Anna-Maria Roth1, Daniela Kauer-Dorner2, Alexandra Resch3, Andreas Schmid4, Marc Thill5, Peter Niehoff6, Corinna Melchert1, Daniel Berger2, György Kovács1. 1. Interdisciplinary Brachytherapy Unit, University of Luebeck, Luebeck, Germany. 2. Department of Radiotherapy and Radiobiology, Medical University Vienna, Vienna, Austria. 3. Department of Radiotherapy and Radiobiology, Medical University Vienna, Vienna, Austria. Electronic address: alexandra.resch@meduniwien.ac.at. 4. Department of Surgery, DRK Hospital, Ratzeburg, Germany. 5. Department of Gynecology and Obstetrics, University of Luebeck, Luebeck, Germany. 6. Department of Radiotherapy, City Hospital Cologne, Cologne, Germany.
Abstract
PURPOSE: To evaluate accelerated partial breast irradiation (APBI) in patients after oncoplastic surgery for early breast cancer. METHODS AND MATERIALS: A retrospective analysis of 136 breasts of 134 patients, who received breast-conserving oncoplastic surgery for low-risk breast cancer between 2002 and 2010 in the Universities of Vienna and Luebeck followed by adjuvant APBI applying total doses of pulse dose rate of 50.4 Gy or high-dose rate (HDR) of 32 Gy over 4 days. Target volume definition was performed by the use of surgical-free margin data, related to intraoperatively fixed clip positions, pre- and postoperative imaging, and palpation. RESULTS: At the time of data acquisition, 131 of 134 patients were alive. The median follow-up time was 39 months (range, 4-106 months). After high-dose rate treatment, 3 of 89 patients showed systemic progress after a mean follow-up of 47 months (range, 19-75 months) and 2 patients had a different quadrant in-breast tumor after 27 and 35 months. One patient died 7 months after treatment of unknown causes. After pulse dose rate treatment, 1 of 45 patients had a local recurrence after 42 months and 1 patient died because of another cause after 13 months. We observed mild fibrosis in 27 breasts, telangiectasia in 6, hyperpigmentation in 14 cases, and keloid formation in 1. CONCLUSIONS: These preliminary results suggest the feasibility of multicatheter APBI after oncoplastic breast-conserving surgery in selected low-risk breast cancer patients; however, special attention to target volume definition is needed. Further prospective investigations with long follow-up are needed to define the real value of the procedure.
PURPOSE: To evaluate accelerated partial breast irradiation (APBI) in patients after oncoplastic surgery for early breast cancer. METHODS AND MATERIALS: A retrospective analysis of 136 breasts of 134 patients, who received breast-conserving oncoplastic surgery for low-risk breast cancer between 2002 and 2010 in the Universities of Vienna and Luebeck followed by adjuvant APBI applying total doses of pulse dose rate of 50.4 Gy or high-dose rate (HDR) of 32 Gy over 4 days. Target volume definition was performed by the use of surgical-free margin data, related to intraoperatively fixed clip positions, pre- and postoperative imaging, and palpation. RESULTS: At the time of data acquisition, 131 of 134 patients were alive. The median follow-up time was 39 months (range, 4-106 months). After high-dose rate treatment, 3 of 89 patients showed systemic progress after a mean follow-up of 47 months (range, 19-75 months) and 2 patients had a different quadrant in-breast tumor after 27 and 35 months. One patient died 7 months after treatment of unknown causes. After pulse dose rate treatment, 1 of 45 patients had a local recurrence after 42 months and 1 patient died because of another cause after 13 months. We observed mild fibrosis in 27 breasts, telangiectasia in 6, hyperpigmentation in 14 cases, and keloid formation in 1. CONCLUSIONS: These preliminary results suggest the feasibility of multicatheter APBI after oncoplastic breast-conserving surgery in selected low-risk breast cancerpatients; however, special attention to target volume definition is needed. Further prospective investigations with long follow-up are needed to define the real value of the procedure.
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