Feasibility of Accelerated Partial Breast Irradiation in a Large Inner-City Public Hospital

Background Breast conserving therapy (BCT) that include breast conserving surgery followed by adjuvant radiation therapy has revolutioned medicine by allowing women to avoid mastectomy. Accelerated partial breast irradiation (APBI) has emerged as a valid alternative to whole-breast irradiation that...

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Bibliographic Details
Published in:Annals of surgical oncology 2012-12, Vol.19 (13), p.4094-4098
Main Authors: Amin, Miral, Gabram, Sheryl, Bumpers, Harvey, Landry, Jerome, Jani, Ashesh B., Diaz, Roberto, Rizzo, Monica
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Breast Neoplasms - pathology
Breast Neoplasms - radiotherapy
Breast Neoplasms - surgery
Breast Oncology
Carcinoma, Ductal, Breast - pathology
Carcinoma, Ductal, Breast - radiotherapy
Carcinoma, Ductal, Breast - surgery
Carcinoma, Intraductal, Noninfiltrating - pathology
Carcinoma, Intraductal, Noninfiltrating - radiotherapy
Carcinoma, Intraductal, Noninfiltrating - surgery
Combined Modality Therapy
Female
Follow-Up Studies
Humans
Mastectomy, Segmental
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - radiotherapy
Neoplasm Recurrence, Local - surgery
Neoplasm Staging
Oncology
Prognosis
Retrospective Studies
Surgery
Surgical Oncology
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Summary:Background Breast conserving therapy (BCT) that include breast conserving surgery followed by adjuvant radiation therapy has revolutioned medicine by allowing women to avoid mastectomy. Accelerated partial breast irradiation (APBI) has emerged as a valid alternative to whole-breast irradiation that requires a shorter time commitment. We report our novel experience with APBI at a large public hospital that serves low-income and potentially noncompliant patients. Methods A retrospective chart review was conducted of women who underwent BCT for stage 0–IIA breast cancer from August 2007 to August 2010 treated with APBI with a brachytherapy catheter. Results Twenty-four patients (20 African American) were considered for APBI. Average age was 61 years. Four patients could not undergo APBI for technical reasons and completed whole-breast irradiation over a 5 week period. Median follow-up was 19 months. Nine patients (37.5 %) had ductal carcinoma-in-situ, and 15 patients (62.5 %) had invasive ductal carcinoma with an average tumor size of 1.1 cm. All patients had negative margins of >2 mm. Two patients (8 %) treated with the brachytherapy catheter had in-breast tumor recurrence. Thus, all 24 patients initially identified for APBI successfully completed adjuvant radiotherapy. Conclusions Patient compliance with postoperative irradiation is key to minimize local recurrence after BCT for breast cancer. This success with a brachytherapy catheter in underserved women in a U.S. public hospital setting indicates that outcomes of compliance and complications are comparable to nationally published results.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-012-2444-x