The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy

Meritxell Arenas; Yasemin Bölükbasi; Liesbeth J. Boersma; Birgitte Offersen; Vassilis Kouloulias; Isabella Palumbo; Lurdes Trigo; Laura Lozza; Fabio Marazzi; Marco Trovo; Sofia Rivera; Orit Kaidar-Person; Charlotte Coles; Icro Meattini; Vincenzo Valentini; Cynthia Aristei; Philip Poortmans; Assisi Think Tank Meeting (ATTM) 2024 members

doi:10.1016/j.breast.2025.103881

The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy

Meritxell Arenas^*, Yasemin Bölükbasi, Liesbeth J. Boersma, Birgitte Offersen, Vassilis Kouloulias, Isabella Palumbo, Lurdes Trigo, Laura Lozza, Fabio Marazzi, Marco Trovo, Sofia Rivera, Orit Kaidar-Person, Charlotte Coles, Icro Meattini, Vincenzo Valentini, Cynthia Aristei, Philip Poortmans, Assisi Think Tank Meeting (ATTM) 2024 members

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

At the Fifth Assisi Think Tank Meeting (ATTM) on breast cancer, one key topic was the role of tumor bed boost in invasive breast cancer and ductal carcinoma in situ. The need for a tumor bed boost after whole breast irradiation is controversial. A literature review assessed boost indications, target volume definition, techniques, dose fractionation, and ongoing trials. Findings indicated that while a boost halves the risk of local recurrence at 10 years, it also leads to worsened cosmetic outcomes and increased fibrosis without improving overall survival. Therefore, we would recommend to omit the boost if the estimated reduction in local recurrence at 10 years is less than 3 %, and to apply shared decision-making with patients, if the boost is expected to reduce the local recurrence rate with >3 % at 10 years. Future research will focus on identifying patient subgroups that can safely omit the boost and improving boost volume precision.

Original language	English
Article number	103881
Number of pages	8
Journal	Breast
Volume	80
DOIs	https://doi.org/10.1016/j.breast.2025.103881
Publication status	Published - 1 Apr 2025

Keywords

Boost technique
Breast cancer
Dose fractionation
Local recurrence
Radiation therapy
Target volume definition
Tumour bed boost

Access to Document

10.1016/j.breast.2025.103881Licence: CC BY-NC-ND

Cite this

Arenas, M., Bölükbasi, Y., Boersma, L. J., Offersen, B., Kouloulias, V., Palumbo, I., Trigo, L., Lozza, L., Marazzi, F., Trovo, M., Rivera, S., Kaidar-Person, O., Coles, C., Meattini, I., Valentini, V., Aristei, C., Poortmans, P., & Assisi Think Tank Meeting (ATTM) 2024 members (2025). The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy. Breast, 80, Article 103881. https://doi.org/10.1016/j.breast.2025.103881

@article{3b79d6b70cdc4c91ac06aee78cf3c671,

title = "The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy",

abstract = "At the Fifth Assisi Think Tank Meeting (ATTM) on breast cancer, one key topic was the role of tumor bed boost in invasive breast cancer and ductal carcinoma in situ. The need for a tumor bed boost after whole breast irradiation is controversial. A literature review assessed boost indications, target volume definition, techniques, dose fractionation, and ongoing trials. Findings indicated that while a boost halves the risk of local recurrence at 10 years, it also leads to worsened cosmetic outcomes and increased fibrosis without improving overall survival. Therefore, we would recommend to omit the boost if the estimated reduction in local recurrence at 10 years is less than 3 %, and to apply shared decision-making with patients, if the boost is expected to reduce the local recurrence rate with >3 % at 10 years. Future research will focus on identifying patient subgroups that can safely omit the boost and improving boost volume precision.",

keywords = "Boost technique, Breast cancer, Dose fractionation, Local recurrence, Radiation therapy, Target volume definition, Tumour bed boost",

author = "Meritxell Arenas and Yasemin B{\"o}l{\"u}kbasi and Boersma, {Liesbeth J.} and Birgitte Offersen and Vassilis Kouloulias and Isabella Palumbo and Lurdes Trigo and Laura Lozza and Fabio Marazzi and Marco Trovo and Sofia Rivera and Orit Kaidar-Person and Charlotte Coles and Icro Meattini and Vincenzo Valentini and Cynthia Aristei and Philip Poortmans and {Assisi Think Tank Meeting (ATTM) 2024 members}",

note = "Publisher Copyright: {\textcopyright} 2025",

year = "2025",

month = apr,

day = "1",

doi = "10.1016/j.breast.2025.103881",

language = "English",

volume = "80",

journal = "Breast",

issn = "0960-9776",

publisher = "Churchill Livingstone",

}

Arenas, M, Bölükbasi, Y, Boersma, LJ, Offersen, B, Kouloulias, V, Palumbo, I, Trigo, L, Lozza, L, Marazzi, F, Trovo, M, Rivera, S, Kaidar-Person, O, Coles, C, Meattini, I, Valentini, V, Aristei, C, Poortmans, P & Assisi Think Tank Meeting (ATTM) 2024 members 2025, 'The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy', Breast, vol. 80, 103881. https://doi.org/10.1016/j.breast.2025.103881

TY - JOUR

T1 - The 2024 Assisi think tank on breast cancer

T2 - Focus on the use of a tumour bed boost after breast conserving therapy

AU - Arenas, Meritxell

AU - Bölükbasi, Yasemin

AU - Boersma, Liesbeth J.

AU - Offersen, Birgitte

AU - Kouloulias, Vassilis

AU - Palumbo, Isabella

AU - Trigo, Lurdes

AU - Lozza, Laura

AU - Marazzi, Fabio

AU - Trovo, Marco

AU - Rivera, Sofia

AU - Kaidar-Person, Orit

AU - Coles, Charlotte

AU - Meattini, Icro

AU - Valentini, Vincenzo

AU - Aristei, Cynthia

AU - Poortmans, Philip

AU - Assisi Think Tank Meeting (ATTM) 2024 members

PY - 2025/4/1

Y1 - 2025/4/1

N2 - At the Fifth Assisi Think Tank Meeting (ATTM) on breast cancer, one key topic was the role of tumor bed boost in invasive breast cancer and ductal carcinoma in situ. The need for a tumor bed boost after whole breast irradiation is controversial. A literature review assessed boost indications, target volume definition, techniques, dose fractionation, and ongoing trials. Findings indicated that while a boost halves the risk of local recurrence at 10 years, it also leads to worsened cosmetic outcomes and increased fibrosis without improving overall survival. Therefore, we would recommend to omit the boost if the estimated reduction in local recurrence at 10 years is less than 3 %, and to apply shared decision-making with patients, if the boost is expected to reduce the local recurrence rate with >3 % at 10 years. Future research will focus on identifying patient subgroups that can safely omit the boost and improving boost volume precision.

AB - At the Fifth Assisi Think Tank Meeting (ATTM) on breast cancer, one key topic was the role of tumor bed boost in invasive breast cancer and ductal carcinoma in situ. The need for a tumor bed boost after whole breast irradiation is controversial. A literature review assessed boost indications, target volume definition, techniques, dose fractionation, and ongoing trials. Findings indicated that while a boost halves the risk of local recurrence at 10 years, it also leads to worsened cosmetic outcomes and increased fibrosis without improving overall survival. Therefore, we would recommend to omit the boost if the estimated reduction in local recurrence at 10 years is less than 3 %, and to apply shared decision-making with patients, if the boost is expected to reduce the local recurrence rate with >3 % at 10 years. Future research will focus on identifying patient subgroups that can safely omit the boost and improving boost volume precision.

KW - Boost technique

KW - Breast cancer

KW - Dose fractionation

KW - Local recurrence

KW - Radiation therapy

KW - Target volume definition

KW - Tumour bed boost

U2 - 10.1016/j.breast.2025.103881

DO - 10.1016/j.breast.2025.103881

M3 - (Systematic) Review article

SN - 0960-9776

VL - 80

JO - Breast

JF - Breast

M1 - 103881

ER -

The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy

Abstract

Keywords

Access to Document

Fingerprint

Cite this