Breast conservation surgery and interstitial brachytherapy in the management of locally recurrent carcinoma of the breast: The Allegheny General Hospital experience

Trombetta, Mark; Julian, Thomas B.; Bhandari, Tanuja; Werts, E. Day; Miften, Moyed; Parda, David S.

doi:10.1016/j.brachy.2007.12.001

Cited by 34 publications

(16 citation statements)

References 34 publications

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“…Our mature data at 67.5 months mean follow up continue to support the use of LDR brachytherapy as an acceptable alternative standard of care in lieu of mastectomy. Since our original report [13] , the cosmetic effects in all patients have remained stable. We note that cosmetic stability occurs at approximately 2-2.5 years from the brachytherapy.…”

Section: Discussionmentioning

confidence: 76%

“…In our original study [13] , we demonstrated efficacy and safety in a non-randomized consecutive patient trial at a mean follow up of 35 months. Although other authors have confirmed our findings using differing dose regimens [14,15] , our LDR trial represents the largest cohort to date treated with uniform dose and prescription parameters.…”

Section: Discussionmentioning

confidence: 92%

“…In our previous publication we described a modification of technique and an improved selection process which aided in prediction of long-term cosmetic outcomes. 13 Patients selected should have adequate breast tissue to accommodate the implant following repeat lumpectomy and the skin should be spared by placing the seeds at least 1.0 cm deep to the skin surface.…”

Section: Discussionmentioning

confidence: 99%

“…The techniques for implantation of these patients have been previously described in detail elsewhere [13] . However, in general, freehand tumor bed implantation was performed using afterloading catheters with the clinical target volume (CTV) consisting of the tumor bed/seroma cavity plus a minimum 1.0cm margin ( Figure 1).…”

Section: Treatment Technique and Planningmentioning

confidence: 99%

“…We and other groups have reported our initial experience with retreatment low-dose rate interstitial brachytherapy (LDR) following IBTR [13][14][15] which demonstrated acceptable local control rates and cosmesis in properly selected patients.…”

Section: Introductionmentioning

confidence: 99%

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Mature follow-up of Low-dose rate interstitial brachytherapy following ipsilateral breast tumor recurrence in patients initially treated with breast conservation therapy

Trombetta

Julian

Kim

et al. 2012

JST

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Objective: To evaluate our mature follow-up data in women who have developed IBTR following conservation surgery and post-operative external radiotherapy retreated by lumpectomy followed by interstitial brachytherapy in lieu of salvage mastectomy. Methods:Between 1/1998 and 10/2006, twenty-two patients with TIS or T1 IBTR were offered interstitial low-dose rate brachytherapy following tumor re-excision as an alternative to salvage mastectomy. All patients had failed lumpectomy followed by standard postoperative external beam radiotherapy (range 5000-6480cGy). The recurrent tumors were excised with final margins of resection free of residual disease. Tumor bed implantation was then carried out with an interstitial technique utilizing 192 Iridium with the target volume consisting of the tumor bed plus a minimum 1.0 centimeter margin (minimum standard dose 4500cGy). Results:With a mean follow up of 67.5 months (range 17-115 months) Twenty-one of 22 patients maintained local control at the time of last follow-up or at the time of their death. The single patient who developed a second local recurrence was treated successfully with mastectomy. Three patients succumbed to systemic disease. Two patients developed localized skin breakdown. One patient developed a contralateral breast cancer. Long-term cosmetic results as defined by the Harvard cosmesis scale and the Allegheny General modification were acceptable. Conclusions:These long-term data suggest that lumpectomy followed by brachytherapy is feasible and may be an acceptable alternative to salvage mastectomy in patients who locally fail conservation breast therapy. The upcoming RTOG retreatment trial (RTOG 1014) should help define the role of repeat conservation therapy in IBTR.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Treatment Technique and Planningmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mature follow-up of Low-dose rate interstitial brachytherapy following ipsilateral breast tumor recurrence in patients initially treated with breast conservation therapy

Trombetta

Julian

Kim

et al. 2012

JST

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Optimal surgical treatment of breast cancer: Implications for local control and survival

Khan

Eladoumikdachi

2010

Journal of Surgical Oncology

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Improvements in the local control of primary breast cancer have been shown to improve long-term survival. The role of surgical therapy in maximizing local control includes: appropriate patient selection for breast conservation; tumor resection with pathologically free margins; careful staging with sentinel node biopsy; appropriate use of axillary dissection; and meticulous surgical technique to achieve these goals. Each component of surgical therapy has the potential for maximizing local control, and therefore for extending survival.

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Second traitement conservateur pour récidive locale du cancer du sein

Castelli¹,

Raoust

Lallement

et al. 2010

Cancer Du Sein en Situation Métastatique

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Breast conservation surgery and interstitial brachytherapy in the management of locally recurrent carcinoma of the breast: The Allegheny General Hospital experience

Cited by 34 publications

References 34 publications

Mature follow-up of Low-dose rate interstitial brachytherapy following ipsilateral breast tumor recurrence in patients initially treated with breast conservation therapy

Mature follow-up of Low-dose rate interstitial brachytherapy following ipsilateral breast tumor recurrence in patients initially treated with breast conservation therapy

Optimal surgical treatment of breast cancer: Implications for local control and survival

Second traitement conservateur pour récidive locale du cancer du sein

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