Accelerated Partial Breast Irradiation

Abstract

Local therapies to treat newly diagnosed breast cancer include a lumpectomy with radiation therapy or a mastectomy. The 20-year data from studies about the safety and efficacy of lumpectomy with full-breast radiation therapy support the safety of this regimen and its role to decrease the risk of ipsilateral recurrence and increase long-term survivorship of women with breast cancer. Accelerated partial breast irradiation (APBI) provides radiation therapy to the tumor bed but spares the remaining breast tissue. APBI accelerates the time required to complete the therapy regimen, with a range of one intraoperative session to five consecutive days compared to five to seven weeks. Several techniques exist to administer APBI, including the insertion of a balloon into the lumpectomy space. Of interest is the widespread use of APBI in community and academic settings that has preceded outcomes of large, randomized clinical trials. Because of selection bias in a number of small, single-institution, nonrandomized studies, published data are of limited value to ensure APBI as a standard of care.

Local Treatment of Breast Cancer

“…The omission of radiation therapy following lumpectomy increases the risk of ipsilateral breast recurrence, and may negatively affect the risk of distant recurrence. [46][47][48][49] …”

“…25,[46][47][48][49] Women who require daily radiation therapy may have conflicts related to transportation, time, work, children, finances, mobility, or access to care issues, and may eliminate this important component of local therapy. 46 Nurses are vital to this patient group for support, interventions, and reinforcement of the importance of this therapy.…”

“…46 Whole breast radiation therapy following a lumpectomy has demonstrated equal mortality rates as mastectomy with fewer long-term side effects. [46][47][48][49] A radiation boost may decrease local recurrence, which may add to the absolute gain in younger patients because of their anticipated longer life span.…”

“…46 Whole breast radiation therapy following a lumpectomy has demonstrated equal mortality rates as mastectomy with fewer long-term side effects. [46][47][48][49] A radiation boost may decrease local recurrence, which may add to the absolute gain in younger patients because of their anticipated longer life span. 25,[46][47][48][49] Women who require daily radiation therapy may have conflicts related to transportation, time, work, children, finances, mobility, or access to care issues, and may eliminate this important component of local therapy.…”

“…[46][47][48][49] Radiation begins 4 to 6 weeks after surgery or following chemotherapy. The omission of radiation therapy following lumpectomy increases the risk of ipsilateral breast recurrence, and may negatively affect the risk of distant recurrence.…”