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A Single Institution Retrospective Comparison Study of Locoregional Recurrence After Accelerated Partial Breast Irradiation Using External Beam Fractionation Compared with Whole Breast Irradiation with 8 Years of Follow-Up

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Accelerated partial breast irradiation (APBI) was developed to address disadvantages of overall treatment time and potentially unnecessary radiation associated with whole breast irradiation (WBI). We report updated results of our single institution study using an external beam APBI regimen with a median follow-up of 8 years.

Methods

A total of 290 APBI patients with AJCC Stage 0–II breast cancer were compared with 290 WBI patients with matched tumor characteristics. Toxicities were scored based on the Common Terminology Criteria for Adverse Events (CTCAE v3.0). Cox regression models were used to predict likelihood of freedom from ipsilateral failure.

Results

Median follow-up was 8 years in the APBI group and 7.5 years in the WBI group. In the APBI group, there were 18 (6.2%) ipsilateral breast tumor recurrence (IBTR), 13 (72%) had elsewhere failures (EF), and 5 (28%) had local failures (LF) with a median time to failure of 64.1 months. In the WBI group, there were three (1.0%) IBTR; one (33%) was an EF and two (67%) were LF with a median time to failure of 91 months. APBI was 4.6 times more likely (hazard ratio 4.57, 95% confidence interval 1.3–16.2, p = 0.02) to have an IBTR than WBI after adjusting for age, tumor size, histology, grade, and estrogen receptor status. Fatigue, erythema, and desquamation toxicities were significantly less in the APBI group then the WBI group.

Conclusions

IBTR rates were higher in external beam APBI group compared with WBI, but APBI had fewer toxicities. Clinicians must weigh the risks and benefits of APBI when making a recommendation for partial breast irradiation after lumpectomy.

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Authors and Affiliations

  1. Department of Medicine, NorthShore University HealthSystem, Evanston, IL, USA

    Shalin Shah MD

  2. Division of Surgical Oncology, Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA

    Alexandra Kyrillos BS, Kristine Kuchta MS, Hussain Habib BS, Catherine Pesce MD & Katharine Yao MD

  3. Department of Radiation Medicine, NorthShore University HealthSystem, Evanston, IL, USA

    Megan Tobias BS, Vathsala Raghavan MD, Arif Shaikh MD & William Bloomer MD

Authors
  1. Shalin Shah MD
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  2. Alexandra Kyrillos BS
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  3. Kristine Kuchta MS
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  4. Hussain Habib BS
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  5. Megan Tobias BS
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  6. Vathsala Raghavan MD
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  7. Arif Shaikh MD
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  8. William Bloomer MD
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  9. Catherine Pesce MD
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  10. Katharine Yao MD
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Corresponding author

Correspondence to Katharine Yao MD.

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Shah, S., Kyrillos, A., Kuchta, K. et al. A Single Institution Retrospective Comparison Study of Locoregional Recurrence After Accelerated Partial Breast Irradiation Using External Beam Fractionation Compared with Whole Breast Irradiation with 8 Years of Follow-Up. Ann Surg Oncol 24, 2935–2942 (2017). https://doi.org/10.1245/s10434-017-5953-9

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  • DOI: https://doi.org/10.1245/s10434-017-5953-9

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