• 文章类型: Journal Article
    确定母乳喂养对妊娠糖尿病妇女产后葡萄糖不耐受风险的影响。
    两项多中心前瞻性队列研究(BEDIP-N和MELINDA)对1008例妊娠糖尿病妇女的子分析。数据收集在怀孕期间和产后平均12周。采用多因素logistic回归分析母乳喂养对糖耐量异常的影响,随着种族的调整,教育,收入,专业活动和BMI。
    在所有参与者中,56.3%(567)纯母乳喂养,10.1%(102)给予混合牛奶喂养,33.6%(339)不母乳喂养。在母乳喂养和混合牛奶喂养组中,平均母乳喂养时间为3.8±2.4和3.7±2.1个月(p=0.496)。与无母乳喂养组[29.5%(100)]相比,母乳喂养组[22.3%(126)]和混合奶喂养组[25.5%(26)]的葡萄糖不耐受率均较低,与无母乳喂养组相比,母乳喂养组葡萄糖不耐受的校正OR为0.7(95%CI0.5-1.0),与无母乳喂养组相比,混合奶喂养组的校正OR为0.7(95%CI0.4-1.2).产后,哺乳期妇女的BMI较低,产后体重保留较少,降低空腹甘油三酯,与混合牛奶喂养和不母乳喂养组相比,胰岛素抵抗更少,胰岛素分泌敏感性指数-2更高。混合牛奶喂养组通常来自非白人背景,与无母乳喂养组相比,血压较低,空腹甘油三酯较低。
    母乳喂养(独家和混合牛奶喂养)与妊娠期糖尿病妇女产后早期葡萄糖耐受不良和代谢改善有关。
    UNASSIGNED: To determine the impact of breastfeeding on the risk of postpartum glucose intolerance in women with gestational diabetes.
    UNASSIGNED: Sub-analysis of two multi-centric prospective cohort studies (BEDIP-N and MELINDA) in 1008 women with gestational diabetes. Data were collected during pregnancy and at a mean of 12 weeks postpartum. Multivariate logistic regression was used to estimate the effect of breastfeeding on glucose intolerance, with adjustment for ethnicity, education, income, professional activity and BMI.
    UNASSIGNED: Of all participants, 56.3% (567) breastfed exclusively, 10.1% (102) gave mixed milk feeding and 33.6% (339) did not breastfeed. Mean breastfeeding duration was 3.8 ± 2.4 and 3.7 ± 2.1 months in the breastfeeding and mixed milk feeding groups (p=0.496). The rate of glucose intolerance was lower in both the breastfeeding [22.3% (126)] and mixed milk feeding [25.5% (26)] groups compared to the no breastfeeding group [29.5% (100)], with an adjusted OR of 0.7 (95% CI 0.5-1.0) for glucose intolerance in the breastfeeding group compared to no breastfeeding group and an adjusted OR of 0.7 (95% CI 0.4-1.2) for the mixed milk feeding group compared to the no breastfeeding group. Postpartum, breastfeeding women had a lower BMI, less often postpartum weight retention, lower fasting triglycerides, less insulin resistance and a higher insulin secretion-sensitivity index-2 than the mixed milk feeding and no breastfeeding group. The mixed milk feeding group was more often from an non-White background, had a lower blood pressure and lower fasting triglycerides compared to the no breastfeeding group.
    UNASSIGNED: Breastfeeding (exclusive and mixed milk feeding) is associated with less glucose intolerance and a better metabolic profile in early postpartum in women with gestational diabetes.
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  • 文章类型: Journal Article
    早期乳腺癌(EBC)是尚未扩散到乳房或腋窝淋巴结以外的癌症。本回顾性队列研究探讨了平消胶囊(PXC)的疗效和安全性。其中包含传统中草药的配方,作为一个中国学术医学中心的EBC患者的辅助治疗。分析接受手术和化疗的EBC患者,并将其分为PXC和非PXC组。无病生存期(DFS)时间,总生存期(OS)时间,研究了人口学特征和不良事件.使用Kaplan-Meier存活曲线比较DFS和OS的差异。这项研究共纳入371名中位年龄为54岁的参与者。所有患者的中位DFS时间为101个月。PXC组的总DFS率为72.1%,而非PXC组为63.6%。对于患有激素受体阴性肿瘤的女性,PXC组的DFS率明显高于非PXC组,无论节点状态如何。与非PXC组相比,PXC辅助治疗≥3个月与中位DFS时间明显延长相关。此外,与对照组相比,PXC组中性粒细胞减少症的发生率为2级或更高,和一个明显的,但无关紧要,PXC组恶心发生率较低(0vs.4.1%)。总之,与单纯化疗相比,PXC作为化疗的辅助治疗与EBC患者的DFS时间延长有关。联合PXC和全身化疗的治疗价值应通过严格的前瞻性临床试验进一步阐明。
    Early breast cancer (EBC) is cancer that has not spread beyond the breast or the axillary lymph nodes. The present retrospective cohort study investigated the efficacy and safety of the Pingxiao capsule (PXC), which contains a formula of traditional Chinese herbs, as adjuvant therapy in patients with EBC in a single Chinese academic medical center. Patients with EBC who had received surgery and chemotherapy were analyzed and divided into the PXC and non-PXC groups. Disease-free survival (DFS) time, overall survival (OS) time, demographic characteristics and adverse events were examined. Kaplan-Meier survival curves were used to compare the differences in DFS and OS. A total of 371 participants with a median age of 54 years were included in this study. The median DFS time of all patients was 101 months. The overall DFS rate was 72.1% in the PXC group compared with 63.6% in the non-PXC group. For women with hormone receptor-negative tumors, the DFS rate in the PXC group was significantly higher than that in the non-PXC group, irrespective of node status. Adjuvant treatment with PXC for ≥3 months was associated with significantly longer median DFS time compared with that in the non-PXC group. In addition, the incidence of neutropenia rated to be grade 2 or higher was significantly lower in the PXC group compared with that in the control group, and a markedly, but non-significantly, lower prevalence of nausea was observed in PXC group (0 vs. 4.1%). In conclusion, PXC as an adjuvant therapy along with chemotherapy is associated with prolonged DFS times in patients with EBC when compared with chemotherapy alone. The therapeutic value of combined PXC and systemic chemotherapy should be further elucidated by rigorous prospective clinical trials.
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  • 文章类型: Journal Article
    根据2020年全球报告,印度女性的乳腺癌发病率已超过宫颈癌。癌症管理也在中心和地区层面得到了简化,从而为案例提供全面的综合管理,以优化最佳结果。在乳腺癌中,有两种手术模式,即保乳手术(BCS)和改良根治术(MRM)现在超过20年,根据疾病的程度推荐化疗。HRQOL(健康相关生活质量)研究已在这些患者组中进行,由于它们在失去像乳房这样的重要器官方面增加了相关性。EORTC30和BR23是标准化和详细的工具,可以用来估计生活质量,记住受疾病影响的一系列领域。
    使用BR-23和EORTC-QLQ-问卷评估手术乳腺癌患者的“身体形象”和“生活质量”(QOL)在1个月(手术后),然后在手术后3至4个月。
    本文试图对在一个中心的大流行期间手术的46名乳腺癌患者的EORTC30和BR23得分进行比较,并同意在预先确定的三个时间段重复这些措施。管理过程中的时间段。
    两种手术的EORTC30和BR23的平均得分没有显着差异。两种手术模式的访视1得分均超过75,而EORTC的访视3得分低于55。所有3次就诊的BR23(测量乳腺癌的核心症状)在45到55之间。弗里德曼的测试表明,该分数对年龄组并不显著,活着的孩子的数量,或生活方式因素,如酒精或烟草咀嚼,虽然二次图描绘了3倍时分数的明显变化,加强了对这些受试者每隔一段时间进行心理健康随访的需要。这项研究在很大程度上提出了对定期和短时间间隔的重复随访和咨询的强烈需求,乳腺癌患者的术后。EORTC30和BR23工具非常适合用于撰写有关乳腺癌患者心理健康的信息。
    UNASSIGNED: Breast cancer incidence has overtaken that of cervical cancer among women in India according to the Globacon 2020 reports. Cancer management is also being streamlined at the Center and district levels, such that comprehensive integrated management is offered to cases to optimize the best results. In breast cancer, there are two modes of surgery namely Breast Conservation Surgery(BCS) and Modified Radical Mastectomy (MRM) now over 2 decades, with recommended Chemo radiation depending on the extent of the disease. HRQOL (Health-related Quality of Life) studies have been done in these groups of patients, due to their added relevance in terms of the loss of a vital organ like the breast. EORTC 30 and BR23 are standardized and detailed tools that have been seen to estimate QOL, keeping in mind a whole array of domains that are affected by the disease.
    UNASSIGNED: To evaluate the \"Body Image\" and \"Quality of life\" (QOL) in operated breast cancer patients using BR -23 and EORTC - QLQ- questionnaire at 1month (after surgery) and then 3 to 4 months after surgery.
    UNASSIGNED: This article attempts to draw a comparison among of EORTC30 and BR 23 scores calculated for 46 breast cancer patients operated during the pandemic time in one center and consenting to repeat the measures at pre-decided three time periods during the course of management.
    UNASSIGNED: No significant differences are noted in the mean scores for EORTC 30 and BR23 for the two types of surgeries. Visit 1 scores for both modes of surgery are over 75 and by Visit 3 become less than 55 for EORTC. BR 23 (which measures the symptoms core to Breast cancer) at all 3 visits are between 45 to 55. Friedman\'s test shows that the scores are not significant for age groups, the number of living children, or lifestyle factors like alcohol or tobacco chewing, though quadratic graphs depict the distinct variations in the scores at the 3 times reinforcing the need for follow-up of mental health in these subjects at intervals. The study largely brings out a strong need for repeated follow-up and counseling at regular and short intervals, post-surgery in breast cancer patients. EORTC 30 and BR 23 tools are excellent to use to essay information on the mental health of patients with breast cancer.
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  • 文章类型: Journal Article
    在产前和产后期间提供给母亲的信息变化的证据,它对母乳喂养意识的影响,印度城乡地区的实践很少。这项研究的目的是评估母亲在怀孕期间经历的变化,delivery,和不同环境的产假及其对婴儿出生前6个月母乳喂养行为的影响。
    在哥印拜陀的城市和农村地区进行了基于社区的分析性横断面研究,泰米尔纳德邦,在调查日期前一年至六个月分娩的800名母亲中,使用简单随机抽样。
    在城市地区,产前检查少于四次的母亲比例明显更高(城市与农村,11.4%对6.2%)。怀孕期间积极经历的平均得分(MD-0.99,95%CI-1.31至-0.69),与农村地区相比,城市地区的分娩和分娩期间的经历(MD-0.59,95%CI-0.83至-0.35)明显较低。城乡纯母乳喂养率分别为75.8%和85.0%,分别。对分娩和分娩期间(OR1.69,95%CI1.18至2.42)和城市地区(OR1.81,95%CI1.27至2.59)的经历不满意的母亲非纯母乳喂养的风险显着增加。
    本研究表明,城市地区的母亲没有得到适当的,adequate,以及医疗保健提供者的及时信息。这是一个小时的需要,培训和激励医疗保健提供者关于产妇产前意识,产内,和产后护理实践,包括母乳喂养和婴儿护理。
    UNASSIGNED: Evidence on variation in the information provided to mothers during antenatal and postnatal periods, its influence on breastfeeding awareness, and practice in urban and rural settings of India is scarce. The aim of the study was to assess the variation in mothers experience during pregnancy, delivery, and maternity period across settings and its influence on breastfeeding practices in the first six months of infants\' life.
    UNASSIGNED: A community-based analytical cross-sectional study was carried out in urban and rural settings of Coimbatore, Tamil Nadu, among 800 mothers who had delivered between one year and six months before the date of the survey using simple random sampling.
    UNASSIGNED: The proportion of mothers with less than four antenatal visits were significantly higher in urban areas (urban vs rural, 11.4% vs 6.2%). The mean scores for positive experiences during pregnancy (MD -0.99, 95% CI -1.31 to -0.69), experiences during birth and maternity period (MD -0.59, 95% CI -0.83 to -0.35) were significantly lower in the urban areas compared to rural areas. The prevalence of exclusive breastfeeding was 75.8% and 85.0% in urban and rural areas, respectively. Mothers not satisfied with experiences during delivery and maternity period (OR 1.69, 95% CI 1.18 to 2.42) and from urban areas (OR 1.81, 95% CI 1.27 to 2.59) were at significantly increased risk of nonexclusive breastfeeding.
    UNASSIGNED: The present study showed that mothers from urban areas were not provided with appropriate, adequate, and timely information by the healthcare providers. It is the need of the hour to train and motivate healthcare providers regarding maternal awareness of antenatal, intranatal, and postnatal care practices including breastfeeding and infant care.
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  • 文章类型: Journal Article
    三阴性乳腺癌(TNBC)是乳腺癌的一种亚型,由于缺乏雌激素受体(ER),因此存在重大的治疗挑战。孕激素受体(PR),和人表皮生长因子受体2(HER2)的表达。因此,传统的激素和靶向治疗在很大程度上是无效的,强调迫切需要新的治疗策略。γδT细胞,以其强大的抗肿瘤特性而闻名,在TNBC治疗中显示出相当大的潜力,因为它们可以识别和消除肿瘤细胞而不依赖于MHC限制。这些细胞在体外和体内都表现出广泛的增殖,并且可以通过细胞毒性作用直接靶向肿瘤或通过促进其他免疫反应间接靶向肿瘤。研究表明,针对Vδ2和Vδ1γδT细胞亚型的扩增和过继转移策略已在临床前TNBC模型中显示出希望。这篇综述汇编并讨论了关于γδT细胞初级亚群的现有文献,它们在癌症治疗中的作用,它们对肿瘤细胞毒性和免疫调节的贡献,并提出了TNBC未来基于γδT细胞的免疫疗法的潜在策略。
    Triple-negative breast cancer (TNBC) is a subtype of breast cancer that presents significant therapeutic challenges due to the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression. As a result, conventional hormonal and targeted therapies are largely ineffective, underscoring the urgent need for novel treatment strategies. γδT cells, known for their robust anti-tumor properties, show considerable potential in TNBC treatment as they can identify and eliminate tumor cells without reliance on MHC restrictions. These cells demonstrate extensive proliferation both in vitro and in vivo, and can directly target tumors through cytotoxic effects or indirectly by promoting other immune responses. Studies suggest that expansion and adoptive transfer strategies targeting Vδ2 and Vδ1 γδT cell subtypes have shown promise in preclinical TNBC models. This review compiles and discusses the existing literature on the primary subgroups of γδT cells, their roles in cancer therapy, their contributions to tumor cell cytotoxicity and immune modulation, and proposes potential strategies for future γδT cell-based immunotherapies in TNBC.
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  • 文章类型: Case Reports
    叶状肿瘤是一种罕见的乳腺纤维上皮肿瘤。这种肿瘤倾向于通过血行途径扩散,肺部常见的转移部位,骨头,还有肝脏.胸膜转移,胃,胰腺,肾脏,和肾上腺是罕见的。我们介绍了一例52岁的女性,患有乳腺恶性叶状肿瘤,并进行了局部肿瘤切除,随后是肺叶切除术的孤立性肺转移,随后诊断出胸膜有多个新的转移部位,胃,胰腺,肾脏,肾上腺,2-脱氧-2-[18F]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描在2年内检测到骨骼。
    Phyllodes tumor is a rare fibroepithelial neoplasm of the breast. This tumor tends to spread by hematogenous route, with common metastatic sites in the lungs, bones, and liver. Metastases to the pleura, stomach, pancreas, kidneys, and adrenal gland are rare. We present a case of a 52-year-old lady with malignant phyllodes tumor of breast undergone local tumor resection, followed by solitary lung metastasis with lobectomy, and subsequently diagnosed of multiple new metastatic sites in pleura, stomach, pancreas, kidneys, adrenal gland, and bone detected on 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography within 2 years.
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  • 文章类型: Case Reports
    Rosai-Dorfman-Destombes(RDD)疾病也被称为伴有大量淋巴结病的窦组织细胞增生症。它是儿童和年轻人罕见的异质性疾病。大多数RDD患者通常表现为无痛性淋巴结病,而结外和多系统表现的疾病是不寻常的。诊断基于影像学与临床病理相关性。Flourine-18氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描对于RDD病变的初始分期很有用,具有类似的外观和亲和力,如中度和高度淋巴瘤。这里,我们介绍了一例55岁女性患者的左乳腺肿块,结果是结外Rosai-Dorfman病.
    Rosai-Dorfman-Destombes (RDD) disease is also known as sinus histiocytosis with massive lymphadenopathy. It is an uncommon heterogeneous disease of children and young adults. Most of the patients with RDD generally present with painless lymphadenopathy, while extranodal and multisystem manifestation of the disease is unusual. The diagnosis is based on the imaging with clinicopathological correlation. Flourine-18 fluorodeoxyglucose positron emission tomography/computed tomography is useful for the initial staging of the RDD lesions, which have similar appearance and avidity like intermediate and high-grade lymphomas. Here, we present the case of a 55-year-old female presented with left breast mass that turned out to be the extranodal Rosai-Dorfman disease.
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  • 文章类型: Journal Article
    肥胖与绝经后乳腺癌的高风险有关。研究表明,肥胖与绝经前乳腺癌风险之间存在相反的相关性。基于代谢健康的各种肥胖表型可能发挥重要作用。本研究旨在评估来自不同肥胖表型女性的血浆外泌体如何影响MCF-7细胞迁移。基质金属蛋白酶-2活性,和凋亡。
    评估分离的外来体的表征及其内化到MCF-7细胞中。用分离自不同组的外泌体处理MCF-7细胞。迁移,观察MMP-2活性、Bax和Bcl-2mRNA表达、p-53和Thr55p-p53蛋白表达及细胞凋亡情况。
    从不健康肥胖个体中分离的外泌体增加MCF-7细胞迁移。关于MMP活动,不健康的正常体重和超重以及健康肥胖组分离的外泌体比治疗组的外泌体增加MMP-2活性。此外,与对应组相比,不健康的正常体重和超重以及健康肥胖获得的外泌体减少了细胞凋亡.
    总之,来自正常体重和超重状态的不健康个体的血浆外泌体,以及那些不健康肥胖的人,对雌激素/孕激素受体阳性乳腺癌细胞的行为产生负面影响。
    在线版本包含补充材料,可在10.1007/s40200-023-01295-1获得。
    UNASSIGNED: Obesity has been linked to a higher risk of postmenopausal breast cancer Yet, research indicates an opposite correlation between obesity and premenopausal breast cancer risk. Various obesity phenotypes based on metabolic health could play a significant part. This study aims to assess how plasma exosomes taken from women with varying obesity phenotypes impact MCF-7 cell migration, matrix metalloproteinase-2 activity, and apoptosis.
    UNASSIGNED: The characterization of isolated exosomes and their internalization into MCF-7 cells was evaluated. The treatment of MCF-7 cells with exosomes isolated from different groups was done. Migration, the activity of MMP-2, mRNA expression of Bax and Bcl-2, protein expression of p-53 and Thr55 p-p53, and apoptosis were assessed.
    UNASSIGNED: Isolated exosomes from unhealthy obese individuals increase MCF-7 cell migration. Regarding MMP activities, unhealthy normal weight and overweight and healthy obese groups isolated exosomes increase the MMP-2 activity than the treated group with exosomes isolated from counterpart groups. Furthermore, unhealthy normal weight and overweight and healthy obese obtained exosomes decrease apoptosis compared to counterpart groups.
    UNASSIGNED: Altogether, plasma exosomes derived from both unhealthy individuals with normal weight and overweight status, as well as those with unhealthy obesity, negatively impacted the behavior of estrogen/progesterone receptor-positive breast cancer cells.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s40200-023-01295-1.
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  • 文章类型: Journal Article
    有规律的体育锻炼(PA)对乳腺癌幸存者有益,尽管大多数人没有投入足够的时间进行练习。癌症治疗的长期副作用代表了采用健康生活习惯的障碍。
    确定影响乳腺癌幸存者中常规PA的意图的因素。
    在我的积极健康(MaSantéActive)计划参与者中进行了相关研究(N=136),使用基于计划行为理论的自我管理问卷。
    多元回归分析表明,感知控制,行为信念和控制信念是意图的决定因素。
    建议根据这些决定因素设计干预措施,以加强乳腺癌幸存者的行为意图。该论文还将告知医疗保健专业人员有关干预目标,以激励患有乳腺癌诊断的女性参与常规PA。
    UNASSIGNED: Regular physical activity (PA) can be beneficial to breast cancer survivors, although the majority do not devote sufficient time to the practice. The long-term side effects of cancer treatment represent barriers to adopting healthy lifestyle habits.
    UNASSIGNED: Identify factors that influence the intention to practise regular PA among breast cancer survivors.
    UNASSIGNED: A correlational study was conducted among my Active Health (Ma Santé Active) program participants (N = 136), using a self-administered questionnaire based on the theory of planned behaviour.
    UNASSIGNED: Multiple regression analysis shows that attitude, perceived control, behavioural beliefs and control beliefs are the determinants of intention.
    UNASSIGNED: It is recommended to design interventions based on these determinants to strengthen the behavioural intention of breast cancer survivors. The paper will also inform healthcare professionals about the intervention targets to be utilized to motivate women with a breast cancer diagnosis to engage in regular PA.
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  • 文章类型: Journal Article
    背景技术放射治疗(RT)是治疗乳腺癌(BC)的重要方式。大型随机试验表明,包括乳内淋巴结(IMLN)在内的预防性区域淋巴结照射可降低BC相关死亡率。然而,由于相对益处和毒性问题,IMLN-RT的采用是可变的.方法将一项调查通过电子邮件发送给全国各地的放射肿瘤学家(RO),询问他们有关BC的IMLN-RT的实践。结果我们收到了128个回复,其中包括私人机构(PI)和政府机构(GI)的放射肿瘤学家。56例(43.8%)常规提供预防性(p)IMLN-RT,另有15例(11.71%)建议在没有后勤限制的情况下提供。几乎所有,121(94.5%)在放射学阳性淋巴结(LN)的情况下放射IMLN。56个RO(43.8%)在淋巴结阴性疾病中提供了预防性IMLN-RT。在那些没有提供IMLN-RT的人中,大多数(84.72%)认为临床证据模棱两可。在提供pIMLN-RT的56人中,34/56(60.71%)提供给局部晚期肿瘤,20/56(35.71%)提供给所有内部和中央肿瘤(ICQT),29/56(51.78%)至>4个腋下LN阳性,9/56(16.07%)至任何腋下LN阳性。大多数,即,36/56(64.28%)辐射上三个肋间空间,9(16.07%)辐射的上五个肋间空间,6(10.9%)根据肿瘤位置决定,而5(9%)照射了所涉及空间下方的一个空间。总的来说,基于模拟的计划在99%的PI中进行,而不是89%的GI(p=0.03)。大多数RO,即,92(72.4%)首选IMRT而不是IMLN-RT。此外,18个(14%)中心的外科医生实施了IMLN的手术方法,其中13人(72.22%)在放射学上明显的情况下操作IMLN。如10例(55.55%)反应建议,优选对第二和第三肋间空间进行IMLN解剖,8人(44.44%)进行胸腔镜IMLN链解剖。预防剂的分布,最终的IMLN-RT,IMLN夹层在GI和PI之间没有显着差异(p=NS)。结论pIMLN-RT仍然不是大多数中心的标准方案,引用文献中的模棱两可的证据。物流,虽然地理标志和地理标志不同,不影响pIMLN-RT的决定。需要进一步努力,使印度IMLN的实践标准化。
    Nita S. NairBackground  Radiotherapy (RT) is an important modality in the management of breast cancers (BC). Large randomized trials have suggested that prophylactic regional nodal irradiation inclusive of internal mammary lymph nodes (IMLN) reduces BC-related mortality. However, the adoption of IMLN-RT has been variable due to relative benefits and toxicity concerns. Methods  A survey was emailed to radiation oncologists (ROs) across the country wherein they were asked about their practice regarding IMLN-RT in BC. Results  We received 128 responses, which included radiation oncologists across both private institutions (PIs) and government institutions (GIs). Fifty-six (43.8%) routinely offer prophylactic(p) IMLN-RT and an additional 15 (11.71%) suggested they would have offered it in the absence of logistic constraints. Almost all, 121 (94.5%) radiate the IMLN in case of radiologically positive lymph nodes (LNs). Fifty-six ROs (43.8%) offered prophylactic IMLN-RT in node-negative disease. Among those who did not offer IMLN-RT, most (84.72%) felt the clinical evidence was equivocal. Of the 56 who offered pIMLN-RT, 34/56 (60.71%) offered to locally advanced tumors, 20/56 (35.71%) offered to all inner and central tumors (ICQT), 29/56 (51.78%) to > 4 axillary LN-positive and 9/56 (16.07%) to any axillary LN-positive. The majority, i.e., 36/56 (64.28%) radiated upper three intercostal spaces, 9 (16.07%) radiated upper five intercostal spaces, and 6 (10.9%) decided based on tumor location, while 5 (9%) irradiated one space below the involved space. Overall, simulation-based planning was undertaken in 99% of PIs as opposed to 89% of GIs ( p  = 0.03). The majority of ROs, i.e., 92 (72.4%) preferred IMRT to IMLN-RT. In addition, the surgical approach to IMLN was practiced by surgeons at 18 (14%) centers, of which 13 (72.22%) operated the IMLN when radiologically evident. The IMLN dissection was preferentially performed for second and third intercostal spaces as suggested in 10 (55.55%) responses, while 8 (44.44%) performed thoracoscopic dissection of the IMLN chain. The distribution of prophylactic, definitive IMLN-RT, and IMLN dissection did not differ significantly between GI and PI ( p  = NS). Conclusion  pIMLN-RT is still not the standard protocol in most centers citing equivocal evidence in the literature. Logistics, though different in GIs and PIs, did not impact the decision of pIMLN-RT. Further efforts would be required to standardize practice in IMLN across India.
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