Annals of Surgical Oncology

, Volume 20, Issue 10, pp 3279–3285

Treatment Efficacy with Accelerated Partial Breast Irradiation (APBI): Final Analysis of the American Society of Breast Surgeons MammoSite® Breast Brachytherapy Registry Trial

  • Chirag Shah
  • Shahed Badiyan
  • J. Ben Wilkinson
  • Frank Vicini
  • Peter Beitsch
  • Martin Keisch
  • Douglas Arthur
  • Maureen Lyden
Breast Oncology

DOI: 10.1245/s10434-013-3158-4

Cite this article as:
Shah, C., Badiyan, S., Ben Wilkinson, J. et al. Ann Surg Oncol (2013) 20: 3279. doi:10.1245/s10434-013-3158-4

Abstract

Background

The purpose of this study was to examine data on treatment efficacy, cosmesis and toxicities for the final analysis of the American Society of Breast Surgeons MammoSite® breast brachytherapy registry trial.

Methods

A total of 1,449 cases of early-stage breast cancer underwent breast conserving therapy. The single-lumen MammoSite® device was used to deliver accelerated partial breast irradiation (APBI) (34 Gy in 3.4 Gy fractions). Of these, 1,255 cases (87 %) had invasive breast cancer (IBC) and 194 cases had DCIS. Median follow-up was 63.1 months with 45 % of all patients having follow-up of 6 years or longer.

Results

There were 41 cases (2.8 %) that developed an ipsilateral breast tumor recurrence (IBTR) for a 5-year actuarial rate of 3.8 % (3.7 % for IBC and 4.1 % for DCIS). Tumor size (odds ratio [OR] = 1.1, p = 0.03) and estrogen receptor negativity (OR = 3.0, p = 0.0009) were associated with IBTR, while a trend was noted for positive margins (OR = 2.0, p = 0.06) and cautionary/unsuitable status compared with suitable status (OR = 1.8, p = 0.07). The percentage of patients with excellent/good cosmetic results at 60, 72, and 84 months was 91.3, 90.5, and 90.6 %, respectively. The overall rates of fat necrosis and infections remained low at 2.5 and 9.6 % with few late toxicity events beyond 2 years. The overall symptomatic seroma rate was 13.4 and 0.6 % beyond 2 years.

Conclusions

The final analysis of treatment efficacy, cosmesis, and toxicity from the American Society of Breast Surgeons MammoSite® breast brachytherapy registry trial confirms previously noted excellent results and compares favorably with other forms of APBI with similar follow-up and to outcomes seen in selected patients treated with whole breast irradiation.

Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Chirag Shah
    • 1
  • Shahed Badiyan
    • 1
  • J. Ben Wilkinson
    • 2
  • Frank Vicini
    • 3
  • Peter Beitsch
    • 4
  • Martin Keisch
    • 5
  • Douglas Arthur
    • 6
  • Maureen Lyden
    • 7
  1. 1.Department of Radiation OncologySumma Health SystemAkronUSA
  2. 2.Department of Radiation OncologyOakland University William Beaumont School of MedicineRoyal OakUSA
  3. 3.Michigan Healthcare Professionals/21st Century OncologyFarmington HillsUSA
  4. 4.Dallas Surgical GroupDallasUSA
  5. 5.Cancer HealthCare AssociatesUniversity of Miami HospitalMiamiUSA
  6. 6.Department of Radiation Oncology, Massey Cancer CenterVirginia Commonwealth UniversityRichmondUSA
  7. 7.Biostat International, IncTampaUSA