Considering Accelerated Partial Breast Irradiation?
Is it an Option for YOU?
Radiation Therapy to the whole breast after removal of a malignant or cancerous tumor (lumpectomy) has been offered to patients as an alternative to removal of the entire breast (mastectomy) over the past four decades. Numerous studies done worldwide reported the outcome of lumpectomy followed by radiation to be equivalent to mastectomy. More than 80 percent of these patients have excellent cosmetic results following their radiation treatments, resulting in less psychological and emotional trauma compared to those who underwent mastectomy.
More recently numerous institutions are undertaking research into irradiating the lumpectomy site versus the whole breast for women over 45 years with early stage breast cancer (stage 0, I or II). Because the majority of recurrences occur within 1 cm of the lumpectomy site the use of partial breast irradiation in preliminary results indicate Accelerated Partial Breast Irradiation (APBI) is equally as effective as whole breast irradiation in preventing cancer recurrence.
APBI is administered two different ways. One is using external beam treatments on a linear accelerator (Teletherapy). The second way is using a catheter balloon (Contura, Savy or Mammosite) inserted into the lumpectomy cavity and irradiated using a radioactive source (HDR Brachytherapy). Either way since the area irradiated is so small and confined the treatments can be accelerated to twice daily for 5 days versus once daily for 6 weeks with whole breast treatments. A shorter treatment course is very attractive to working women, women with busy schedules, women with transportation problems or women who have difficulty ambulating.
APBI began in 2002 with the FDA approval of the specialized catheter balloons. Since that time hundreds of women over the age of 45 years with early stage breast cancer have been treated using APBI both under NCI sponsored clinical trials and off trial. While long term results will not be known for decades the immediate results (less than 10 years) are proving APBI to be equally as effective at local control as whole breast irradiation. Until then, patients are offered APBI as an option with the understanding that it is not yet the standard of care in this Country.
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