S220
Clinical - Breast
ESTRO 2026
received RT without deep-inspiration breast-hold technique.With a median follow-up time of 11.8 years (IQR: 9.8-12.7 years), 29 patients (4.7%) developed MACE. In multivariable analysis, LAD V40 outperformed MHD as the strongest dosimetric predictor of MACE (sHR=1.023 per 1% increase, 95% CI: 1.005-1.040, p=0.010), alongside age (sHR=1.086, p<0.001) and prior cardiac events (sHR=5.421, p=0.001), with an optimism-corrected Harrell’s C-index of 0.868. Figure 1 display the NTCP curves for MACE with increasing LAD V40, stratified by history of cardiac events and age at RT.
Conclusion: This multicenter cohort study with >10-year follow-up showed that LAD V40 outperformed mean heart dose as the strongest predictor for major adverse cardiac events after breast RT. The NTCP model enables personalized risk assessment and may guide the use of cardiac-sparing techniques in high risk patients. Keywords: Cardiotoxicity, NTCP modeling, Radiotherapy Imaging Characteristics and Clinical Significance of Incidental Axillary Lymph Nodes on Radiotherapy Planning Tomography in Breast Cancer Patients Meltem Kirli Bolukbas 1 , Fatma Celik Yabul 2 , Merve Sahin 1 , Murat Cikot 3 , Esengul Kocak Uzel 1 1 Department of Radiation Oncology, Health Sciences University Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. 2 Department of Radiology, Health Sciences University Bakirkoy Dr. Sadi Digital Poster Highlight 863 Konuk Training and Research Hospital, Istanbul, Turkey. 3 Department of General Surgery, Health Sciences University Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey Purpose/Objective: In breast cancer management, axillary approaches during both initial surgery and after neoadjuvant chemotherapy (NACT) are increasingly de-escalated,
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