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The American Brachytherapy Society consensus statement for accelerated partial-breast irradiation
Chirag Shah1, Frank Vicini2, Simona F Shaitelman3
1Department of Radiation Oncology, Taussig Cancer Institute, Cleveland, OH.
Brachytherapy
|October 28, 2017
Summary
Accelerated partial-breast irradiation (APBI) offers an alternative to whole-breast irradiation for select early-stage breast cancer patients. This guideline details appropriate patient selection and recommended APBI techniques for safe and effective treatment.
Area of Science:
- Oncology
- Radiation Oncology
- Breast Cancer Treatment
Background:
- Adjuvant radiation therapy is standard after breast-conserving surgery for ductal carcinoma in situ and early invasive breast cancer.
- Accelerated partial-breast irradiation (APBI) is an alternative to whole-breast irradiation.
Purpose of the Study:
- To provide updated data and recommendations for clinicians on APBI.
- To guide appropriate patient selection and techniques for APBI delivery.
Main Methods:
- An extensive literature search was conducted by experts from the American Brachytherapy Society.
- Clinical experience was integrated with evaluated data on APBI techniques and patient selection.
Main Results:
- Ideal APBI candidates are aged 45+, have tumors ≤3cm, are node-negative, and have no lymphovascular invasion.
- Interstitial brachytherapy and intensity-modulated radiation therapy show the strongest evidence for APBI techniques.
- Applicator brachytherapy and 3D conformal radiotherapy have moderate evidence; intraoperative and electronic brachytherapy are not recommended outside trials.
Conclusions:
- Updated guidelines summarize data supporting APBI.
- The guidelines promote appropriate and safe utilization of APBI techniques.
