Partial breast irradiation techniques in early breast cancer

Area of Science:

• Oncology
• Radiotherapy
• Surgical Oncology

Background:

• Whole breast irradiation is a standard treatment for early breast cancer following breast-conserving surgery.
• Accelerated partial breast irradiation (APBI) is emerging as a potential alternative to whole breast irradiation.
• APBI involves delivering radiation to a smaller portion of the breast over a shorter period.

Purpose of the Study:

• To present various accelerated partial breast irradiation techniques.
• To discuss ongoing phase III trials evaluating the efficacy and safety of APBI.
• To provide recommendations for the clinical implementation of APBI.

Main Methods:

• Overview of intraoperative APBI techniques: external beam irradiation (photons, electrons) and interstitial high dose rate (HDR) brachytherapy.
• Overview of postoperative APBI techniques: interstitial brachytherapy (HDR, PDR, LDR), intracavitary brachytherapy, and external beam radiotherapy (electrons, photons, protons).
• Review of current phase III clinical trials comparing APBI with whole breast irradiation.

Main Results:

• Accelerated partial breast irradiation encompasses diverse techniques for targeted radiation delivery.
• Ongoing trials are crucial for establishing the oncological outcomes and toxicity profiles of APBI.
• Evidence from trials will guide the selection of appropriate APBI techniques for specific patient populations.

Conclusions:

• Accelerated partial breast irradiation presents a promising option for selected early breast cancer patients.
• Further data from phase III trials are needed to solidify APBI's role in breast cancer treatment guidelines.
• Personalized radiotherapy approaches, including APBI, are advancing breast cancer care.