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Background: Large-scale trials have shown that hypofractionated adjuvant breast radiotherapy was as effective in terms of survival and local control as conventional fractionated radiotherapy, and acute toxicity was reduced with hypofractionated radiotherapy. However, there is a lack of data about the toxicity of breast with regional nodal irradiation (RNI). The aim of this study was to assess the effect of fractionation on radiation-related acute skin toxicity in patients receiving RNI in addition to whole-breast or chest wall irradiation, using real-life data., Methods: We conducted a prospective, multicenter cohort study with systematic computerized data collection integrated into Mosaiq®. Three comprehensive cancer centers used a standardized form to prospectively collect patient characteristics, treatment characteristics and toxicity., Results: Between November 2016 and January 2022, 1727 patients were assessed; 1419 (82.2%) and 308 (17.8%) patients respectively received conventional fractionated and hypofractionated radiation therapy. Overall, the incidence of acute grade 2 or higher dermatitis was 28.4% (490 patients). Incidence was lower with hypofractionated than with conventional fractioned radiation therapy (odds ratio (OR) 0.34 [0.29;0.41]). Two prognostic factors were found to increase the risk of acute dermatitis, namely 3D (vs IMRT) and breast irradiation (vs chest wall)., Conclusion: Using real-life data from unselected patients with regional nodal irradiation, our findings confirm the decreased risk of dermatitis previously reported with hypofractionated radiation therapy in clinical trials. Expansion of systematic data collection systems to include additional centers as well as dosimetric data is warranted to further evaluate the short- and long-term effects of fractionation in real life., (© 2022. The Author(s).)

Introduction: Breast cancer of young women has medico-psychological issues, particularly in the perspective of "after cancer" period. The objective of the study was to analyze the changes in management, in a decade including the publication of Cancer Plans I and II., Methods: This retrospective unicentric study involved two populations of women aged 40 and treated at the "Institut de cancérologie de Lorraine" in 2002-2004 (P1) and 2012-2014 (P2). Epidemiological-demographic, histological, diagnostic and therapeutic sequences were analyzed., Results: 216 patients were included. The mean age was 35.7 years (range 22-40), with no significant epidemiological difference, except for an increased rate of obesity in P2. Preoperative biopsies became almost systematic and the pre-therapeutic care plan rate increased over the decade from 3.8% to 8% (p < 0.001). The rate of breast-conserving treatment remained stable. The sentinel lymph node rate increased from 4.4% in P1 to 31.9% in P2 (p < 0.001), while the rate of lymph node dissection decreased (p < 0.001) between the two periods. Resort to breast nurses, psycho-oncologists, fertility experts and oncogenetic consultations has also increased., Conclusion: There is an improvement in the care and management of young women under 40 because of the first Cancer Plans. A study about the impact on the prognosis and a reflection to improve the experience of illness for these women are to lead., (Copyright © 2019 Société Française du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés.)

Importance: Many women dread undergoing mammography, and some may not attend or reattend breast cancer screening because of the discomfort or pain induced by breast compression., Objective: To evaluate the noninferiority of the self-compression mammography technique for reducing breast thickness compared with standard compression., Design, Setting, and Participants: This prospective, parallel-group, noninferiority randomized clinical trial was conducted from May 7, 2013, to October 26, 2015, at 6 cancer care centers in France. Participants were women aged 50 to 75 years, without a history of recent breast surgical procedure or treatment, and who could perform self-compression. Analyses were performed on intention-to-treat basis from January 27, 2017, to March 30, 2018., Interventions: Patients were randomized 1:1 to the self-compression group or the standard compression group., Main Outcomes and Measures: Primary end point was breast thickness expressed as the mean of 4 views: right and left craniocaudal and right and left mediolateral oblique. The predefined noninferiority margin was a difference of 3 mm, with a 1-sided 95% CI. Secondary end points included compression force, image quality, requirement for additional views, pain, and patient satisfaction and radiographer assessment questionnaires., Results: Among the 549 women randomized, 548 (97.3%) completed the trial. Of these, 275 (48.8%) (mean [SD] age, 61.35 [6.34] years) were randomized to the self-compression arm and 273 (48.5%) (mean [SD] age, 60.84 [6.41] years) to the standard compression arm. The difference in the mean thickness between the 2 arms was lower than the noninferiority margin, with an upper 1-sided 95% CI less than 3 mm (-0.17; 95% CI,-∞ to 1.89 mm; P < .05). Compression force was higher in the self-compression group compared with the standard compression arm for the 4 mammographic views. Pain was statistically significantly lower in the self-compression group (n = 274) compared with the standard compression group (n = 269) (median [interquartile range (IQR)] score, 2 [1-5] vs 3 [1-5]; P = .009). No difference was reported in the image quality scores of the 2 groups or in the number of additional views performed (median [IQR] extra views, 2 [2-2] vs 2 [2-3] extra views; P = .64), whatever the indication, including insufficient image quality (29 [16.8%] vs 27 [15.0%] insufficient quality views; P = .65). No adverse effects or pain were reported by the participants after the self-compression mammography., Conclusions and Relevance: Self-compression does not appear to be inferior to standard compression mammography in achieving minimal breast thickness without increasing pain or compromising image quality; this technique may be an effective option for women who want to be involved in their breast examination., Trial Registration: ClinicalTrials.gov identifier: NCT02866591.

Background: Breast carcinoma in men is an uncommon disease. The aim of this study is to compare overall survival (OS) and disease-specific survival (DSS) in a group of matched men and women with breast cancer., Methods: Each man with breast cancer recorded in the database was matched with two women. Matching was done based on age, year of diagnosis, and stage. To compare breast cancer characteristics between men and women, the chi-square test was used for qualitative data and the t-test for quantitative data. Overall survival and DSS were calculated using Kaplan-Meier methods. Cox proportional hazards models have been used to compare survival rates between men and women., Results: The 58 male breast cancer patients were matched with 116 female patients. The mean age at diagnosis was 63.9 +/- 11.9 years for men and 65.7 +/- 11.5 years for women (P = .72). The median follow-up was 9.7 years for men and 10.7 years for women. The 5- and 10-year OS for men were, respectively, 58.9% and 33.9%. The 5- and 10-year OS for women were 68.2% and 52.1%. Men with breast cancer had a significant risk of dying compared with women (hazard ratio [HR] = 1.59; 95% confidence interval (95% CI), 1.04-2.42, P = .03). The 5- and 10-year DSS were 73.0% and 55.1% for men, and 72.8 and 61.2% for women, respectively. There was no difference in DSS between the two matched groups (HR = 1.26; 95% CI, 0.76-2.10, P = .37)., Conclusions: The prognosis for men with breast carcinoma is similar to that for women with similar-stage disease.

In order to determine the feasibility of a personal care schedule, we studied provider delays among women with breast cancer in hospitals of a French Regional Cancer Network. In 2001, 148 women have been treated by surgery in the Alexis Vautrin Comprehensive Cancer Centre (AVCCC), then by adjuvant chemotherapy and radiotherapy. Before surgery, individual variations in delays was observed: from 0 to 65 days between the appointment making and the first consultation, from 3 to 108 days to start the treatment. After surgery, no significant difference in delays was found between women treated at AVCCC and those managed in another network institution (average delays: 35 days between surgery and chemotherapy, 4 months for chemotherapy, 3 weeks between chemotherapy and radiotherapy, and 35 days for radiotherapy). These results suggest an efficient organisation that allow to establish a personal care schedule for each patient after providing anatomopathological data.

Oncolor, the French regional cancer network of Lorraine, proposes clinical guidelines for the diagnosis, the treatment and the follow-up of cancers. In addition to paper documents, two computerized supports, a web site and the Kasimir software have been developed to make the use of these guidelines and their updating easier. This study aims at evaluating these three tools in breast and prostate cancer and to determine if computerized supports provide an additional help and an added value. From May to July 2001, 25 physicians of the Oncolor network have analysed, by consulting the guidelines on each of the 3 supports, 23 clinical cases of breast cancer and 22 cases of prostate cancer, i.e. in total 1,293 cases. We observe for breast cancer a response rate consistent with the guideline significantly higher with the Kasimir software compared to paper (87.1% versus 77.8%) or to Internet (87.1% versus 75.8%), an optimisation of the recourse to a specialised physician or a pluridisciplinary committee and globally a good satisfaction of the users. These results induce us to continue with the Kasimir experiment, to develop it for other cancers, especially those with a complex management and to evaluate its impact on medical practices.