Accelerated Partial Breast Irradiation Using Brachytherapy for Breast Cancer: Patterns in Utilization and Guideline Concordance

Hattangadi, J.A.; Taback, Nathan; Neville, Bridget A.; Harris, Jay R.; Punglia, Rinaa S.

doi:10.1093/jnci/djr495

Cited by 47 publications

(42 citation statements)

References 48 publications

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“…[10][11][12][13] Our study furthers the discussion and evaluates the effect of increasing PBI rates on overall RT use. There was a noticeable increase in the use of PBI after 2004, which coincides with the approval of Medicare reimbursement for balloon brachytherapy.…”

Section: Discussionmentioning

confidence: 80%

“…A course of PBI can be completed within 5 days, and many have speculated that the availability of such a modality would increase the use of RT. Indeed, there has been a dramatic uptake in the use of PBI since its introduction in the early 2000s, [10][11][12][13] but few studies have explored the coincident effect on overall rates of RT, particularly among populations who might benefit most from the availability of a shorter treatment schedule.…”

mentioning

confidence: 99%

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Increased Use of Partial-Breast Irradiation Has Not Improved Radiotherapy Utilization for Early-Stage Breast Cancer

2014

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Section: Discussionmentioning

confidence: 80%

mentioning

confidence: 99%

Increased Use of Partial-Breast Irradiation Has Not Improved Radiotherapy Utilization for Early-Stage Breast Cancer

2014

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“…To our knowledge, no study has yet documented the trends in utilization of BCT vs mastectomy since APBI has become more broadly used, and we would welcome research toward this end. The population-based studies that have been published have found that brachytherapy-based APBI has been most prevalent in renowned tertiary care hospitals and advanced cancer centers [85].This difference in treatment delivery may be due to both patient preference and available resources, as HDR brachytherapy and the expert team are not available in centers in rural areas. So far, there has been no published documentation on the trends in usage of external beam -based APBI in these center.…”

Section: Comparison Of Apbi Modalities:-mentioning

confidence: 99%

Accelerated Partial-Breast Irradiation: A State of the Art Strategy.

Hamoud¹,

Ghorbel²,

Falfali³

et al. 2017

IJAR

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Breast conservative surgery, partial breast irradiation, whole breast irradiation, , cosmetic results, Brachytherapy Breast-conserving therapy consists of wide local excision (WLE) followed by whole-breast irradiation (WBI).It is already widely accepted as an alternative to mastectomy. It is used for the treatment of patients with early-stage breast cancer. Accelerated partial-breast irradiation (APBI) is a new strategy. It is characterized by being shorter & an alternative radiation technique for a highly selected patients with favorable early-stage breast cancer. The objective of this review article is to analyze different modalities of APBI delivery and discuss the possible benefits and harms associated with this new platform. …………………………………………………………………………………………………….... Introduction:-Breast cancer has the highest incidence among all cancers in female. In early-stage breast cancer (stage ≤ II), the use of breast-conserving therapy (BCT) is a well-established treatment option. It is comparable to total mastectomy with good results as far as rates of local-regional control and overall survival. It enables patients to maintain their breasts with an acceptable cosmetic results [1]. In the initial trials regarding BCT that were done in the 1970s and 1980s, the new strategy typically involved segmental mastectomy with level I & II axillary lymph node dissection, followed by whole-breast irradiation (WBI). Radiation therapy (RT) is given with a dose of 45-50 Gy over the course of 5 weeks, with or without a boost to the tumor bed. WBI is a relatively well-tolerated treatment. This modality has resulted in good long-term cosmetic results, with low rates of treatment-associated morbidity. The Early Breast Cancer Trialists' Collaborative Group in their meta-analysis has demonstrated that the addition of radiation therapy (RT) to breast-conserving surgery has improved not only local-regional control, but also long-term overall survival [2]. In accelerated partial breast irradiation (APBI) a limited volume of breast tissue is irradiated. This includes tumor bed, lumpectomy or wide local excision with safety margins. It is delivered over a short period of time with increasing the fraction dose. Changing the strategy from whole breast irradiation to a small target (only part of the breast) as in APBI needs full investigation & scrutiny not only because of potential changes in local control but also for its possible impact on the overall survival . Aim of This Review:-Despite of the presence of advanced studies, the role, indication and the optimum APBI technique are still yet to be clearly identified. Therefore, in this review, we will try to find an answer for a number of controversial issues for better identification of the following:

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“…This concept has been challenged by approaches focussing on more convenient treatment providing a lower total radiation dose given in fewer slightly larger fractions and delivered over a shorter period of time by use of hypofractionation schedules [35,36,37]. In addition, the necessity of applying WBI in all patients was questioned by the idea of partial breast irradiation (PBI) [38,39,40,41]. The combination of these techniques, accelerated partial breast irradiation (APBI), was also subject of recently published studies [42].…”

Section: Adjuvant Radiotherapymentioning

confidence: 99%

AGO Recommendations for Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2013

et al. 2013

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Accelerated Partial Breast Irradiation Using Brachytherapy for Breast Cancer: Patterns in Utilization and Guideline Concordance

Abstract: APBIb after breast-conserving surgery has been rapidly adopted in the United States. Use varied by race, ethnicity, and widely by region, especially among patients who may not be suitable for this radiation technique.

Cited by 47 publications

References 48 publications

Increased Use of Partial-Breast Irradiation Has Not Improved Radiotherapy Utilization for Early-Stage Breast Cancer

Increased Use of Partial-Breast Irradiation Has Not Improved Radiotherapy Utilization for Early-Stage Breast Cancer

Accelerated Partial-Breast Irradiation: A State of the Art Strategy.

AGO Recommendations for Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2013

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