Update on ASTRO's Partial Breast Irradiation Guidelines: Case-based Discussion

Breast cancer is the most diagnosed cancer in women. The most commonly diagnosed form of breast cancer in the United States is early-stage breast cancer, for which there are outstanding outcomes. Multiple randomized controlled trials with long-term follow-up have recently been published evaluating the comparative effectiveness of partial breast and whole breast irradiation. It is imperative for radiation oncologists to practice in an informed way regarding this data, as appropriate patient selection and selection of treatment regimen is key to ideal outcomes. This activity is a presentation of the updated ASTRO guidelines on partial breast irradiation, focusing on cohorts of patients in whom this treatment is recommended and radiotherapy regimens that are recommended when delivering partial breast irradiation, focusing on oncologic control and toxicities. A patient-centered approach to these issues is also presented.

The activity engages the audience in a variety of clinical case scenarios, highlighting guideline recommendations for partial breast irradiation based on the most recent randomized controlled trial data. An outline will be provided to practitioners regarding levels of clarity regarding guideline recommendations and the strength of evidence supporting usage of partial breast irradiation in distinct cohorts of breast cancer patients. Appropriate techniques, dose fractionation schemes, target volume and planning parameters for delivery of partial breast irradiation are also discussed. Toxicity and cosmetic outcomes with distinct forms of partial breast irradiation are discussed. This discussion includes polling the audience regarding how they would treat in certain scenarios. A patient advocate involved in writing the PBI guidelines offers her tips on how best to discuss the selection of partial breast treatment volume as well as technique with patients in a shared decision-making approach that is patient-centric. Registrants will leave the activity familiar with the updated partial breast irradiation guideline recommendations and will be able to integrate this clinically relevant guidance on optimal selection for and delivery of partial breast RT.

Topic:

  1. Introduction
    Janice Lyons, MD
  2. Panel Discussion of Clinical Case Scenarios Addressing Implementation of Recommendations: KQ 1-4
    Simona F. Shaitelman, MD, EdM
  3. Panel Discussion of Clinical Case Scenarios Addressing Implementation of Recommendations: KQ 1-4
    Bethany M. Anderson, MD
  4. Panel Discussion of Clinical Case Scenarios Addressing Implementation of Recommendations: KQ 1-4
    Naamit Kurshan Gerber, MD
  5. Panel Discussion of Clinical Case Scenarios Addressing Implementation of Recommendations: KQ 1-4
    Jose G. Bazan Jr., MD, MS
  6. Provider Recommendations from the Patient Perspective
    Patricia Spears, BS, FASCO
  7. Conclusions/Key Take Aways/Q and A
    Janice Lyons, MD
    Full Panel 

This activity is available from November 12, 2024, through 11:59 p.m. Eastern time on November 11, 2026. 

This activity was originally recorded at the 2024 ASTRO Annual Meeting.

Target Audience

The activity is designed to meet the interests of medical oncologists, radiation oncologists, surgeons, physicists, pathologists, radiation dosimetrists and residents.   

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Implement change in clinical practice with regards to treatment recommendations and radiation dose, fractionation and technique, because of remarks from the panel on partial breast irradiation. 
  • Report on the evidence base evaluated to formulate guideline recommendations.
  • Discuss strategies for incorporating the ASTRO partial breast irradiation guidelines into physician practice and patient preferences, education and empowerment. 
Course summary
Available credit: 
  • 1.25 AMA PRA Category 1 Credit™
    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 1.25 Certificate of Attendance
    This activity was designated for 1.25 AMA PRA Category 1 Credit™.
Course opens: 
11/12/2024
Course expires: 
11/11/2026
Cost:
$0.00
Rating: 
0
  • Jean L. Wright, MD, FASTRO, is employed by Johns Hopkins University and the National Institutes of Health. Dr. Wright receives compensation from Up To Date. Dr. Wright receives honoraria from ASTRO for her role as an APEx surveyor and from Elsevier Journals for serving as Editor of the breast section of the journal. Dr. Wright receives grant/research funding and salary support from Oncospace and the prostate cancer foundation. Dr. Wright serves as an oral board examiner with the American Board of Radiology and is Chair of the clinical affairs and quality committee with ASTRO.   
  • Suzanne B. Evans, MD, FASTRO, is employed by Yale University. Dr. Evans receives honoraria and in-kind donations from Clarity Patient Safety Organization. Dr. Evans serves as Vice Chair of the Clinical Affairs and Quality Committee of ASTRO. 
  • Janice Lyons, MD, is employed by University Hospitals Seidman Cancer Center and Case Western Reserve University. Dr. Lyons receives honoraria from Primum. Dr. Lyons serves as Chair of the PBI guideline committee with ASTRO, is a member of the breast cancer guideline committee of NCCN, and is a member of the exam development committee of ABR.
  • Simona F. Shaitelman, MD, EdM, is employed by The University of Texas MD Anderson Cancer Center. Dr. Shaitelman receives grant/research funding from Exact Sciences and the NIH. Dr. Shaitelman receives compensation from Becton, Dickinson and Company (BD). Dr. Shaitelman serves as the breast representative for Elekta. 
  • Bethany M. Anderson, MD, is employed by the University of Wisconsin. Dr. Anderson is a breast cancer committee member of NCCN, serves as Associate Editor of the Clinical Breast Cancer journal, section editor for the Brachytherapy medical journal, associate section editor of the IJROBP and is an oral board examiner with ABR.
  •  Naamit Kurshan Gerber, MD, is employed by New York University Grossman School of Medicine. Dr. Gerber receives grant/research funding from PreludeDx and honoraria from the John Theurer Cancer Center. Dr. Gerber serves as a member of the APBI Guidelines committee of ASTRO. 
  • Jose G. Bazan Jr., MD, MS, is employed by City of Hope National Medical Center. Dr. Bazan receives honoraria from the ASTRO VA Breast Panel. Dr. Bazan is a member of the oral exam committee with ABR and is Associate Editor of the IJROBP.
  • Patricia Spears, BS, FASCO, is employed by the University of North Carolina.    

The person(s) above served as the developer(s) of this activity. Additionally, the Education Committee had control over the content of this activity. All relevant relationships have been mitigated.

Disclosure link: 
Committee Disclosures

The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing education to physicians.

ASTRO is awarded Deemed Status by the American Board of Radiology to provide SA-CME as part of Part II Maintenance of Certification. 

Available Credit

  • 1.25 AMA PRA Category 1 Credit™
    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 1.25 Certificate of Attendance
    This activity was designated for 1.25 AMA PRA Category 1 Credit™.

Price

Cost:
$0.00
Please login or register to take this course.

Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.

Nonmember: $149
Member: $99
Member-in-training: $49
Student/Grad Student/PGY: $49
Postdoctoral Fellow: $49

If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount. 

Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the course by the end of the qualification date. The qualification date for each course is listed in the course catalog on the ASTRO website under availability.

Participants using ASTRO's online courses to satisfy the requirement of a Maintenance of Certification (MOC) program should verify the number, type and availability dates of any course before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased courses that do not align with their MOC requirement.

The course and its materials will only be available on the ASTRO website until November 11, 2026, regardless of purchase date. At the expiration of the qualification, participants will no longer have access to the course or its materials. ASTRO reserves the right to remove a course before the end of its qualification period.

Required Hardware/software

One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.