Abstract
Breast-conserving treatment (BCT) is considered the standard therapy for most early-stage breast cancer cases and has given excellent results. Evidence is growing that after BCT, most recurrences appear at or near the lumpectomy cavity. Therefore, several leading institutions are investigating the possibility to limit the peroperative treatment only to the volume of breast surrounding the original tumor site. Reducing the treated volume can also lead to possible changes in overall treatment time that could be a major issue, particularly for older patients. To date, no conclusive data are available on the possible role of the partial irradiation of the breast (PBI) in early-stage breast cancer, but in this chapter we will try to review the rationale and the research of all the most popular technique for peroperative PBI currently underway.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Arthur DW, Koo D, Zwicker RD et al (2003) Partial breast brachytherapy after lumpectomy: low-dose-rate and high-dose-rate experience. Int J Radiat Oncol Biol Phys 56:681-689
Arthur DW, Winter K, Kuske RR et al (2008) A phase II trial of brachytherapy alone after lumpectomy for select breast cancer: tumor control and survival outcomes of RTOG 95-17. Int J Radiat Oncol Biol Phys 72(2):467-473
Bartelink H, Horiot JC, Poortmans P et al (2001) Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N Engl J Med 345:1378-1387
Bush DA, Slater JD, Garberoglio C et al (2007) A technique of partial breast irradiation utilizing proton beam radiotherapy: comparison with conformal x-ray therapy. Cancer J 13(2):114-118
Chen PY, Gustafson GS, Mitchell C et al (2008) Three-year clinical experience utilizing 3D-conformal radiation therapy to deliver accelerated partial breast irradiation (APBI). Int J Radiat Oncol Biol Phys 72(1):S3-S4
Clarke M, Collins R, Darby S et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366:2087-2106
Cuttino LW, Keisch M, Jenrette JM et al (2008) Multi-institutional experience using the MammoSite radiation therapy system in the treatment of early-stage breast cancer: 2-year results. Int J Radiat Oncol Biol Phys 71(1):107-114
Formenti SC, Truong MT, Goldberg JD et al (2004) Prine accelerated partial breast irradiation after breast conserving surgery: preliminary clinical results and dose-volume histogram analysis. Int J Radiat Oncol Biol Phys 60(2):493-504
Holmes DR, Baum M, Joseph D (2007) The TARGIT trial: targeted intraoperative radiation therapy versus conventional postoperative whole-breast radiotherapy after breast-conserving surgery for the management of early-stage invasive breast cancer (a trial update). Am J Surg 194:507-510
Ivaldi GB, Leonardi MC, Orecchia R et al (2008) Preliminary results of electron intraoperative therapy boost and hypofractionated external beam radiotherapy after breast-conserving surgery in premenopausal women. Int J Radiat Oncol Biol Phys 72(2):485-493
Keisch M, Vicini F, Kuske RR et al (2003) Initial clinical experience with the MammoSite breast brachytherapy applicator in women with early stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 55:289-293
Kozak KR, Smith BL, Adams J et al (2006) Accelerated partial-breast irradiation using proton beams: initial clinical experience. Int J Radiat Oncol Biol Phys 66:691-698
Lazovich DA, White E, Thomas DB et al (1991) Underutilization of breast-conserving surgery and radiation therapy among women with stage I or II breast cancer. JAMA. 266:3433-3438
Lomax AJ (2008) Intensity modulated proton therapy and its sensitivity to treatment uncertainties 2: the potential effects of inter-fraction and inter-field motions. Phys Med Biol 53(4):1043-1056
Luini A, Orecchia R, Gatti G et al (2005) The pilot trial on intraoperative radiotherapy with electrons (ELIOT): update on the results. Breast Cancer Res Treat 93:55-59
Mussari S, Sabino Della Sala W, Busana L et al (2006) Full-dose intraoperative radiotherapy with electrons in breast cancer. First report on late toxicity and cosmetic results from a single-institution experience. Strahlenther Onkol 182(10):589-595
Newcomb PA, Carbone PP (1993) Cancer treatment and age: patient perspectives. J Natl Cancer Inst 85:1580-1584
Nold RJ, Beamer RL, Helmer SD et al (2000) Factors influencing a woman’s choice to undergo breast-conserving surgery versus modified radical mastectomy. Am J Surg 180:413-418
NSABP B-39, RTOG 0413 (2006) A Randomized Phase III Study of conventional whole breast irradiation versus partial breast irradiation for women with stage 0, I, or II breast cancer. Clin Adv Hematol Oncol 4:719-721.
Petit JY, Veronesi U, Rey P et al (2008) Nipple-sparing mastectomy: risk of nipple-areolar recurrences in a series of 579 cases. Breast Cancer Res Treat 114:97-101
Polgár C, Major T, Fodor J et al (2004) High-dose-rate brachytherapy alone versus whole breast radiotherapy with or without tumor bed boost after breast-conserving surgery: seven-year results of a comparative study. Int J Radiat Oncol Biol Phys 60:1173-1181
Polgár C, Lovey K, Major T et al (2006) Partial breast irradiation (PBI) versus whole breast irradiation (WBI) after breast conserving surgery for low risk breast cancer patients: 5-year results of a randomized study. Radiother Oncol 81:S148
Proulx GM, Stomper PC, Hurd T et al (2001) Breast-conserving therapy (BCT) : radiatiating the entire breast may not be necessary. Breast J 7(4):275
Reitsamer R, Sedlmayer F, Kopp M et al (2006) The Salzburg concept of intraoperative radiotherapy for breast cancer: results and considerations. Int J Cancer 118:2882-2887
Strnad V, Ott O, Pötter R et al (2004) Interstitial brachytherapy alone after breast conserving surgery: interim results of a German-Austrian multicenter phase II trial. Brachytherapy 3(3):115-119
Vaidya JS, Baum M, Tobias JS et al (2001) Targeted inra-operative radiotherapy (TARGIT): an innovative method of treatment for early breast cancer. Ann Oncol 12:1075-1080
Veronesi U, Marubini E, Mariani L et al (2001) Radiotherapy after breast-conserving surgery in small breast carcinoma: long-term results of a randomized trial. Ann Oncol 12:997-1003
Veronesi U, Cascinelli N, Mariani L et al (2002) Twenty-year follow-up of a surgery with radical mastectomy for early breast cancer. N Engl J Med 16:1227-1232
Vicini F, Beitsch PD, Quiet CA et al (2008) Three-year analysis of treatment efficacy, cosmesis, and toxicity by the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial in patients treated with accelerated partial breast irradiation (APBI). Cancer 112:758-766
Vicini FA, Kestin L, Chen P et al (2003a) Limited-field radiation therapy in the management of early stage breast cancer. J Natl Cancer Inst 95:1205-1210
Vicini FA, Remouchamps V, Wallace M et al (2003b) Ongoing clinical experience utilizing3D conformal external beam radiotherapy to deliver partial-breast irradiation in patients with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 57(5):1247-1253
Vicini FA, Antonucci JV, Wallace M et al (2007) Long-term efficacy and patterns of failure after accelerated partial breast irradiation: a molecular assay-based clonality evaluation. Int J Radiat Oncol Biol Phys 68(2):341-346
Vicini FA, Winter K, Straube W et al (2008) Initial efficacy results of RTOG 0319: three dimensional conformal radiation therapy (3D-CRT) confined to the region of the lumpectomy cavity for state I/II breast carcinoma. Int J Radiat Oncol Biol Phys 72(1):S3
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer-Verlag London
About this chapter
Cite this chapter
Orecchia, R., Ivaldi, G.B., Leonardi, M.C. (2010). Peroperative Radiotherapy. In: Reed, M., Audisio, R. (eds) Management of Breast Cancer in Older Women. Springer, London. https://doi.org/10.1007/978-1-84800-265-4_11
Download citation
DOI: https://doi.org/10.1007/978-1-84800-265-4_11
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-84800-264-7
Online ISBN: 978-1-84800-265-4
eBook Packages: MedicineMedicine (R0)