Accelerated Partial Breast Irradiation With Multi-Catheter Brachytherapy: Local Control, Side Effects and Cosmetic Outcome for 274 Patients. Results of the German-Austrian Multi-centre Trial

Article Outline

• Purpose/Objective(s)
• Materials/Methods
• Results
• Conclusions
• Copyright

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Purpose/Objective(s) 

To evaluate the safety and effectiveness of accelerated partial breast irradiation (APBI) with multi-catheter brachytherapy.

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Materials/Methods 

Between 11/2000 and 04/2005, 274 patients participated. Patients were eligible for APBI if they had histologically confirmed breast cancer, a tumour diameter ≤3 cm, complete resection with clear margins ≥2 mm, negative axillary lymph nodes or singular nodal micrometastasis, no distant metastases, hormone receptor-positive tumours, and were ≥35 years. Patients were excluded if mammographically they showed a multicentric invasive growth pattern, poorly differentiated tumours, residual diffuse microcalcifications, extensive intraductal component, or vessel invasion. Median follow-up was 38 months (range; 9–76).

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Results 

The local control rate was 98.5% (270/274), the 3 year-local-recurrence-free survival probability, 99.6%. Peri-operative complications occurred in 5.5% (15/274): 9 (3.3%) experienced implant infection and 6 (2.2%) hematoma. Acute toxicity (Grade 1/2-radiodermatitis) was seen in 6.6% (18/274). Late side effects ≥ Grade 3 (fibrosis, teleangiectasia) occurred in 1.8% (4/274). Cosmetic results were good/excellent in 94% (253/274).

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Conclusions 

This analysis underlined the safety and effectiveness of APBI in a carefully selected subgroup with favourable disease characteristics. Of course, longer follow-up and randomised trials are necessary to conclusively assess the potential of APBI.