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

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

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.

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Acknowledgment

The MammoSite® breast brachytherapy registry trial was supported in part by a Grant by Hologic, Inc., Bedford, MA. Hologic, Inc. had no access to or influence on the data, analysis, or conclusions of this paper prior to publication.

Conflict of interest

There are no conflicts of interest to declare except Martin Keisch, M.D.: Consultant/Advisory Board, Hologic, Inc., Bedford, Massachusetts.

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Authors and Affiliations

  1. Department of Radiation Oncology, Summa Health System, Akron, OH, USA

    Chirag Shah MD & Shahed Badiyan MD

  2. Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA

    J. Ben Wilkinson MD

  3. Michigan Healthcare Professionals/21st Century Oncology, Farmington Hills, MI, USA

    Frank Vicini MD, FACR

  4. Dallas Surgical Group, Dallas, TX, USA

    Peter Beitsch MD

  5. Cancer HealthCare Associates, University of Miami Hospital, Miami, FL, USA

    Martin Keisch MD

  6. Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA

    Douglas Arthur MD

  7. Biostat International, Inc, Tampa, FL, USA

    Maureen Lyden MS

Authors
  1. Chirag Shah MD
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  2. Shahed Badiyan MD
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  3. J. Ben Wilkinson MD
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  4. Frank Vicini MD, FACR
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  5. Peter Beitsch MD
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  6. Martin Keisch MD
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  7. Douglas Arthur MD
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  8. Maureen Lyden MS
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Corresponding author

Correspondence to Chirag Shah MD.

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Shah, C., Badiyan, S., Ben Wilkinson, J. et al. Treatment Efficacy with Accelerated Partial Breast Irradiation (APBI): Final Analysis of the American Society of Breast Surgeons MammoSite® Breast Brachytherapy Registry Trial. Ann Surg Oncol 20, 3279–3285 (2013). https://doi.org/10.1245/s10434-013-3158-4

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  • DOI: https://doi.org/10.1245/s10434-013-3158-4

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