The Evolution of Accelerated, Partial Breast Irradiation as a Potential Treatment Option for Women with Newly Diagnosed Breast Cancer Considering Breast Conservation

2004 ◽  
Vol 19 (6) ◽  
pp. 673-705 ◽  
Author(s):  
Frederick M. Dirbas ◽  
Stefanie S. Jeffrey ◽  
Don R. Goffinet
Keyword(s):  
Breast Cancer ◽  
Treatment Option ◽  
Breast Conservation ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Potential Treatment ◽  
Newly Diagnosed ◽  
Breast Irradiation

Accelerated Partial Breast Irradiation in Early-Stage Breast Cancer

2007 ◽  
Vol 25 (8) ◽  
pp. 996-1002 ◽  
Author(s):  
Mary Ella Sanders ◽  
Troy Scroggins ◽  
Federico L. Ampil ◽  
Benjamin D. Li
Keyword(s):  
Breast Cancer ◽  
Time Course ◽  
Treatment Time ◽  
Early Stage ◽  
Breast Conservation ◽  
Intraoperative Radiotherapy ◽  
Accelerated Partial Breast Irradiation ◽  
Intracavitary Brachytherapy ◽  
Partial Breast Irradiation ◽  
Breast Irradiation

Whole-breast irradiation, as part of breast-conservation therapy (BCT), has well-established results, good cosmesis, and low toxicity. Results from the BCT trials suggest that the risk for ipsilateral breast cancer recurrence resides within close proximity to the original tumor site. This leads investigators to consider the role of an accelerated and more tumor bed–focused course of radiotherapy. Accelerated partial-breast irradiation (APBI) involves treating a limited volume of breast tissue, with dose of irradiation per fraction increased and the treatment time course decreased. Four currently available methods of APBI are interstitial brachytherapy, intracavitary brachytherapy, intraoperative radiotherapy, and three-dimensional conformal external-beam radiotherapy. Patient selection is critical. This review article presents some preliminary clinical observations and limitations that suggest a potential role for APBI as a more user-friendly mode for delivering radiotherapy after lumpectomy for early breast cancer.

Accelerated Partial Breast Irradiation and Hypofractionated Whole Breast Radiation

2011 ◽  
Vol 07 (01) ◽  
pp. 31
Author(s):  
Bryan P Rowe ◽  
Meena S Moran ◽  
◽  
Keyword(s):  
Breast Cancer ◽  
Treatment Time ◽  
Early Stage ◽  
Breast Conservation ◽  
Early Stage Breast Cancer ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Tumor Bed ◽  
Advantages And Disadvantages

Breast conservation therapy (BCT), consisting of local excision of the breast tumor to achieve negative margins followed by whole breast irradiation, is standard treatment for early-stage breast cancer. The conventional radiotherapy course treats the entire breast, typically followed by a boost to the tumor bed over six to seven weeks. While the efficacy and cosmetic outcomes of conventionally fractionated whole breast radiation are well-established, two strategies are being investigated to address the lengthy treatment time associated with adjuvant radiotherapy for early-stage breast cancer. Accelerated partial breast irradiation (APBI) involves treatment to the tumor bed plus a small margin, allowing completion of therapy in five days or less. A variety of techniques, each with unique advantages and disadvantages, is currently under investigation for delivering APBI. Hypofractionated whole breast radiation (hWBRT) involves treating the entire breast with larger daily doses of radiation over three to four weeks. This article reviews the principles behind APBI and hWBRT, the indications for each technique, and relevant data supporting their use.

scholarly journals The Role of Brachytherapy in the Treatment of Breast Cancer

Breast Care ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. 157-161 ◽  
Author(s):  
Daniela Kauer-Dorner ◽  
Daniel Berger
Keyword(s):  
Breast Cancer ◽  
Treatment Options ◽  
Breast Conservation ◽  
Recurrence Risk ◽  
Breast Conserving Surgery ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Breast Cancer Patients ◽  
Tumor Bed

Radiotherapy plays an important part in the management of breast cancer. Especially after breast-conserving surgery, external whole breast irradiation, occasionally with an additional local boost, is an integral part of breast conservation. Besides external radiation techniques, brachytherapy (BT) has long been among the treatment options, especially with regard to local boost application. With the emerging implementation of accelerated partial breast irradiation (APBI), BT in general and interstitial multi-catheter BT in particular, are gaining an increasing role in the management of a selected group of early breast cancer patients. APBI is an approach to reduce the irradiated area to the former tumor bed rather than treating the whole breast tissue in patients with a low baseline local recurrence risk. After a variety of phase I-III clinical studies, it is clearly evident that APBI will play a role in the treatment of this selected patient group. In this review, we focus on the clinical development and different available techniques of breast BT and provide a preview of prospects for its use.

Five-day accelerated partial breast irradiation (APBI) using intensity modulated radiation therapy (IMRT) in stage 0-II breast cancer: A report of 214 cases with up to 39 month follow-up.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12508-e12508
Author(s):  
Rufus J. Mark ◽  
Valerie Gorman ◽  
Michal Wolski ◽  
Steven McCullough
Keyword(s):  
Breast Cancer ◽  
Intensity Modulated Radiation Therapy ◽  
Target Volume ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Skin Reactions ◽  
Cosmetic Results ◽  
Non Invasive

e12508 Background: Randomized trials in stage 0-II breast cancer have proven that APBI given via HDR implant in 5 days is equivalent to whole breast irradiation (WBI) given in 5-6 weeks in regard to breast tumor local recurrence (LR). However, complications have been significant. Recently APBI using non-invasive IMRT given in 5 fractions has been shown in another randomized trial with 10 year follow-up to be equivalent to WBI in 6 weeks, with respect to LR. IMRT was superior in regard to acute effects, late effects, and cosmesis. In the randomized clinical trial of APBI IMRT, the Clinical Target Volume (CTV) was defined by the injection of individual fiducial markers bordering the surgical cavity. We have used the Biozorb fiducial system to localize the CTV for IMRT. We sought to confirm the APBI IMRT results with this simpler less labor intensive fiducial placement system. Methods: Between 2017 and 2021, 214 patients have undergone IMRT targeted to a Biozorb defined CTV with the walls of the surgical cavity sewn to the Biozorb device. Eligible patients were older than age 40, had tumor sizes < 3 cm, negative surgical margins, and negative sentinel node dissections. IMRT dose was 30 Gy given in 5 fractions. Dose Constraints were as follows : V-30 Gy < 105%, Ipsilateral Breast V-15 Gy < 50%, Ipsilateral Lung V-10 Gy < 20%, Contralateral Lung V-5 Gy < 10%, Heart V-3 Gy < 20%, Contralateral Breast Dmax < 2 Gy and Skin Dmax < 27 Gy. The Planning Target Volume (PTV) ranged from 27 to 355 cc with a median of 80 cc. PTV = CTV + 1-2 cm. Results: Follow-up ranged from 1-39 months with a median of 20 months. LR has been 0% (0/214). There have been no skin reactions or seromas. Infection has occurred in one patient (0.5%). Four (1.9%) patients developed pain around the Biozorb site. This resolved on a short courses of steroids in all cases. Cosmetic results as rated by the Surgeon, Radiation Oncologist, and Nurse, were rated excellent in 99.0% (212/214) of cases. Conclusions: Non-invasive APBI with IMRT given qd over 5 days targeted to Biozorb has resulted in LR, complications, and cosmetic results which compare favorably to invasive APBI given bid with HDR implant. At last follow-up, there have been no LR, skin reactions, or significant complications. Cosmesis has been excellent in 99.0% of patients.

scholarly journals Accelerated partial breast irradiation in elderly breast cancer patients

2020 ◽  
Vol 9 (S1) ◽  
pp. S29-S36
Author(s):  
Igor Sirák ◽  
Miroslav Hodek ◽  
Pavel Jandík ◽  
Jakub Grepl ◽  
Petr Paluska ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Breast Cancer Patients
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