Literature DB >> 23054123

Should ductal carcinoma-in-situ (DCIS) be removed from the ASTRO consensus panel cautionary group for off-protocol use of accelerated partial breast irradiation (APBI)? A pooled analysis of outcomes for 300 patients with DCIS treated with APBI.

Frank Vicini1, Chirag Shah, J Ben Wilkinson, Martin Keisch, Peter Beitsch, Maureen Lyden.   

Abstract

PURPOSE: To analyze outcomes in patients with ductal carcinoma-in-situ (DCIS) treated with accelerated partial breast irradiation (APBI) within a pooled set of patients.
METHODS: A total of 300 women with DCIS underwent APBI between April 1993 and November 2010 as part of American Society of Breast Surgeons MammoSite Registry Trial (n = 192) or at William Beaumont Hospital (n = 108). Patients with pure DCIS <3 cm (n = 125) were assigned to the cautionary risk group per American Society of Radiation Oncology consensus panel guidelines for off-protocol use of APBI and analyzed compared to a pooled invasive suitable (n = 653) risk group and pooled invasive suitable/cautionary (n = 1,298) risk group.
RESULTS: The rate of ipsilateral breast tumor recurrence (IBTR) for all 300 DCIS patients was 2.6 % at 5 years with no regional recurrences, while cause-specific survival was 99.5 % and overall survival (OS) was 96.4 %. When comparing the cautionary DCIS group to the invasive suitable/cautionary group, no difference in IBTR was noted (2.6 vs. 3.1 %, P = 0.90) with significant improvements in distant metastases (0 vs. 2.5 %, P = 0.05), disease-free survival (98.5 vs. 94.4 %, P = 0.05), and OS (95.7 vs. 90.8 %, P = 0.03) noted for DCIS patients. When comparing cautionary DCIS patients to invasive suitable patients, no difference in IBTR were noted (2.6 vs. 2.4 %, P = 0.76), while improved OS for DCIS patients was noted (95.7 vs. 90.9 %, P = 0.02).
CONCLUSIONS: This analysis of the largest cohort of patients with DCIS treated with APBI supports previously reported excellent outcomes; as a result of small numbers of events, further data are necessary to confirm these findings.

Entities:  

Mesh:

Year:  2012        PMID: 23054123     DOI: 10.1245/s10434-012-2694-7

Source DB:  PubMed          Journal:  Ann Surg Oncol        ISSN: 1068-9265            Impact factor:   5.344


  5 in total

1.  [Accelerated partial breast irradiation using interstitial multicatheter brachytherapy: A valid treatment option for breast cancer patients with a low-risk profile?].

Authors:  David Krug
Journal:  Strahlenther Onkol       Date:  2016-02       Impact factor: 3.621

2.  Accelerated partial breast irradiation through brachytherapy for ductal carcinoma in situ: factors influencing utilization and risks of second breast tumors.

Authors:  Ying Liu; Derek T Schloemann; Min Lian; Graham A Colditz
Journal:  Breast Cancer Res Treat       Date:  2015-04-19       Impact factor: 4.872

Review 3.  Intraoperative Electron Radiotherapy (IOERT) as an Alternative to Standard Whole Breast Irradiation: Only for Low-Risk Subgroups?

Authors:  Sergio Maluta; Stefano Dall'Oglio; Donald A Goer; Nadia Marciai
Journal:  Breast Care (Basel)       Date:  2014-05       Impact factor: 2.860

4.  Minimally invasive tumor bed implant (MITBI) and peri-operative high-dose-rate brachytherapy (PHDRBT) for accelerated minimal breast irradiation (AMBI) or anticipated boost (A-PHDRBT-boost) in breast-conserving surgery for ductal carcinoma in situ.

Authors:  Marta Gimeno Morales; Fernando Martinez-Regueira; Natalia Rodriguez-Spiteri; Begoña Olartecoechea; Isabel Rubio; Antonio Esgueva; Luis Pina; Arlette Elizalde; Carolina Sobrido Sampedro; Miguel Angel Idoate; Marta Abengozar; Luis Ramos; Felipe Calvo Manuel; Rafael Martínez-Monge; Mauricio Cambeiro
Journal:  J Contemp Brachytherapy       Date:  2020-12-16

Review 5.  Accelerated partial breast irradiation with brachytherapy: patient selection and technique considerations.

Authors:  Daniel M Trifiletti; Kara D Romano; Shayna L Showalter; Kelli A Reardon; Bruce Libby; Timothy N Showalter
Journal:  Breast Cancer (Dove Med Press)       Date:  2015-07-29
  5 in total

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