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Adjuvant irradiation for breast cancer

BMJ 2000; 321 doi: (Published 11 November 2000) Cite this as: BMJ 2000;321:1227

Treatment plans need to be made with better anatomical information

  1. Elisabeth Whipp, consultant clinical oncologist (,
  2. Charles Candish, specialist grade registrar
  1. Bristol Oncology Centre, Bristol BS2 8ED
  2. University Department of Clinical Oncology, Western General Hospital, Lothian University Hospitals NHS Trust, Edinburgh EH4 2XU

    EDITOR—Kunkler's editorial on adjuvant irradiation for breast cancer addressed an important problem.1 More and more patients of all age groups with potentially highly curable disease are being treated with both adjuvant chemotherapy and radiation. It is therefore most important that the treatment should be given in the safest possible manner while maintaining its therapeutic advantage. Increasingly, people recognise that radiotherapy can improve survival in breast cancer, and practitioners are becoming aware not just of the cardiac morbidity that occurs but also of the cardiac mortality.

    To investigate the magnitude of these problems we have undertaken a series of magnetic resonance scans on patients before radiotherapy planning and treatment. The advent of magnetic resonance imaging has allowed us to quantify the accuracy with which radiotherapy treatments are being delivered in breast cancer. The architecture of our magnetic resonance scanner is open and allows patients to be scanned in the treatment position. Magnetic resonance images have the advantage over other imaging techniques in that they …

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