Abstract
Breast conservation surgery followed by whole breast irradiation has been established as a standard of care for the treatment of early stage breast cancer and is associated with excellent local control and overall survival. As most inbreast recurrences occur in the area surrounding the primary breast cancer, it has been hypothesized that selected breast cancer patients may be adequately treated with accelerated partial breast irradiation (APBI), obviating the need for whole breast irradiation. Advantages of APBI include a shorter treatment schedule that may result in perceived patient convenience and more women opting for breast conservation therapy. These possible benefits of APBI must be balanced with the potential risk of recurrence within untreated breast tissue and the possible long term toxicity associated with larger doses per fraction and accelerated course of irradiation. Although, the preliminary results with APBI are encouraging, appropriate patient selection and optimal dosimetric guidelines remain to be clearly defined.
Keywords: Breast cancer, accelerated partial breast irradiation, breast conservation therapy, breast tissue, lymph node-negative breast cancer, lymph node-positive patients, radiotherapy, multifocality, multicentricity, mastectomy specimens, mammographic-histologic techniques, tumor foci, residual carcinoma, lumpectomy, quadrantectomy, intraoperative radiation, 3D conformal external beam radiotherapy, brachytherapy, Iridium192, Direct visualization, surgical clips, ultrasound, computed tomography, necrosis, retrospective matched-pair study analysis, nonlobular breast cancer histology, cosmetic results, Single Balloon-Catheter (MammoSite) Technique, seroma formation rates, ductal carcinomas, prognostic factors, radiobiological equivalent, radiation dose, fractionation, biologically effective doses, American Society of Radiation Oncology (ASTRO), BRCA1/BRCA2 mutations, Bowel Project, lymph nodes
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