The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy

Meritxell Arenas¹, Yasemin Bölükbaşı², Liesbeth J Boersma³, Birgitte Offersen⁴, Vassilis Kouloulias⁵, Isabella Palumbo⁶, Lurdes Trigo⁷, Laura Lozza⁸, Fabio Marazzi⁹, Marco Trovo¹⁰, Sofia Rivera¹¹, Orit Kaidar-Person¹², Charlotte Coles¹³, Icro Meattini¹⁴, Vincenzo Valentini¹⁵, Cynthia Aristei¹⁶, Philip Poortmans¹⁷; Assisi Think Tank Meeting (ATTM) 2024 members

Collaborators, Affiliations

Collaborators

Assisi Think Tank Meeting (ATTM) 2024 members:
Simona Borghesi, Antonella Ciabattoni, Pierfrancesco Franco, Marco Krengli, David Krug, Maria Cristina Leonardi, Valeria Masiello, Angel Montero Luis, Valerio Nardone, Sara Pedretti, Elisabetta Perrucci, Ivica Ratosa, Trine Tramm

Affiliations

¹ Radiation Oncology Department, Hospital Universitari Sant Joan de Reus, Faculty of Medicine, University of Rovira i Virgili, Spain. Electronic address: meritxell.arenas@urv.cat.
² Faculty of Medicine, University of Koc Radiation Oncology Department, Türkiye. Electronic address: ybolukbasi@kuh.ku.edu.tr.
³ Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands. Electronic address: liesbeth.boersma@maastro.nl.
⁴ Department of Experimental Clinical Oncology, Department of Oncology, Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark. Electronic address: birgoffe@rm.dk.
⁵ Department of Clinical Radiation Oncology, National and Kapodistrian University of Athens, ATTIKON University Hospital, Greece. Electronic address: vkouloul@med.uoa.gr.
⁶ Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia and Perugia General Hospital, Perugia, Italy. Electronic address: isabella.palumbo@unipg.it.
⁷ Department of Brachytherapy, Instituto Português de Oncologia do Porto Francisco Gentil, E.P.E, Portugal. Electronic address: lurdes.trigo@ipoporto.min-saude.pt.
⁸ Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumouri, Milan, Italy. Electronic address: laura.lozza@istitutotumouri.mi.it.
⁹ Radiation Oncology, Fondazione Policlinico Gemelli IRCCS, Roma, Italy. Electronic address: fabio.marazzi@policlinicogemelli.it.
¹⁰ Department of Radiation Oncology, Azienda Sanitaria Universitaria Integrata UD, Udine, Italy. Electronic address: marco.trovo@asufc.sanita.fvg.it.
¹¹ Gustave Roussy, Radiotherapy Departement, Paris-Saclay University, F-94805, VILLEJUIF France. Electronic address: Sofia.RIVERA@gustaveroussy.fr.
¹² Sheba Medical Center, Ramat Gan, Israel; Tel Aviv University, Tel Aviv, Israel. Electronic address: Orit.kaidarperson@sheba.health.gov.il.
¹³ Department of Oncology, University of Cambridge, UK. Electronic address: cec50@cam.ac.uk.
¹⁴ Department of Experimental and Clinical Biomedical Sciences M Serio, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. Electronic address: icro.meattini@unifi.it.
¹⁵ Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Universit'a Cattolica del Sacro Cuore e Fondazione Policlinico Gemelli IRCSS Roma, Italy. Electronic address: vincenzo.valentini@policlinicogemelli.it.
¹⁶ Section of Radiation Therapy, University of Perugia and Perugia General Hospital, Italy. Electronic address: cynthia.aristei@unipg.it.
¹⁷ Department of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk, Antwerp, Belgium. Electronic address: philip.poortmans@telenet.be.

PMID: 39854807
PMCID: PMC11804728
DOI: 10.1016/j.breast.2025.103881

Review

The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy

Meritxell Arenas et al. Breast. 2025 Apr.

. 2025 Apr:80:103881.

doi: 10.1016/j.breast.2025.103881. Epub 2025 Jan 20.

Authors

Collaborators

Assisi Think Tank Meeting (ATTM) 2024 members:
Simona Borghesi, Antonella Ciabattoni, Pierfrancesco Franco, Marco Krengli, David Krug, Maria Cristina Leonardi, Valeria Masiello, Angel Montero Luis, Valerio Nardone, Sara Pedretti, Elisabetta Perrucci, Ivica Ratosa, Trine Tramm

Affiliations

¹ Radiation Oncology Department, Hospital Universitari Sant Joan de Reus, Faculty of Medicine, University of Rovira i Virgili, Spain. Electronic address: meritxell.arenas@urv.cat.
² Faculty of Medicine, University of Koc Radiation Oncology Department, Türkiye. Electronic address: ybolukbasi@kuh.ku.edu.tr.
³ Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands. Electronic address: liesbeth.boersma@maastro.nl.
⁴ Department of Experimental Clinical Oncology, Department of Oncology, Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark. Electronic address: birgoffe@rm.dk.
⁵ Department of Clinical Radiation Oncology, National and Kapodistrian University of Athens, ATTIKON University Hospital, Greece. Electronic address: vkouloul@med.uoa.gr.
⁶ Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia and Perugia General Hospital, Perugia, Italy. Electronic address: isabella.palumbo@unipg.it.
⁷ Department of Brachytherapy, Instituto Português de Oncologia do Porto Francisco Gentil, E.P.E, Portugal. Electronic address: lurdes.trigo@ipoporto.min-saude.pt.
⁸ Radiotherapy Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumouri, Milan, Italy. Electronic address: laura.lozza@istitutotumouri.mi.it.
⁹ Radiation Oncology, Fondazione Policlinico Gemelli IRCCS, Roma, Italy. Electronic address: fabio.marazzi@policlinicogemelli.it.
¹⁰ Department of Radiation Oncology, Azienda Sanitaria Universitaria Integrata UD, Udine, Italy. Electronic address: marco.trovo@asufc.sanita.fvg.it.
¹¹ Gustave Roussy, Radiotherapy Departement, Paris-Saclay University, F-94805, VILLEJUIF France. Electronic address: Sofia.RIVERA@gustaveroussy.fr.
¹² Sheba Medical Center, Ramat Gan, Israel; Tel Aviv University, Tel Aviv, Israel. Electronic address: Orit.kaidarperson@sheba.health.gov.il.
¹³ Department of Oncology, University of Cambridge, UK. Electronic address: cec50@cam.ac.uk.
¹⁴ Department of Experimental and Clinical Biomedical Sciences M Serio, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. Electronic address: icro.meattini@unifi.it.
¹⁵ Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Universit'a Cattolica del Sacro Cuore e Fondazione Policlinico Gemelli IRCSS Roma, Italy. Electronic address: vincenzo.valentini@policlinicogemelli.it.
¹⁶ Section of Radiation Therapy, University of Perugia and Perugia General Hospital, Italy. Electronic address: cynthia.aristei@unipg.it.
¹⁷ Department of Radiation Oncology, Iridium Netwerk, Wilrijk, Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk, Antwerp, Belgium. Electronic address: philip.poortmans@telenet.be.

PMID: 39854807
PMCID: PMC11804728
DOI: 10.1016/j.breast.2025.103881

Abstract

At the Fifth Assisi Think Tank Meeting (ATTM) on breast cancer, one key topic was the role of tumor bed boost in invasive breast cancer and ductal carcinoma in situ. The need for a tumor bed boost after whole breast irradiation is controversial. A literature review assessed boost indications, target volume definition, techniques, dose fractionation, and ongoing trials. Findings indicated that while a boost halves the risk of local recurrence at 10 years, it also leads to worsened cosmetic outcomes and increased fibrosis without improving overall survival. Therefore, we would recommend to omit the boost if the estimated reduction in local recurrence at 10 years is less than 3 %, and to apply shared decision-making with patients, if the boost is expected to reduce the local recurrence rate with >3 % at 10 years. Future research will focus on identifying patient subgroups that can safely omit the boost and improving boost volume precision.

Keywords: Boost technique; Breast cancer; Dose fractionation; Local recurrence; Radiation therapy; Target volume definition; Tumour bed boost.

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Conflict of interest statement

Declaration of competing interests All the authors declare no confict of interest.

References

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The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy

Collaborators

Affiliations

The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical