Accelerated partial breast irradiation using the strut-adjusted volume implant single-entry hybrid catheter in brachytherapy for breast cancer in the setting of breast augmentation

Bloom, Elizabeth Stroh; Kirsner, S.; Mason, B.; Nelson, Christopher Lee; Hunt, Kelly K.; Baumann, Donald P.; Gifford, Kent A

doi:10.1016/j.brachy.2010.06.008

Cited by 27 publications

(15 citation statements)

References 13 publications

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“…Combining the data presented in this report with previously reported outcomes from primarily stage 1–2 breast cancer in patients with previous augmentation (2–10, 12, 14, 15, 17, 18, 20) demonstrate excellent disease control after both whole breast irradiation and APBI. After 0.5 to over 10 years of follow-up, cases treated with adjuvant RT generated a crude local failure rate of 2.3% (5/221) and overall disease free survival rate of 95.5% (211/221).…”

Section: Discussionsupporting

confidence: 70%

“…Our previous publication (19) is the only investigation utilizing external beam rather than brachytherapy, and the only full-length treatment apart from a few case reports (18, 20). Findings from these reports of whole breast or partial breast irradiation are summarized in the Table S1 in Supplementary Material.…”

Section: Discussionmentioning

confidence: 99%

“…After 0.5 to over 10 years of follow-up, cases treated with adjuvant RT generated a crude local failure rate of 2.3% (5/221) and overall disease free survival rate of 95.5% (211/221). Cases treated with APBI had a crude local failure of 1.7% (2/120) with no distant failures (17, 18, 20, 21). Although longer follow-up is necessary, these efficacy rates are certainly comparable to rates reported after whole breast irradiation and APBI in early stage breast cancer in patients without prior breast augmentation.…”

Section: Discussionmentioning

confidence: 99%

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External Beam Accelerated Partial Breast Irradiation Yields Favorable Outcomes in Patients with Prior Breast Augmentation

et al. 2014

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Purpose: To report outcomes in breast cancer patients with prior breast augmentation treated with external beam accelerated partial breast irradiation (EB-APBI) utilizing intensity-modulated radiotherapy or 3-dimensional conformal radiotherapy, both with IGRT.Materials and Methods: Sixteen stage 0/1 breast cancer patients with previous elective bilateral augmentation were treated post-lumpectomy on institutional EB-APBI trials (01185132 and 01185145 on clinicaltrials.gov). Patients received 38.5 Gy in 10 fractions over five consecutive days. Breast/chest wall pain and cosmesis were rated by patient; cosmesis was additionally evaluated by physician per RTOG criteria.Results: The median follow-up from accelerated partial breast irradiation (APBI) completion was 23.9 months (range, 1.2–58.6). Little to no change in cosmesis or pain from baseline was reported. Cosmetic outcomes at last follow-up were judged by patients as excellent/good in 81.2% (13/16), and by physicians as excellent/good in 93.8% (15/16). Ten patients (62.5%) reported no breast/chest wall pain, five (31.2%) reported mild pain, and one (6.2%) reported moderate pain. All patients remain disease free at last follow-up. The median ipsilateral breast, planning target volume (PTV), and implant volumes were 614, 57, and 333 cm3. The median ratios of PTV/ipsilateral breast volume (implant excluded) and PTV/total volume (implant included) were 9 and 6%.Conclusion: These 16 breast cancer cases with prior bilateral augmentation treated with EB-APBI demonstrate favorable clinical outcomes. Further exploration of EB-APBI as a treatment option for this patient population is warranted.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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External Beam Accelerated Partial Breast Irradiation Yields Favorable Outcomes in Patients with Prior Breast Augmentation

et al. 2014

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“…The CT images were transferred to a Nucletron Oncentra (Elekta Corp., Stockholm, Sweden) planning system. The patient was planned using methodology outlined in the literature 8 , 9 , 10 . The patient was now ready to begin treatment.…”

Section: Methodsmentioning

confidence: 99%

Contralateral breast dose from partial breast brachytherapy

Robinson

Nelson

Bloom

et al. 2015

J Applied Clin Med Phys

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The purpose of this study was to determine the dose to the contralateral breast during accelerated partial breast irradiation (APBI) and to compare it to external beam‐published values. Thermoluminescent dosimeter (TLD) packets were used to measure the dose to the most medial aspect of the contralateral breast during APBI simulation, daily quality assurance (QA), and treatment. All patients in this study were treated with a single‐entry, multicatheter device for 10 fractions to a total dose of 34 Gy. A mark was placed on the patient's skin on the medial aspect of the opposite breast. Three TLD packets were taped to this mark during the pretreatment simulation. Simulations consisted of an AP and Lateral scout and a limited axial scan encompassing the lumpectomy cavity (miniscan), if rotation was a concern. After the simulation the TLD packets were removed and the patients were moved to the high‐dose‐rate (HDR) vault where three new TLD packets were taped onto the patients at the skin mark. Treatment was administered with a Nucletron HDR afterloader using Iridium‐192 as the treatment source. Post‐treatment, TLDs were read (along with the simulation and QA TLD and a set of standards exposed to a known dose of 6 MV photons). Measurements indicate an average total dose to the contralateral breast of 70 cGy for outer quadrant implants and 181 cGy for inner quadrant implants. Compared to external beam breast tangents, these results point to less dose being delivered to the contralateral breast when using APBI.PACS number: 87.55.D‐

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“…SAVI uses 6, 8 or 10 peripheral source channels with one center channel and inserted in collapse form into the tumor cavity through a small incision in the breast. 37,38 The catheters are then expanded to conform to the shape of the cavity and allow for precise delivery of radiation. MammoSite ML consists of a balloon catheter that is inserted into the lumpectomy then expanded, and radiation is delivered through a tiny seed attached to the catheter, irradiating the area surrounding the cavity.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of surface dose outside the treatment area for five breast cancer irradiation modalities using thermo-luminescent dosimeters

Khànal

2015

Int J Cancer Ther Oncol

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Evaluation of surface dose outside the treatment area for five breast cancer irradiation modalities using thermo-luminescent dosimeters Original Article AbstractPurpose: To measure and compare the surface dose outside the treatment area at six different points of interest (POIs) for five different breast cancer radiation treatment modalities by using thermo-luminescent dosimeters (TLDs). This experiment will evaluate the magnitude of the dose due to scatter and leakage radiation at different areas outside the target on a patient that could potentially lead, in the long term, to radiation induced secondary malignancies. Methods: TLD-100 were calibrated according to the University of Wisconsin Radiation Calibration Laboratory protocol and then used for dose measurements at selected POIs namely sternum, lower abdomen, contralateral breast, thyroid, shoulder, and eye. Twenty five breast cancer patients and the following modalities were included in this study: Strut-adjusted volume implant (SAVI), mammosite multi-lumen (ML), Accuboost, electron boost and photon boost. The surface doses in all patients were measured in a single fraction. The delivered target doses were normalized to 200 cGy. Finally, breast quadrant analysis was performed. Results: The maximum average dose for each POI was as follows: Sternum 6.51 cGy (SD 2.93), lower abdomen 4.50 cGy (SD 2.63), contralateral breast 8.52 cGy (SD 3.86), thyroid 5.50 cGy (SD 2.75), shoulder 5.58 cGy (SD 2.77), and eye 2.65 cGy (SD 0.68). The highest POI dose of 15.84 cGy was found in contralateral breast. Conclusion: The measured surface dose at each POI varies with the modality of treatment. The surface doses show a strong correlation to the tumor bed location in the breast quadrant. The SAVI, electron boost, and photon boost modalities had delivered smaller surface dose at POIs than the Accuboost and Mammosite ML modalities. While the measured doses fall within the low range, its significance in producing second malignancies would require a large cohort of patients and a longer follow up.

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Accelerated partial breast irradiation using the strut-adjusted volume implant single-entry hybrid catheter in brachytherapy for breast cancer in the setting of breast augmentation

Cited by 27 publications

References 13 publications

External Beam Accelerated Partial Breast Irradiation Yields Favorable Outcomes in Patients with Prior Breast Augmentation

External Beam Accelerated Partial Breast Irradiation Yields Favorable Outcomes in Patients with Prior Breast Augmentation

Contralateral breast dose from partial breast brachytherapy

Evaluation of surface dose outside the treatment area for five breast cancer irradiation modalities using thermo-luminescent dosimeters

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