Is active rheumatoid arthritis (RA) a contraindication to hypofractionated breast irradiation?
How does a diagnosis of active RA inform your treatment approach for patients with breast cancer, if at all?
Answer from: Radiation Oncologist at Academic Institution
I offer hypofractionated treatment to these patients. In review of the UK START data, the risk for breast shrinkage/normal tissue changes is lower with modest hypofractionation, suggesting that the lower overall dose may be beneficial. I would usually review RA medications, discuss any medicati...
Answer from: Radiation Oncologist at Community Practice
Active RA with some sort of skin manifestation may make me consider delaying/deferring RT, but it would not change what fractionation I use.Here is recent data that shows no difference in toxicity across various fractionation schemes in patients with CVD.
Answer from: Radiation Oncologist at Academic Institution
Hypofractionation showed less acute and chronic effects in comparison to conventional fractionation. So if there are no contraindications to RT, then hypofractionation is the preferred option.
Answer from: Radiation Oncologist at Academic Institution
It depends on how hypofractionated. I would be ok with a 4-week schedule but not 2 or 1 week. It also depends on the age and comorbidities of the patient and their logistical situation. Late complications or “effects” occur late. And “effects” sounds less unsettling. I follow...