Abstract
BackgroundBrachytherapy as adjuvant treatment for early-stage breast cancer has become widely available and offers patients an expedited treatment schedule. Given this, many women are electing to undergo brachytherapy in lieu of standard fractionation radiotherapy. We compare outcomes between patients treated with accelerated partial breast irradiation (APBI) via multicatheter interstitial brachytherapy versus patients who were also eligible for and offered APBI but who chose whole breast radiation (WBI).MethodsPatients treated from December 2002 through May 2007 were reviewed. Selection criteria included patients with pTis-T2N0 disease, ≤ 3 cm unifocal tumors, and negative margins who underwent breast conservation surgery. Local control (LC), cause-specific (CSS) and overall survival (OS) were analyzed.Results202 patients were identified in the APBI cohort and 94 patients in the WBI cohort. Median follow-up for both groups exceeded 60 months. LC was 97.0% for the APBI cohort and 96.2% for the WBI cohort at 5 years (ns). Classification by 2010 ASTRO APBI consensus statement categories did not predict worse outcomes.ConclusionAPBI via multicatheter interstitial brachytherapy provides similar local failure rates compared to WBI at 5 years for properly selected patients. Excellent results were seen despite the high fraction of younger patients (< 60 years old) and patients with DCIS.
Highlights
Prospective randomized controlled trials have established breast conservation therapy (BCT), consisting of partial mastectomy and adjuvant radiation therapy, offers equivalent disease control in women with Stage I and II breast cancer as compared to mastectomy and significantly superior disease control when compared to partial mastectomy alone [1,2]
We have offered accelerated partial breast irradiation (APBI) or whole breast radiation (WBI) therapy as treatment options for early-stage breast cancer in appropriately selected patients since December 2002
Given the presence of these three patients in the APBI cohort, we included patients seen in the study time period who were in their thirties, who received WBI, and who would have met the other eligibility criteria for APBI
Summary
Prospective randomized controlled trials have established breast conservation therapy (BCT), consisting of partial mastectomy and adjuvant radiation therapy, offers equivalent disease control in women with Stage I and II breast cancer as compared to mastectomy and significantly superior disease control when compared to partial mastectomy alone [1,2]. The standard method for administering breast irradiation as a part of BCT is whole breast irradiation (WBI) delivered in five daily fractions per week for several weeks. In an effort to expedite radiation therapy, accelerated. Brachytherapy as adjuvant treatment for early-stage breast cancer has become widely available and offers patients an expedited treatment schedule. We compare outcomes between patients treated with accelerated partial breast irradiation (APBI) via multicatheter interstitial brachytherapy versus patients who were eligible for and offered APBI but who chose whole breast radiation (WBI)
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