Early stage breast cancer conserving treatment: high dose rate brachytherapy boost to the tumour bed.
BACKGROUND
The dose administered to the tumour bed is a risk-factor for local recurrence in localised breast cancer following breast-conserving surgery.


METHODS
All patients (n=94) received 50 Gy external beam radiotherapy and one application of 700 cGy at 85% isodose with high dose rate brachytherapy.


RESULTS
Of the cases, 84% were infiltrating ductal carcinoma; 31.2% were G3; 28% were intraductal component > 25%; 54% had margin < 1 cm or unknown. With a mean follow-up of 65 months (range: 36-107 months), the overall actuarial survival at 5 and 8 years was 93.2% and 84.2%, respectively; disease-free survival was 88.3% and 84.6%, respectively; local control was 92.2% and 88.75%, respectively. Local recurrence rate was 5.3%, and distant dissemination rate was 8.5%. Among the risk-factors analysed, only the presence of 4 or more lymph node involvement implied a higher risk for local recurrence (p =0.0001). For distant dissemination, the risk-factors were: 4 or more lymph nodes involved (p = 0.0001),G3 (p =0.029), tumour >3 cm (p = 0.001), irradiation volume with external beam radiotherapy (p =0.0001), and presence of local recurrence (p = 0.001).


CONCLUSIONS
High dose rate brachytherapy is an effective method for reducing local recurrence, and increasing local control.
López Carrizosa
María Concepción
MC
Servicio de Oncología Radioterápica, Hospital Central de la Defensa, C/Glorieta del Ejército s/n, 28047 Madrid, Spain. josaldel@libertaddigital.net
Samper Ots
Pilar María
PM
Vallejo Ocaña
Carmen
C
Rodríguez Pérez
Aurora
A
Sáez Garrido
Juan de Dios
Jde D
Delgado Pérez
José María
JM
D001918:Brachytherapy / Q000379:methods*; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate