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Accelerated partial breast irradiation utilizing brachytherapy: patient selection and workflow.

Chirag Shah1, Jessica Wobb2, Bindu Manyam1

  • 1Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.

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Summary

Accelerated partial breast irradiation (APBI) is a standard breast cancer treatment. This review covers patient selection and workflow for safe and effective APBI delivery, noting current guidelines need improvement for risk stratification.

Keywords:
APBIbrachytherapybreast cancerbreast conserving therapyradiation therapy

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Surgical Oncology

Background:

  • Accelerated partial breast irradiation (APBI) is a standard care option for selected breast cancer patients post-conserving surgery.
  • Interstitial brachytherapy was used in early trials, but applicator-based brachytherapy is now more common due to complexity.
  • Existing consensus guidelines for APBI patient selection have limitations in stratifying local recurrence risk.

Purpose of the Study:

  • To review patient evaluation and selection methods for APBI.
  • To define workflow mechanisms for safe and effective APBI delivery.
  • To highlight the need for updated guidelines for APBI patient selection.

Main Methods:

  • Review of existing literature and consensus statements on APBI.
  • Analysis of current techniques for APBI delivery (interstitial vs. applicator-based).
  • Discussion of critical workflow elements for safe APBI implementation.

Main Results:

  • Current APBI guidelines do not adequately stratify patients by local recurrence risk.
  • Updated guidelines are anticipated to improve patient selection.
  • Safe and effective APBI delivery relies on multidisciplinary approaches and quality assurance.

Conclusions:

  • APBI is an evolving standard of care for breast cancer treatment.
  • Refined patient selection criteria and optimized workflows are crucial for APBI success.
  • Further research is needed to enhance risk stratification and improve APBI outcomes.