Leslie Botnick, MD: Radiation Oncology Data from SABCS 2011
Dr. Leslie Botnick discusses radiation oncology data coming out of the 34th Annual CTRC-AACR San Antonio Breast Cancer Symposium, specifically the Brachytherapy study which concluded limiting radiation increases mastectomies.
Dr. Botnick is the Chief Medical Officer and Founder of Vantage Oncology.
The Group Room at the 34th Annual CTRC-AACR San Antonio Breast Cancer Symposium was made possible by support from:
Selma Schimmel, Founder & CEO, Vital Options International:
Hello and welcome to the Group Room where we’re at the 34th Annual CTRC-AACR San Antonio Breast Cancer Symposium. So now I’m joined by Doctor Leslie Botnick. Doctor Botnick is a board-certified radiation oncologist, practicing at the Center for Radiation Therapy in Beverly Hills, California. You’re also the Co-founder and Medical Chief Officer of Advantage Oncology.
This is a multi-disciplinary meeting so at this meeting you’ve got radiation oncologists, you’ve got surgeons, you’ve got medical oncologists, you’ve got the whole spectrum of researchers involved in oncology breast medicine. There was a breaking therapy presentation. Can you tell us a little about that?
Leslie Botnick, MD, Chief Medical Officer and Founder, Vantage Oncology:
That’s partial breast radiation and it could be done by external radiation, it could be done where you put a catheter, a surgeon puts the catheter in, it’s a surgical procedure, surgical fee where they put the catheter in, it’s expanded and then you go to the radiotherapy department and they use what’s called high-dose rate radiation which is a source that goes into these tubes twice a day for five days. And that’s intracavitary brachytherapy; so you get some additional surgical procedure because the tube is being placed and you’re getting radiation twice a day for five days and it just treats the quadrant of the breast.
And why I mention that is, that many years ago there was a Veronesi study where they did quadrantectomies and initially everyone said it’s exactly the same except the breast doesn’t look at good. Well, ten, fifteen years later they found out that the recurrence rates were actually higher and survival differences occurred. So I think we sometimes need to temper some of the use of newer technology and try to understand that when we’re just talking about breast cancer it’s multiple dots, it’s not only in one area.
And the brachytherapy study you were just speaking about said that it’s associated with twofold increase risk for mastectomy complications. Why?
Leslie Botnick, MD:
They didn’t explain why but usually I assume it’s because of recurrence somewhere else in the breast. That data hasn’t been refined because it’s a Medicare blind study; it don’t tell you why. So there is a study, I think, the RTOG and SMPB is doing a study that’s looking at partial breast radiation. So we’ll eventually find out that answer but the point is to study, and the chances of getting this into the community where it’s not under a study-control situation could be as high as 20%. You have to say to yourself ‘well maybe we shouldn’t be doing it that much’ and we should be doing it under study-control.
What’s the future, do you think? Where are we going with the research in radiation therapy?
Leslie Botnick, MD:
I think you hear it from the meeting people are trying to do less, and by doing less means doing less surgery; so can we figure out what to do based on biologics? So a negative estrogen receptor, progestin receptor in Her2-Negative patients, can we just do an initial biopsy and maybe a central node or not, and then give to the adjuvant chemo therapy – switch chemotherapy if it’s not working, use radiation earlier; in a sense, never taking axillary dissection and just moving the primary tumor after the adjuvant. These are all things being discussed here.
Thank you Doctor Botnick. Doctor Leslie Botnick, Co-Founder and Chief Medical Officer of Vantage Oncology.
Leslie Botnick, MD
Thank you, Selma.
END OF VIDEO