Patient-reported outcomes of catheter-based accelerated partial breast brachytherapy and whole breast irradiation, a single institution experience

Accelerated partial breast irradiation (APBI) using the implanted brachytherapy device MammoSite® was approved for routine use by the Food and Drug Administration in 2002. The American Society of Breast Surgeons MammoSite® Breast Brachytherapy Registry served as a guideline for our institution to begin offering this treatment in 2005. This report reviews our available data to provide an analysis of patient outcomes over 12 years of use at a single institution. A retrospective review was conducted of records of 150 patients who underwent APBI or attempted APBI after breast-sparing surgeries between 2006 and 2017. These charts were analyzed for documentation of patient age, cancer stage, incidence of recurrence, and posttreatment complications. Of the patients evaluated, 99 per cent (149/150) completed treatment. The median time since treatment completion is now 8.9 years. One hundred eleven patients (74%) are now greater than five years posttreatment. Ipsilateral breast recurrence was found in 2.7 per cent of patients (4/149), and 1.3 per cent of patients (2/149) developed new primary breast tumors. Acute complications, mostly skin erythema (21%), were uncommon and self-limited. Subacute effects were generally fibrosis (13%) and mild local pain (9.4%). APBI for breast cancer after breast-conserving surgery continues to be used at our institution for select patients with good outcomes. Local control and toxicity are similar to that reported in the literature. Five-year local recurrence rates compare favorably with national trials. Occasional complications included fibrosis, persistent pain, and skin irritation.

Download Full-text

Impact of Chemotherapy on Acute Toxicity in Breast Cancer Patients Treated with Breast Conserving Surgery and Hypofractionated Whole Breast Irradiation: A Single Institution Experience

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2017.06.618 ◽

2017 ◽

Vol 99 (2) ◽

pp. E12

Author(s):

T. Diwanji ◽

J.Y. Lin ◽

A. Lozano ◽

A.M. Chhabra ◽

J.K. Molitoris ◽

...

Keyword(s):

Breast Cancer ◽

Acute Toxicity ◽

Cancer Patients ◽

Breast Conserving Surgery ◽

Whole Breast Irradiation ◽

Breast Irradiation ◽

Breast Cancer Patients ◽

Single Institution ◽

Hypofractionated Whole Breast Irradiation

Download Full-text

Intraoperative irradiation in breast cancer: preliminary results in 80 patients as partial breast irradiation or anticipated boost prior to hypo-fractionated whole breast irradiation

Clinical & Translational Oncology ◽

10.1007/s12094-021-02728-0 ◽

2021 ◽

Author(s):

X. Li ◽

J. Sanz ◽

N. Argudo ◽

M. Vernet-Tomas ◽

N. Rodríguez ◽

...

Keyword(s):

Breast Cancer ◽

Patient Reported Outcomes ◽

Well Being ◽

Partial Breast Irradiation ◽

X Rays ◽

Breast Irradiation ◽

Intraoperative Irradiation ◽

Patient Reported ◽

First Results ◽

Good Cosmesis

Abstract Purpose To present the first results of intraoperative irradiation (IORT) in breast cancer with a low-energy photon system used as partial breast irradiation (PBI) or as an anticipated boost before whole breast hypo-fractionated irradiation (IORT + WBI), concerning tolerance, side effects, quality of life, and patient-reported outcomes. Materials and methods Eighty patients treated with an Intrabeam® system of 50 kV X-rays received a 20 Gy dose intraoperatively were included. Moderate daily hypofractionation of 2.7 Gy in 15 fractions up to 40.5 Gy was administered if high-risk factors were present. Acute post-operative toxicity, surgery complications, chronic toxicity, patient-reported cosmesis and Breast-Q questionnaire were performed at follow-up visits. Results Thirty-one patients were treated as PBI and the remaining 49 as IORT + WBI. Only the IORT + WBI group presented acute toxicity, mainly mild acute dermatitis (11 patients) and one subacute mastitis. A total of 20 patients presented fibrosis (18 patients grade I, 2 patients grade II), 15 (30.5%) patients in the IORT + WBI group and 3 (9.6%) patients in the group of PBI. The cosmesis evaluation in 73 patients resulted poor, fair, good or excellent in 2, 7, 38 and 26 patients, respectively. In PBI group Breast-Q scored higher, especially in terms of their psychosocial well-being (78 vs 65) and satisfaction with radiation-induced toxicity (77 vs 72, respectively) compared to IORT + WBI group. Conclusion IORT is a well-tolerated procedure with low toxicity, good cosmesis and favorable patient-reported outcomes mainly when administered as PBI.

Download Full-text