Accelerated partial breast irradiation: potential roles following breast-conserving surgery

Area of Science:

• Oncology
• Radiation Oncology
• Surgical Oncology

Background:

• Mastectomy and whole breast irradiation (WBI) show equivalent survival for early-stage breast cancer.
• WBI's multi-week course limits access to breast-conserving therapy for some patients.
• Accelerated partial breast irradiation (APBI) is an emerging alternative.

Purpose of the Study:

• To review the current medical literature on APBI.
• To examine randomized trials and prospective studies of APBI.
• To outline current recommendations for APBI use.

Main Methods:

• Literature review of randomized trials and prospective institutional studies.
• Analysis of data on various APBI techniques, including brachytherapy and external beam methods.
• Evaluation of follow-up data and local control rates.

Main Results:

• Several APBI techniques exist, with limited long-term data for most.
• Multicatheter interstitial brachytherapy has the longest follow-up but is uncommon.
• Balloon brachytherapy and 3D conformal external beam APBI show comparable local control to WBI in selected patients.

Conclusions:

• APBI may enhance access to breast conservation for select early-stage breast cancer patients.
• Limited follow-up data exist for APBI, highlighting the need for more research.
• Strict, evidence-based selection criteria are crucial for appropriate APBI patient selection.