Second conservative treatment for ipsilateral breast cancer recurrence using high-dose rate interstitial brachytherapy: Preliminary clinical results and evaluation of patient satisfaction

Hannoun‐Lévi, Jean‐Michel; Castelli, J.; Plesu, Adrien; Courdi, A.; Raoust, I.; Lallement, M.; Flipo, B.; Ettore, F.; Chapelier, C.; Follana, Philippe; Ferrero, Jean-­Marc; Figl, Andrea

doi:10.1016/j.brachy.2010.05.004

Cited by 40 publications

(27 citation statements)

References 36 publications

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“…Currently, information about the outcomes of patients who develop an IBTR and receive reirradiation using APBI or alternative techniques are limited; however, reirradiation potentially may reduce the local recurrence rates produced by excision alone (Table 3). [9][10][11][15][16][17][18] Although our analyses were limited by a small number of patients (n ¼ 9), the patients in our series who underwent repeat BCT had excellent outcomes at 2 years. One of the largest series reported to date on the use of repeat BCT comes from a retrospective study that was performed at the University of Pittsburgh.…”

Section: Historic Perspectivementioning

confidence: 99%

Outcome after ipsilateral breast tumor recurrence in patients who receive accelerated partial breast irradiation

Shah

Vicini

Keisch

et al. 2012

Cancer

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BACKGROUND:The objective of this study was to examine clinical outcomes and patterns of failure in patients with early stage breast cancer who developed an ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) using accelerated partial breast irradiation (APBI). METHODS: In total, 1440 patients (1449 tumors) with early stage breast cancer who underwent BCT were treated with the MammoSite device to deliver APBI (34 Gray [Gy] in 3.4-Gy fractions). One thousand two hundred fifty-five patients (87%) had invasive breast cancer (IBC) (median tumor size, 10 mm), and 194 patients (13%) had ductal carcinoma in situ (DCIS) (median tumor size, 8 mm). The median follow-up was 60 months. RESULTS: Fifty patients (3.5%) developed an IBTR for a 5-year actuarial rate of 3.61% (3.65% for IBC and 3.36% for DCIS). It was determined that 36 recurrences (72%) represented new primary cancers, and 14 recurrences (28%) represented recurrences of the index lesion. Of the 32 recurrences with known histology, 78% were IBC, and 22% were DCIS. After IBTR, 28 of 38 patients (74%) underwent salvage mastectomy, and 9 of 38 patients (26%) had a second attempt at BCT. Adjuvant therapies included tamoxifen in 8 patients (16%) and systemic chemotherapy in 6 patients (12%).The 3-year rates of disease-free survival, cause-specific survival, and overall survival after IBTR were 58.7%, 92.1%, and 80.5%, respectively. CONCLUSIONS: With 5 years of follow-up, APBI produced clinical outcomes and patterns of failure comparable to those achieved with whole breast irradiation. Patients who developed an IBTR after APBI had excellent 3-year survival outcomes after salvage treatments. Cancer 2012;118:4126-31. V C 2012 American Cancer Society.KEYWORDS: Breast conserving therapy, brachytherapy, radiation, partial breast irradiation, MammoSite. INTRODUCTIONWith more than 25 years of follow-up, it has been demonstrated that breast-conserving therapy (BCT) provides longterm outcomes equivalent to the outcomes achieved with mastectomy in the management of early stage breast cancer. Although whole-breast irradiation (WBI) has been considered the standard adjuvant radiation therapy (RT) technique in these patients, 1 concern that remains is the 6 to 7 weeks required to deliver RT. Some studies indicate that up to 20% of patients do not receive adjuvant RT, and protracted treatment times and distance from an RT facility have been identified as contributing factors. 1 Accelerated partial breast irradiation (APBI) is a relatively new technique that allows for the delivery of adjuvant RT while shortening the treatment course to 1 week or less. Currently, APBI can be delivered using multiple techniques, including interstitial catheters, a balloon-based catheter, or external-beam RT. With 5 to 10 years of follow-up, it has been demonstrated that APBI is associated with excellent clinical outcomes. 2,3 One concern with BCT is how to address recurrent local disease within the previously irradiated breast. One strategy to help stratify these recurrence...

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Section: Historic Perspectivementioning

confidence: 99%

Outcome after ipsilateral breast tumor recurrence in patients who receive accelerated partial breast irradiation

Shah

Vicini

Keisch

et al. 2012

Cancer

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“…Dans l'étude suisse SAKK 23/82 [5], les facteurs indépendants de mauvais pronostique de survie globale sont un intervalle libre inférieur à 12 mois (p = 0,003), un âge supérieur à 65 ans (HR = 2,11 ; p = 0,003), un âge supérieur à 65 ans (HR = 2,11 ; p IC 95 % : [1,57]), et un envahissement ganglionnaire à la rechute (HR = 2,66 ; IC 95 % : [1,41]). Un DFI supérieur à 12 mois est donc un facteur indé-pendant de bon pronostique (HR = 0,37 ; IC 95 % : [0,19-0,72]) [5,78].…”

Section: Critères De Choix D'un Traitement Systémique Devant Une Rl Iunclassified

Prise en charge de la récidive homolatérale d’un cancer du sein après traitement conservateur initial

Barreau¹,

Ettore²,

Giard³

et al. 2011

Oncologie

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“…Dans ces séries de patientes très sélectionnées, la récidive a été traitée par tumorectomie, isolément [1,52,79,216,256], ou suivie d'une irradiation partielle du lit tumoral, par curiethérapie [91,92,163] ou irradiation externe [58,209].…”

Section: Données De La Littératureunclassified

“…Le taux de seconde récidive dans le sein conservé est compris entre 3 % à 21 mois [92] et 38 % à 52 mois [256]. Pour les séries avec un recul de plus de trois ans, le taux moyen de seconde récidive locale est compris entre 20 et 35 % à cinq ans [79,137,216].…”

Section: Données De La Littératureunclassified

Groupe chirurgie

Barranger¹,

Classe²,

Clough³

et al. 2011

Oncologie

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Groupe de travail : Emmanuel Barranger (chirurgie oncologique), Jean-Marc Classe (chirurgie oncologique), Krishna Clough (chirurgie oncologique), Sylvia Giard (chirurgie oncologique), Gilles Houvenaeghel (chirurgie oncologique), Claude Nos (chirurgie oncologique) Les questions ont été scindées en deux groupes : Problématique liée à la chirurgie du sein ; Problématique liée à la chirurgie du ganglion axillaire sentinelle. Problématique liée à la chirurgie du seinÉtat de l'art des recommandations actuelles sur les marges de sécurité nécessaires lors de l'exérèse conservatrice d'un cancer du sein récidive locale dont la distance en millimètre de la marge n'est qu'un des éléments (niveau de preuve 2, grade B). Cancer du sein multifocal : la question du traitement chirurgical conservateur Veille bibliographique Literature Monitoring tumoraux à plus de 2 cm de la lésion principale dans 43 % des cas [96]. Luttges et al. retrouvent 46 % de tumeurs multifocales et 22 % de tumeurs multicentriques dans leur étude de 1 666 pièces de mastectomie. Tot retrouve 35 % de tumeurs multifocales et 4 % de tumeurs multicentriques dans son étude de 519 pièces [239].Le carcinome lobulaire infi ltrant présente un plus haut risque de multifocalité [60]. Néanmoins, dans la limite d'une résection en marges saines, la chirurgie conservatrice peut lui être appliquée avec la même garantie de contrôle local que pour le carcinome canalaire infi ltrant [195,196,215].

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Second conservative treatment for ipsilateral breast cancer recurrence using high-dose rate interstitial brachytherapy: Preliminary clinical results and evaluation of patient satisfaction

Cited by 40 publications

References 36 publications

Outcome after ipsilateral breast tumor recurrence in patients who receive accelerated partial breast irradiation

Outcome after ipsilateral breast tumor recurrence in patients who receive accelerated partial breast irradiation

Prise en charge de la récidive homolatérale d’un cancer du sein après traitement conservateur initial

Groupe chirurgie

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