancer resulted in fewer surgical procedures during the study period and a pronounced decrease in surgery of the lower tumor stages.
The temporary halt of the national screening program for breast cancer resulted in fewer surgical procedures during the study period and a pronounced decrease in surgery of the lower tumor stages.
This study aimed to explore the current status and pattern of practice for reirradiation using brachytherapy (ReRT-BT) through a survey in Japan.

We distributed an e-mail-based questionnaire to 153 institutions equipped with high-dose-rate brachytherapy facilities.

We received responses from 76 institutions (49.7%). Forty-three of these institutions performed ReRT-BT and 42 institutions (55%) performed ReRT-BT during 2009-2018. However, 29 of the 42 institutions (69%) reported difficulty in obtaining ReRT-BT case information from their respective databases. Almost all the institutions encountered insufficient database system to extract details about the ReRT-BT cases. Responses from 33 institutions included the number of ReRT-BT cases; this increased from 90 in the period 2009-2013 (institution median=0.5; 0-16) to 172 in the period 2014-2018 (institution median=2; 0-26). Nine institutions had to perform ReRT-BT for more than one case per year. The major location for cancer treatment was the pelvis (94%), followed by the head and neck (5%) and others (1%). In six site-specific scenarios, barring uterine corpus cancer recurrence, more than 90% of radiation oncologists agreed to perform ReRT-BT, whereas other areas (head and neck, prostate, and rectal cancer) gained 16-37% agreement.

This decade saw an increase in the number of ReRT-BT cases in Japan and radiation oncologists' interest in ReRT-BT as a viable therapeutic option. However, scarce availability, immature education system, and insufficient database system are barriers to further consensus building.
This decade saw an increase in the number of ReRT-BT cases in Japan and radiation oncologists' interest in ReRT-BT as a viable therapeutic option. However, scarce availability, immature education system, and insufficient database system are barriers to further consensus building.
On average, physicians spend 10 years embroiled in malpractice litigation, exacerbating burnout and depression. Only a limited number of studies regarding medical malpractice in radiation oncology have been published, mostly in the last few years. We undertook this review with the goal of looking specifically at brachytherapy-related medical malpractice literature.

We used the PubMed search engine using the terms radiation oncology medical malpractice. The search yielded 34 references published between 1988 and 2019.

The incidence of radiation oncology malpractice claims was roughly similar to other specialties, with fairly typical payouts of $100,000-$200,000. Consistent with overall national medical malpractice statistics, a trend toward lesser numbers of radiation oncology claims from 1985 through 2017 has occurred. Medical malpractice data related specifically to brachytherapy are very, very limited. No author has provided sufficient details regarding precisely what leads to brachytherapy malpractice cases.

Hopefully, the recent spate of publications will segue into a more concerted effort to provide practitioners with detailed actionable descriptions of events leading to malpractice allegations.
Hopefully, the recent spate of publications will segue into a more concerted effort to provide practitioners with detailed actionable descriptions of events leading to malpractice allegations.
The purpose of the study was to report dosimetric differences for breast brachytherapy plans optimized for clinical target volume (CTV) generated using conventional isotropic expansion of tumor bed volume (TBV) and Groupe Européen de Curiethérapie-European Society for Radiotherapy and Oncology (GEC-ESTRO) recommendations to expand the TBV anisotropically to achieve a total safety margin of 2cm (resection margin size+added safety margin).

Institutional records of 100 patients who underwent accelerated partial breast irradiation using multicatheter interstitial brachytherapy from May 2015 to March 2020 were reviewed retrospectively. Two sets of CT-based plans were made, one with 1-cm isotropic margins around the tumor bed (CTV_ISO) and the other with anisotropic margins (CTV_GEC). Plans were evaluated and compared using the American Brachytherapy Society and GEC-ESTRO guidelines.

The median TBV was 36.97cc. The median margin widths were as follows anterior 1.2, posterior 1.0, superior 1.0, inferior 0.9, m lower conformity, the impact of which was predominantly seen in smaller implants. Rest of the dosimetric constraints were achieved in both the plans as per the American Brachytherapy Society and GEC-ESTRO guidelines.
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