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      Accelerated partial breast irradiation with interstitial multicatheter brachytherapy after breast-conserving surgery for low-risk early breast cancer

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          Abstract

          Patients with low-risk invasive ductal carcinoma treated with breast-conserving surgery (BCS) were included in a multicatheter brachytherapy APBI protocol. The primary endpoint was ipsilateral breast recurrence. Between December 2008–December 2017, 186 low-risk breast cancer patients were treated with APBI using interstitial multicatheter brachytherapy and followed prospectively. At 5-years of follow-up, cumulative local recurrence (LR) and cause-specific survival was 1.1% (95% CI 0.3–1.9) and 98.3% (95% CI 97.3–99.3%) respectively. No grade 3 adverse effects were observed. Postoperative APBI using multicatheter brachytherapy after BCS in early breast cancer patients have excellent rates of local control and survival, without significant toxicity.

          Highlights

          • •

            Low risk early breast cancer patients have low rate of recurrences.

          • •

            APBI with interstitial multicatheter brachytherapy in low risk early breast cancer patients have excellent rates of local control and survival.

          • •

            Reducing time of treatment.

          • •

            Reducing adverse effects.

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          Most cited references16

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          5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial.

          Vratislav Strnad, Oliver J Ott, Guido Hildebrandt … (2016)
          In a phase 3, randomised, non-inferiority trial, accelerated partial breast irradiation (APBI) for patients with stage 0, I, and IIA breast cancer who underwent breast-conserving treatment was compared with whole-breast irradiation. Here, we present 5-year follow-up results.
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            Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement.

            Candace R. Correa, Eleanor E R Harris, Maria Leonardi … (2017)
            To update the accelerated partial breast irradiation Consensus Statement published in 2009 and provide guidance on use of intraoperative radiation therapy (IORT) for partial breast irradiation in early-stage breast cancer, based on published evidence complemented by expert opinion.
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              Breast-conserving therapy with partial or whole breast irradiation: ten-year results of the Budapest randomized trial.

              Z Sulyok, Miklos Kasler, Tibor Major … (2013)
              To report the long-term results of a single-institution randomized study comparing the results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Between 1998 and 2004, 258 selected women with pT1 pN0-1mi M0, grade 1-2, non-lobular breast cancer without the presence of extensive intraductal component and resected with negative margins were randomized after BCS to receive 50 Gy WBI (n=130) or PBI (n=128). The latter consisted of either 7 × 5.2 Gy high-dose-rate (HDR) multi-catheter brachytherapy (BT; n=88) or 50 Gy electron beam (EB) irradiation (n=40). Primary endpoint was local recurrence (LR) as a first event. Secondary endpoints were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and cosmetic results. After a median follow up of 10.2 years, the ten-year actuarial rate of LR was 5.9% and 5.1% in PBI and WBI arms, respectively (p=0.77). There was no significant difference in the ten-year probability of OS (80% vs 82%), CSS (94% vs 92%), and DFS (85% vs 84%), either. The rate of excellent-good cosmetic result was 81% in the PBI, and 63% in the control group (p<0.01). Partial breast irradiation delivered by interstitial HDR BT or EB for a selected group of early-stage breast cancer patients produces similar ten-year results to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with HDR BT implants compared with the outcome after WBI. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Contributors
                Nieves G. Rodriguez-Ibarria
                Ma Beatriz Pinar
                Laura García
                M. Auxiliadora Cabezón
                Marta Lloret
                Ma Dolores Rey-Baltar
                J. Ignacio Rdguez-Melcón
                Pedro C. Lara
                Journal
                Journal ID (nlm-ta): Breast
                Journal ID (iso-abbrev): Breast
                Title: The Breast : official journal of the European Society of Mastology
                Publisher: Elsevier
                ISSN (Print): 0960-9776
                ISSN (Electronic): 1532-3080
                Publication date PMC-release: 22 April 2020
                Publication date Collection: August 2020
                Publication date (Electronic): 22 April 2020
                Volume: 52
                Pages: 45-49
                Affiliations
                [a ]Dr. Negrin University Hospital, Bco La Ballena s/n, 35010, Las Palmas de Gran Canaria, Las Palmas, Spain
                [b ]Las Palmas de Gran Canaria University, Juan de Quesada, 30, 35001, Las Palmas de Gran Canaria, Las Palmas, Spain
                [c ]San Roque University Hospitals, Dolores de la Rocha, 5, 35001, Las Palmas de Gran Canaria, Las Palmas, Spain
                [d ]Fernando Pessoa Canarias University, Dolores dela Rocha 14, Las Palmas de Gran Canaria, Las Palmas, Spain
                [e ]Fundación Canaria del Instituto Canario de Investigación del Cáncer, Avda de la Trinidad 61 Torre Agustín Arevalo 7 plantaLa Laguna, Santa Cruz de Tenerife, 38204 Spain
                Author notes
                [∗ ]Corresponding author. nrodiba@ 123456gobiernodecanarias.org
                Article
                Publisher ID: S0960-9776(20)30102-8
                DOI: 10.1016/j.breast.2020.04.008
                PMC ID: 7375648
                PubMed ID: 32380439
                SO-VID: 6ef65e74-6717-4c5c-9d6a-2a5a571ea014
                Copyright © © 2020 The Author(s)
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 12 December 2019
                Date revision received : 31 March 2020
                Date accepted : 18 April 2020
                Categories
                Subject: Short Communication

                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: partial breast irradiation,brachytherapy,early breast cancer,breast cancer
                Data availability:
                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: partial breast irradiation, brachytherapy, early breast cancer, breast cancer

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