Financial Toxicity of Partial Versus Whole Breast Irradiation: A Systematic Review

To determine if accelerated partial breast irradiation (APBI) is associated with less financial toxicity (financial difficulties that patients experience due to treatment, such as out-of-pocket costs, transportation costs, and time away from work) than whole breast irradiation (WBI).

We searched bibliographic databases for studies published from database inception through April 2024. Eligible studies were randomized clinical trials and observational studies that evaluated financial toxicity of APBI or WBI treatments among adult women with early-stage breast cancer. Pairs of independent reviewers selected the studies.

Nine studies met the inclusion criteria. One study using the comprehensive score for financial toxicity did not report a significant difference between APBI and WBI. Four studies using the European Organization for Research and Treatment of Cancer QLQ-C30 financial difficulties question reported greater financial difficulties with WBI when compared with APBI, with 2 studies reporting differences within 3 months of radiotherapy and 2 studies reporting differences at 1-2 years. Four studies evaluated the cost of travel and days away from work and reported less financial impact associated with APBI when compared with WBI.

APBI is associated with less financial toxicity than WBI, which may be dependent on the shorter duration of treatment.