Breast conservation therapy utilizing partial breast brachytherapy for early-stage cancer of the breast: a retrospective review from the Saint Luke's Cancer Institute
Accelerated partial breast irradiation (APBI) is a convenient alternative to whole-breast irradiation, as less overall time is needed for completion. The use of APBI outside the framework of large prospective clinical trials has markedly increased. To our knowledge, no high-volume, community-based b...
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| Veröffentlicht in: | American journal of clinical oncology 2015-04, Vol.38 (2), p.174-178 |
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| creator | Edwards, Jason M Herzberg, Susan M Shook, John W Beirne, Tammy K N Schomas, David A |
| description | Accelerated partial breast irradiation (APBI) is a convenient alternative to whole-breast irradiation, as less overall time is needed for completion. The use of APBI outside the framework of large prospective clinical trials has markedly increased. To our knowledge, no high-volume, community-based breast program has published their experience with APBI.
The records of 93 consecutive patients who underwent APBI utilizing Mammosite Radiation Therapy System from 2005 to 2010 at Saint Luke's Cancer Institute in Kansas City, MO, were retrospectively reviewed. The Kaplan-Meier method was used to estimate the ipsilateral breast recurrence rate and recurrence-free survival.
Median age at diagnosis was 63 years (range, 45 to 86 y) and mean follow-up was 29 months. Patient stratification ASTRO consensus classifications for APBI was 37% suitable, 57% cautionary, and 6% unsuitable. The 3-year breast control rate was 98.7%. Three-year overall recurrence-free survival was 94.4%, and 3-year mastectomy-free survival was 97.4%. Using univariate analysis, no tumor or patient factors were associated with ipsilateral breast recurrence. However, tumor grade (P |
| doi_str_mv | 10.1097/COC.0b013e31828f5b1f |
| format | Article |
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The records of 93 consecutive patients who underwent APBI utilizing Mammosite Radiation Therapy System from 2005 to 2010 at Saint Luke's Cancer Institute in Kansas City, MO, were retrospectively reviewed. The Kaplan-Meier method was used to estimate the ipsilateral breast recurrence rate and recurrence-free survival.
Median age at diagnosis was 63 years (range, 45 to 86 y) and mean follow-up was 29 months. Patient stratification ASTRO consensus classifications for APBI was 37% suitable, 57% cautionary, and 6% unsuitable. The 3-year breast control rate was 98.7%. Three-year overall recurrence-free survival was 94.4%, and 3-year mastectomy-free survival was 97.4%. Using univariate analysis, no tumor or patient factors were associated with ipsilateral breast recurrence. However, tumor grade (P<0.05), stage (P=0.04), estrogen receptor status (P<0.001), progesterone receptor status (P<0.001), tumor size (P<0.001), and ASTRO suitability criteria (P=0.027) were associated with overall recurrence-free survival. No differences were observed when outcomes of patients with ductal carcinoma in situ were compared with those with invasive disease.
In our high-volume community-based program, APBI outcomes are comparable with those reported from large academic institutions. We also found relationships between tumor stage, grade, negative estrogen receptor status, and ASTRO suitability criteria with overall recurrence rates. The continued careful application of APBI in appropriately selected patients appears warranted until phase III trials comparing this modality to whole-breast irradiation have matured.</description><identifier>ISSN: 0277-3732</identifier><identifier>EISSN: 1537-453X</identifier><identifier>DOI: 10.1097/COC.0b013e31828f5b1f</identifier><identifier>PMID: 23608831</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Aged, 80 and over ; Brachytherapy - methods ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Breast Neoplasms - radiotherapy ; Carcinoma, Ductal, Breast - mortality ; Carcinoma, Ductal, Breast - pathology ; Carcinoma, Ductal, Breast - radiotherapy ; Carcinoma, Intraductal, Noninfiltrating - mortality ; Carcinoma, Intraductal, Noninfiltrating - pathology ; Carcinoma, Intraductal, Noninfiltrating - radiotherapy ; Female ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Retrospective Studies ; Treatment Outcome</subject><ispartof>American journal of clinical oncology, 2015-04, Vol.38 (2), p.174-178</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-99b8263336db69023b7eb430eb2dea46c7bc92e09e32aa4e95229bad3a1ce2d73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23608831$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Edwards, Jason M</creatorcontrib><creatorcontrib>Herzberg, Susan M</creatorcontrib><creatorcontrib>Shook, John W</creatorcontrib><creatorcontrib>Beirne, Tammy K N</creatorcontrib><creatorcontrib>Schomas, David A</creatorcontrib><title>Breast conservation therapy utilizing partial breast brachytherapy for early-stage cancer of the breast: a retrospective review from the Saint Luke's Cancer Institute</title><title>American journal of clinical oncology</title><addtitle>Am J Clin Oncol</addtitle><description>Accelerated partial breast irradiation (APBI) is a convenient alternative to whole-breast irradiation, as less overall time is needed for completion. The use of APBI outside the framework of large prospective clinical trials has markedly increased. To our knowledge, no high-volume, community-based breast program has published their experience with APBI.
The records of 93 consecutive patients who underwent APBI utilizing Mammosite Radiation Therapy System from 2005 to 2010 at Saint Luke's Cancer Institute in Kansas City, MO, were retrospectively reviewed. The Kaplan-Meier method was used to estimate the ipsilateral breast recurrence rate and recurrence-free survival.
Median age at diagnosis was 63 years (range, 45 to 86 y) and mean follow-up was 29 months. Patient stratification ASTRO consensus classifications for APBI was 37% suitable, 57% cautionary, and 6% unsuitable. The 3-year breast control rate was 98.7%. Three-year overall recurrence-free survival was 94.4%, and 3-year mastectomy-free survival was 97.4%. Using univariate analysis, no tumor or patient factors were associated with ipsilateral breast recurrence. However, tumor grade (P<0.05), stage (P=0.04), estrogen receptor status (P<0.001), progesterone receptor status (P<0.001), tumor size (P<0.001), and ASTRO suitability criteria (P=0.027) were associated with overall recurrence-free survival. No differences were observed when outcomes of patients with ductal carcinoma in situ were compared with those with invasive disease.
In our high-volume community-based program, APBI outcomes are comparable with those reported from large academic institutions. We also found relationships between tumor stage, grade, negative estrogen receptor status, and ASTRO suitability criteria with overall recurrence rates. The continued careful application of APBI in appropriately selected patients appears warranted until phase III trials comparing this modality to whole-breast irradiation have matured.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brachytherapy - methods</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Carcinoma, Ductal, Breast - mortality</subject><subject>Carcinoma, Ductal, Breast - pathology</subject><subject>Carcinoma, Ductal, Breast - radiotherapy</subject><subject>Carcinoma, Intraductal, Noninfiltrating - mortality</subject><subject>Carcinoma, Intraductal, Noninfiltrating - pathology</subject><subject>Carcinoma, Intraductal, Noninfiltrating - radiotherapy</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0277-3732</issn><issn>1537-453X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU1v1DAQhi0EokvhHyDkG1xSbE9ix9xoxEellXoAJG7R2Jm0hmwSbGfR8oP4naTslgOn0UjP-45GD2PPpbiQwprXzXVzIZyQQCBrVfeVk_0DtpEVmKKs4OtDthHKmAIMqDP2JKVvQohKC_OYnSnQoq5Bbtjvy0iYMvfTmCjuMYdp5PmWIs4HvuQwhF9hvOEzxhxw4O5Iu4j-9nCP9VPkhHE4FCnjDXGPo6fIp_6u6BR5w5FHynFKM_kc9rRu-0A_eR-n3V_uE4Yx8-3ynV4m3hwrrsaUQ14yPWWPehwSPTvNc_bl_bvPzcdie_3hqnm7LTwonQtrXa00AOjOaSsUOEOuBEFOdYSl9sZ5q0hYAoVYkq2Usg47QOlJdQbO2atj7xynHwul3O5C8jQMONK0pFZqrW2tjZYrWh5Rvz6VIvXtHMMO46GVor0z1K6G2v8NrbEXpwuL21H3L3SvBP4Aw8-SWA</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Edwards, Jason M</creator><creator>Herzberg, Susan M</creator><creator>Shook, John W</creator><creator>Beirne, Tammy K N</creator><creator>Schomas, David A</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150401</creationdate><title>Breast conservation therapy utilizing partial breast brachytherapy for early-stage cancer of the breast: a retrospective review from the Saint Luke's Cancer Institute</title><author>Edwards, Jason M ; Herzberg, Susan M ; Shook, John W ; Beirne, Tammy K N ; Schomas, David A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-99b8263336db69023b7eb430eb2dea46c7bc92e09e32aa4e95229bad3a1ce2d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brachytherapy - methods</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Carcinoma, Ductal, Breast - mortality</topic><topic>Carcinoma, Ductal, Breast - pathology</topic><topic>Carcinoma, Ductal, Breast - radiotherapy</topic><topic>Carcinoma, Intraductal, Noninfiltrating - mortality</topic><topic>Carcinoma, Intraductal, Noninfiltrating - pathology</topic><topic>Carcinoma, Intraductal, Noninfiltrating - radiotherapy</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Edwards, Jason M</creatorcontrib><creatorcontrib>Herzberg, Susan M</creatorcontrib><creatorcontrib>Shook, John W</creatorcontrib><creatorcontrib>Beirne, Tammy K N</creatorcontrib><creatorcontrib>Schomas, David A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Edwards, Jason M</au><au>Herzberg, Susan M</au><au>Shook, John W</au><au>Beirne, Tammy K N</au><au>Schomas, David A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Breast conservation therapy utilizing partial breast brachytherapy for early-stage cancer of the breast: a retrospective review from the Saint Luke's Cancer Institute</atitle><jtitle>American journal of clinical oncology</jtitle><addtitle>Am J Clin Oncol</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>38</volume><issue>2</issue><spage>174</spage><epage>178</epage><pages>174-178</pages><issn>0277-3732</issn><eissn>1537-453X</eissn><abstract>Accelerated partial breast irradiation (APBI) is a convenient alternative to whole-breast irradiation, as less overall time is needed for completion. The use of APBI outside the framework of large prospective clinical trials has markedly increased. To our knowledge, no high-volume, community-based breast program has published their experience with APBI.
The records of 93 consecutive patients who underwent APBI utilizing Mammosite Radiation Therapy System from 2005 to 2010 at Saint Luke's Cancer Institute in Kansas City, MO, were retrospectively reviewed. The Kaplan-Meier method was used to estimate the ipsilateral breast recurrence rate and recurrence-free survival.
Median age at diagnosis was 63 years (range, 45 to 86 y) and mean follow-up was 29 months. Patient stratification ASTRO consensus classifications for APBI was 37% suitable, 57% cautionary, and 6% unsuitable. The 3-year breast control rate was 98.7%. Three-year overall recurrence-free survival was 94.4%, and 3-year mastectomy-free survival was 97.4%. Using univariate analysis, no tumor or patient factors were associated with ipsilateral breast recurrence. However, tumor grade (P<0.05), stage (P=0.04), estrogen receptor status (P<0.001), progesterone receptor status (P<0.001), tumor size (P<0.001), and ASTRO suitability criteria (P=0.027) were associated with overall recurrence-free survival. No differences were observed when outcomes of patients with ductal carcinoma in situ were compared with those with invasive disease.
In our high-volume community-based program, APBI outcomes are comparable with those reported from large academic institutions. We also found relationships between tumor stage, grade, negative estrogen receptor status, and ASTRO suitability criteria with overall recurrence rates. The continued careful application of APBI in appropriately selected patients appears warranted until phase III trials comparing this modality to whole-breast irradiation have matured.</abstract><cop>United States</cop><pmid>23608831</pmid><doi>10.1097/COC.0b013e31828f5b1f</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Brachytherapy - methods Breast Neoplasms - mortality Breast Neoplasms - pathology Breast Neoplasms - radiotherapy Carcinoma, Ductal, Breast - mortality Carcinoma, Ductal, Breast - pathology Carcinoma, Ductal, Breast - radiotherapy Carcinoma, Intraductal, Noninfiltrating - mortality Carcinoma, Intraductal, Noninfiltrating - pathology Carcinoma, Intraductal, Noninfiltrating - radiotherapy Female Humans Kaplan-Meier Estimate Middle Aged Neoplasm Recurrence, Local - epidemiology Retrospective Studies Treatment Outcome |
| title | Breast conservation therapy utilizing partial breast brachytherapy for early-stage cancer of the breast: a retrospective review from the Saint Luke's Cancer Institute |
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