Accelerated partial breast irradiation: advances and controversies

Area of Science:

• Oncology
• Radiation Oncology
• Surgical Oncology

Background:

• Breast-conserving therapy (lumpectomy plus adjuvant irradiation) is the standard for early-stage breast cancer.
• Accelerated partial breast irradiation (APBI) has emerged as an alternative to whole breast irradiation (WBI) over the past two decades.
• APBI involves focused irradiation of the lumpectomy cavity over a shorter treatment period.

Purpose of the Study:

• To review the development and current status of APBI as an alternative to WBI.
• To discuss the advantages and controversies surrounding APBI in early-stage breast cancer management.

Main Methods:

• Review of multiple APBI modalities: brachytherapy, external beam irradiation, and intraoperative irradiation.
• Comparison of APBI treatment duration and dose delivery with conventional radiotherapy.
• Analysis of reported complications and follow-up durations from APBI trials.

Main Results:

• APBI offers shorter treatment durations and more focused irradiation compared to WBI.
• High biological doses can be delivered to high-risk areas in a compressed timeframe.
• Controversies exist regarding APBI, including a higher risk of complications in some retrospective studies and limited follow-up in intraoperative APBI trials.

Conclusions:

• APBI provides a valuable alternative to WBI for carefully selected early-stage breast cancer patients.
• Further research and longer follow-up are needed to fully establish the long-term safety and efficacy of APBI, particularly intraoperative techniques.