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Hypofractionated whole and partial breast irradiation: Brazilian Society of Radiotherapy (SBRT) consensus.

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Partial breast irradiation: when less could be more.

Alexandre Vasconcellos Alvim Ambrósio1, Guilherme Rocha Melo Gondim2, Murilo José Inocente Inácio1

  • 1Department of Radiotherapy, Angelina Caron Hospital, Campina Grande do Sul, Brazil.

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|February 4, 2022
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Summary

Partial breast irradiation offers a shorter, effective treatment for early breast cancer, overcoming distance barriers for Brazilian women. This approach improves access to radiotherapy, enhancing oncological outcomes.

Keywords:
Breast cancerpartial breast irradiationradiotherapy

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Area of Science:

  • Oncology
  • Radiotherapy
  • Surgical Oncology

Background:

  • Breast cancer is a leading cause of cancer death in Brazilian women.
  • Standard treatment involves breast-conserving surgery (BCS) and whole breast radiotherapy.
  • Radiotherapy access is limited by distance and scarcity of centers, especially in low- and middle-income countries, leading to undertreatment.

Purpose of the Study:

  • To evaluate accelerated partial breast irradiation (APBI) as a solution to radiotherapy access barriers.
  • To highlight the potential of APBI to reduce treatment time and logistical challenges.
  • To present evidence supporting APBI's safety and efficacy for selected early breast cancer patients.

Main Methods:

  • Review of 8 randomized phase III clinical trials on partial breast irradiation.
  • Analysis of local control rates from AC Camargo Cancer Center (95.6% at 10 years).
  • Assessment of patient travel distances at Angelina Caron Hospital (median 24 Km).

Main Results:

  • APBI is a safe, effective, and convenient treatment for selected early breast cancer patients.
  • APBI significantly reduces treatment time compared to whole breast irradiation.
  • Implementing APBI, particularly intraoperative techniques, could save patients a median of 1,440 traveled distance.

Conclusions:

  • Accelerated partial breast irradiation addresses critical access barriers in radiotherapy for breast cancer.
  • APBI offers comparable oncological outcomes to whole breast irradiation for select patients.
  • Intraoperative partial breast irradiation presents a promising strategy to improve treatment delivery and patient convenience.