Abstract
Background: Breast-conserving surgery (BCS) followed by whole breast irradiation (WBI) has become the standard of care for treating patients with early-stage breast cancer. Recently, various radiation techniques followed by BCS have been reported. We have been investigating “personalized radiotherapy after BCS” ranging from accelerated partial breast irradiation (APBI) to WBI with regional nodal irradiation (RNI) based on the axillary node status. In this study, we compared different cohorts that received personalized radiotherapy. Method: Of 317 consecutive patients who underwent BCS followed by radiotherapy since November 2007, 187 who received APBI and 122 who received WBI were analyzed. Results: The local-only recurrence rate was 1.1% in the APBI group and 3.3% in the WBI group, and the regional-only recurrence rate was 1.1% for APBI and 0.8% for WBI. Conclusions: The clinical efficacy of APBI for local control after BCS was comparable to that of WBI ± RNI. Although this study was based on a small number of patients with a short follow-up period, the feasibility of breast-conserving therapy using multicatheter brachytherapy to achieve acceptable clinical outcomes was demonstrated.
Highlights
Breast-conserving surgery (BCS) followed by whole breast irradiation (WBI) is reportedly as effective as mastectomy and has become the standard of care for treating patients with early-stage breast cancer [1,2]
These rapid advances in accelerated partial breast irradiation (APBI) radiation therapy have been introduced for patients for whom the absence of positive nodes has been confirmed by sentinel-node (SN) biopsy (SNB), and the addition of regional nodal radiation (RNI) to WBI is recommended for pa
Patients who undergo BCS generally receive WBI at our institution; we have introduced the concept of “personalized radiation therapy after BCS” to deliver radiation therapy based on the results of SNB and axillary lymph node dissection (ALND) that ranges from APBI to WBI with regional nodal irradiation (RNI)
Summary
Breast-conserving surgery (BCS) followed by whole breast irradiation (WBI) is reportedly as effective as mastectomy and has become the standard of care for treating patients with early-stage breast cancer [1,2]. The Oxford meta-analysis demonstrated a significant reduction of local recurrence and an overall survival benefit with adjuvant breast radiation therapy after BCS [3,4], 15% - 30% of patients who undergo BCS refuse WBI [5,6,7,8,9,10]. Considering the above, the efficacy and feasibility of accelerated partial breast irradiation (APBI) as an alternative to WBI have been evaluated in many Phases II and III studies [18,19,20,21,22] These rapid advances in APBI radiation therapy have been introduced for patients for whom the absence of positive nodes has been confirmed by sentinel-node (SN) biopsy (SNB), and the addition of regional nodal radiation (RNI) to WBI is recommended for pa-. This study was based on a small number of patients with a short follow-up period, the feasibility of breast-conserving therapy using multicatheter brachytherapy to achieve acceptable clinical outcomes was demonstrated
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