scholarly journals Partial Breast Irradiation Versus Whole Breast Radiotherapy for Early-Stage Breast Cancer: A Decision Analysis

2008 ◽  
Vol 70 (2) ◽  
pp. 469-476 ◽  
Author(s):  
David J. Sher ◽  
Eve Wittenberg ◽  
Alphonse G. Taghian ◽  
Jennifer R. Bellon ◽  
Rinaa S. Punglia
Keyword(s):  
Breast Cancer ◽  
Decision Analysis ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Breast Radiotherapy ◽  
Whole Breast Radiotherapy

scholarly journals No Difference in Overall Survival and Non-Breast Cancer Deaths after Partial Breast Radiotherapy Compared to Whole Breast Radiotherapy—A Meta-Analysis of Randomized Trials

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2309
Author(s):  
Jan Haussmann ◽  
Wilfried Budach ◽  
Stefanie Corradini ◽  
David Krug ◽  
Balint Tamaskovics ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Randomized Trials ◽  
Early Stage ◽  
Meta Analysis ◽  
Early Stage Breast Cancer ◽  
Effect Sizes ◽  
Breast Irradiation ◽  
Breast Radiotherapy ◽  
Whole Breast Radiotherapy

Purpose/objective: Adjuvant radiotherapy after breast conserving surgery is the standard approach in early stage breast cancer. However, the extent of breast tissue that has to be targeted with radiation has not been determined yet. Traditionally, the whole breast was covered by two opposing tangential beams. Several randomized trials have tested partial breast irradiation (PBI) compared to whole breast irradiation (WBI) using different radiation techniques. There is evidence from randomized trials that PBI might result in lower mortality rates compared to WBI. We aimed to reassess this question using current data from randomized trials. Material/methods: We performed a systematic literature review searching for randomized trials comparing WBI and PBI in early stage breast cancer with publication dates after 2009. The meta-analysis was performed using the published event rates and the effect sizes for overall survival (OS), breast cancer-specific survival (BCSS), and non-breast cancer death (NBCD) as investigated endpoints. Analysis of subgroups using different radiation techniques was intended. We used hazard ratios (HR) and risk differences (RD) to estimate pooled effect sizes. Statistical analysis was performed using the inverse variance heterogeneity model. Results: We identified eleven studies randomizing between PBI and WBI. We did not find significant differences in OS (n = 14,070; HR = 1.02; CI-95%: 0.89–1.16; p = 0.810, and n = 15,203; RD = −0.001; CI-95%: −0.008–0.006; p = 0.785) and BCSS (n = 15,203; RD = 0.001; CI-95%: −0.002–0.005; p = 0.463). PBI also did not result in a significant decrease of NBCD (n = 15,203; RD = −0.003; CI-95%: −0.010–0.003; p = 0.349). A subgroup analysis by radiation technique also did not point to any detectable differences. Conclusion: In contrast to a previous assessment of mortality, we could not find a detrimental effect of WBI on OS or NBCD. A longer follow-up might be necessary to fully assess the long-term mortality effects of PBI compared to WBI.

scholarly journals Intraoperative Radiotherapy for Breast Cancer: The Lasting Effects of a Fleeting Treatment

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Harriet B. Eldredge-Hindy ◽  
Anne L. Rosenberg ◽  
Nicole L. Simone
Keyword(s):  
Breast Cancer ◽  
Patient Satisfaction ◽  
Early Stage ◽  
External Beam Radiotherapy ◽  
Breast Conservation ◽  
Intraoperative Radiotherapy ◽  
Ipsilateral Breast Tumor Recurrence ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Breast Radiotherapy

In well-selected patients who choose to pursue breast conservation therapy (BCT) for early-stage breast cancer, partial breast irradiation (PBI) delivered externally or intraoperatively, may be a viable alternative to conventional whole breast irradiation. Two large, contemporary randomized trials have demonstrated breast intraoperative radiotherapy (IORT) to be noninferior to whole breast external beam radiotherapy (EBRT) when assessing for ipsilateral breast tumor recurrence in select patients. Additionally, IORT and other PBI techniques are likely to be more widely adopted in the future because they improve patient convenience by offering an accelerated course of treatment. Coupled with these novel techniques for breast radiotherapy (RT) are distinct toxicity profiles and unique cosmetic alterations that differ from conventional breast EBRT and have the potential to impact disease surveillance and patient satisfaction. This paper will review the level-one evidence for treatment efficacy as well as important secondary endpoints like RT toxicity, breast cosmesis, quality of life, patient satisfaction, and surveillance mammography following BCT with IORT.

scholarly journals Accelerated Partial Breast Irradiation as an Alternative to Whole-Breast Irradiation in Breast-Conserving Therapy for Early-Stage Breast Cancer

2005 ◽  
Vol 1 (1) ◽  
pp. 59-71
Author(s):  
Timothy M Pawlik ◽  
Henry M Kuerer
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Local Therapy ◽  
Breast Conserving Surgery ◽  
Breast Conserving Therapy ◽  
Early Stage Breast Cancer ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Whole Breast Irradiation ◽  
Breast Irradiation

Breast-conserving therapy has been established as a standard treatment for women with early-stage breast cancer. Whole-breast irradiation has traditionally been utilized to consolidate local therapy following conservative surgery. Recently, the need for whole-breast irradiation after breast-conserving surgery has become controversial, with some investigators advocating accelerated partial breast irradiation as an alternative. Accelerated partial breast irradiation is delivered over a shorter period and only to a portion of the breast. This review will examine the emerging role of accelerated partial breast irradiation in the treatment of early-stage breast cancer and review the biologic rationale for, techniques of, and limitations of partial breast irradiation following breast-conserving surgery.

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