Accelerated Partial Breast Irradiation

Accelerated Partial Breast Irradiation (APBI) refers to the use of limited, focused RT as a more convenient alternative to conventional whole breast radiation radiation therapy (WBRT) for women following breast-conserving surgery. Compared with WBRT, APBI delivers a higher dose of RT per day to a limited volume of tissue, encompassing the lumpectomy bed with margin over a shorter period of time and leading to potentially fewer late skin and surrounding organ side effects. Randomized clinical trials have shown that partial-breast irradiation provides comparable local control to whole-breast irradiation in appropriately selected patients with early-stage breast cancer. Treatment options with accelerated partial breast irradiation available through our departments include:

1. Intracavitary Brachytherapy: A radiation delivery device is placed into the lumpectomy cavity. Single lumen and multi-lumen balloon catheter and non-balloon devices have all been used successfully. A radioactive source imbedded in a wire is guided into the catheter to temporarily expose the 1-2 cm radial margin beyond the cavity to the prescribed dose of radiation, taking approximately 5-10 minutes. This is repeated twice daily for 5 days, for a total of 10 fractions.

2. External beam radiation therapy (EBRT) with 3D conformal or IMRT treatment techniques: This treatment utilizes a linear accelerator-based treatment algorithm to design radiation utilizes multiple angled beams to create a dose-distribution that conforms to the 1-2 cm margin beyond the lumpectomy cavity. The treatment is typically given either daily or every other day for approximately 5 days.