Accelerated partial breast irradiation- pros and cons

Breast conservation surgery followed by whole breast irradiation has been established as a standard of care for the treatment of early stage breast cancer and is associated with excellent local control and overall survival. As most in-breast recurrences occur in the area surrounding the primary breast cancer, it has been hypothesized that selected breast cancer patients may be adequately treated with accelerated partial breast irradiation (APBI), obviating the need for whole breast irradiation. Advantages of APBI include a shorter treatment schedule that may result in perceived patient convenience and more women opting for breast conservation therapy. These possible benefits of APBI must be balanced with the potential risk of recurrence within untreated breast tissue and the possible long term toxicity associated with larger doses per fraction and accelerated course of irradiation. Although, the preliminary results with APBI are encouraging, appropriate patient selection and optimal dosimetric guidelines remain to be clearly defined.