[Postoperative accelerated partial radiotherapy for breast cancer]

Interstitial accelerated partial breast irradiation is generally limited to patients with extremely low risk of local recurrence.

Between 2004 and 2008, 53 women in the early-stage of breast cancer were treated with multicatheter interstitial brachytherapy in very short general anaesthesia. All patients had T1 (1-22 mm) tumour with no positive auxiliary node and with negative surgical margins. Implants were positioned using a template guide. The dose was prescribed to the tumour bed plus 2 cm margin. A total of 32.0 Gy was delivered in 8 fractions of 4.0 Gy, each given twice a day over a 4-5 day period, using high-dose-rate 192Ir brachytherapy. The follow up of all patients was 2-50 months (median 40 months).

Preoperative morbidity: bacterial infection of the implant in 3 patients, haematoma in 43 patients. Acute toxicity: radio dermatitis--no patients. Late toxicity: mild breast pain in two patients, fat necrosis in 1 patient, oil cyst in 1 patient, dis-pigmentation in no patients, fibrosis in no patients. Cosmetic results: Excellent and good in 50 patients.

This analysis indicates that accelerated partial breast irradiation with 192-iridium interstitial multicatheter HDR-implants is feasible with low preoperative morbidity, low acute and mild late toxicity at a median follow up of 40 months. The cosmetic result is not significantly affected. Our short-term results with multicatheter interstitial brachytherapy continue to demonstrate excellent local and regional control rates and cosmetic results.