Breast cancer: external-beam APBI yields excellent long-term control

  • Kennedy WR & al.
  • Pract Radiat Oncol
  • 18 Sep 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • 7-year data show that accelerated partial breast irradiation (APBI) delivered with 3D conformal external beam radiation (3D-CRT) yields 95.2% 7-year PFS and good-to-excellent cosmesis in 75.2% of patients with early breast cancer.

Why this matters

  • This is the longest study to date of external-beam ABPI.

Study design

  • Retrospective cohort of 266 patients undergoing APBI delivered with 3D-CRT during 2006-2012 at the Washington University School of Medicine with >1 year of follow-up.
  • Funding: None.

Key results

  • Median follow-up, 87 (range, 13-156) months.
  • 60.9% of cohort was "suitable" for APBI, 32.7% were "cautionary," and 6.4% were "unsuitable," according to consensus groupings by the American Society for Radiation Oncology (ASTRO).
  • Ipsilateral breast tumor recurrence (IBTR) was 1.8%.
  • PFS was 95.2%.
  • Margin status (
  • 75.2% had good to excellent cosmesis, and 24.8% had fair to poor.
  • 2 patients (0.8%) had poor cosmesis warranting plastic surgery.
  • Adverse cosmesis was associated with greater percentage of irradiated breast (OR, 1.101; P=.021) and higher dose per fraction (400 cGy vs 385 cGy; P=.039).

Limitations

  • Retrospective, observational design.
  • Single-center study may limit generalizability.