The use of high-dose-rate brachytherapy alone after lumpectomy in patients with early-stage breast cancer treated with breast-conserving therapy.
OBJECTIVE
We present the preliminary results of our in-house protocol using outpatient high-dose-rate (HDR) brachytherapy as the sole radiation modality following lumpectomy in patients with early-stage breast cancer.


METHODS
Thirty-seven patients with 38 Stage I-II breast cancers received radiation to the lumpectomy cavity alone using an HDR interstitial implant with (192)Ir. A minimum dose of 32 Gy was delivered on an outpatient basis in 8 fractions of 4 Gy to the lumpectomy cavity plus a 1- to 2-cm margin over consecutive 4 days.


RESULTS
Median follow-up is 31 months. There has been one ipsilateral breast recurrence for a crude failure rate of 2.6% and no regional or distant failures. Wound healing was not impaired in patients undergoing an open-cavity implant. Three minor breast infections occurred, and all resolved with oral antibiotics. The cosmetic outcome was good to excellent in all patients.


CONCLUSIONS
In selected patients with early-stage breast cancer, treatment of the lumpectomy cavity alone with outpatient HDR brachytherapy is both technically feasible and well tolerated. Early results are encouraging, however, longer follow-up is necessary before equivalence to standard whole-breast irradiation can be established and to determine the most optimal radiation therapy technique to be employed.
Baglan
K L
KL
Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI 48073, USA.
Martinez
A A
AA
Frazier
R C
RC
Kini
V R
VR
Kestin
L L
LL
Chen
P Y
PY
Edmundson
G
G
Mele
E
E
Jaffray
D
D
Vicini
F A
FA
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001918:Brachytherapy / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage
D007496:Iridium Radioisotopes