Accelerated Partial Breast Irradiation

  • Accelerated partial breast irradiation includes multiple techniques such as: 
    • Interstitial brachytherapy
    • Applicator brachytherapy
    • External beam radiation therapy
  • The Groupe Européen de Curie thérapie of European Society for Radiotherapy and Oncology (GEC-ESTRO) trial:
    • Randomized 1184 patients with: 
      • Low-risk invasive carcinoma or ductal carcinoma in situ (DCIS) treated with breast-conserving surgery to either whole-breast irradiation (WBI) or APBI using multi catheter brachytherapy: 
        • The cumulative incidence of local recurrence at 5 years was: 
          • 1.44% with APBI
          • 0.92% with WBI
  • The Florence trial:
    • Randomized 520 patients to either WBI or APBI with intensity-modulated radiation therapy:
      • With a mean follow-up of 5 years: 
        • The rate of local recurrence was: 
          • 1.5% in both arms
  • The American Society of Breast Surgeons’ Mammo Site Registry found: 
    • 5-year rates of local recurrence were less than 4%
  • An older randomized trial from Hungary using interstitial APBI and electrons: 
    • 5-year local recurrence rate of 4.7%
  • It is important to recognize that these outcomes are likely due to: 
    • The highly selected, low-risk patient populations included in many of the APBI trials as evidenced by the tables / guidelines:
      • Patients tend to be: 
        • Postmenopausal
        • Tumors less than 3 cm, without DCIS
        • Node negative
        • ER-positive

#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #BreastCancer #CASO #CenterforAdvancedSurgicalOncology #PalmettoGeneralHospital

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