The Role of Interstitial Brachytherapy for Breast Cancer Treatment: An Overview of Indications, Applications, and Technical Notes

Abstract

Breast cancer represents the second leading cause of cancer-related death in the female population, despite continuing advances in treatment options that have significantly accelerated in recent years. Conservative treatments have radically changed the concept of healing, also focusing on the psychological aspect of oncological treatments. In this scenario, radiotherapy plays a key role. Brachytherapy is an extremely versatile radiation technique that can be used in various settings for breast cancer treatment. Although it is invasive, technically complex, and requires a long learning curve, the dosimetric advantages and sparing of organs at risk are unequivocal. Literature data support muticatheter interstitial brachytherapy as the only method with strong scientific evidence to perform partial breast irradiation and reirradiation after previous conservative surgery and external beam radiotherapy, with longer follow-up than new, emerging radiation techniques, whose effectiveness is proven by over 20 years of experience. The aim of our work is to provide a comprehensive view of the use of interstitial brachytherapy to perform breast lumpectomy boost, breast-conserving accelerated partial breast irradiation, and salvage reirradiation for ipsilateral breast recurrence, with particular focus on the implant description, limits, and advantages of the technique.

Review of brachytherapy clinical trials: a cross-sectional analysis of ClinicalTrials.gov

“…Many recent BCa trials have focused on testing the safety and efficacy of APBI as adjuvant treatment among patients with low-risk, early-stage BCa. There is interest in evaluating an interstitial brachytherapy boost following breast-conserving surgery and EBRT [ 36 , 37 ]. The preliminary results of an NSABP-initiated randomized phase 3 trial (n = 4216) evaluating the efficacy of partial breast irradiation compared with whole breast radiation therapy showed that APBI with interstitial brachytherapy was not inferior in quality of life compared to whole-breast irradiation [ 38 ].…”

Linac-based stereotactic salvage reirradiation for intraprostatic prostate cancer recurrence: toxicity and outcomes

“…The critical issue of Re-I is treatment tolerance of previously irradiated normal tissues and organs at risk (OARs) that could preclude dose delivery with curative intent [7]. However, taking into account the implementation of modern RT modalities, Re-I has been considered as feasible for prostate cancer as for other solid tumors in clinical practice [8][9][10][11].…”

Breast Development and Cancer

“…In this scenario, radiotherapy plays a key role. The review written by Cozzi extensively describes the indications, applications and advantages of interstitial brachytherapy [ 10 ].…”