title: Accelerated partial breast irradiation using the MammoSite device: early technical experience and short-term clinical follow-up.
abstract: The MammoSite brachytherapy system is a novel form of intracavitary accelerated partial breast irradiation (APBI) that allows treatment over a 5- to 7-day course after breast conserving surgery (BCS). Fifty-one patients with invasive breast carcinoma underwent BCS and APBI using the MammoSite device, with 30 (59%) patients having drain placement in the lumpectomy cavity. Main outcome measures included time to initiating APBI, cosmesis using the Harvard Scale, and local and distant tumor recurrence with short-term follow-up. Five (9.8%) devices were explanted because of unfavorable final pathological findings or infection. Mean time to the start of APBI in patients without drain placement was 7.2 days (range, 5-12 days) compared with 5.1 days (range, 3-8 days) in patients with drains (P = 0.003). Cosmetic results were excellent in 25 (54.3%) patients, good in 19 (41.3%) patients, and fair in 2 (4.4%) patients. With a mean follow-up of 16 months (range, 6-38 months), no ipsilateral breast recurrences developed in any of the 51 patients. Thirteen patients had at least a 2-year follow-up. Two patients developed brain metastases and died at 19 and 23 months, respectively. The favorable short-term outcomes support further studies comparing APBI with standard whole-breast irradiation in patients undergoing BCS.
authors.affiliation: Department of Surgery, Kaiser Permanente Los Angeles Medical Center, California, USA.
authors.forename: Peter I
authors.initials: PI
authors.lastname: Tsai
authors.forename: Marianne
authors.initials: M
authors.lastname: Ryan
authors.forename: Kelly
authors.initials: K
authors.lastname: Meek
authors.forename: Monica C
authors.initials: MC
authors.lastname: Ryoo
authors.forename: Michael
authors.initials: M
authors.lastname: Tome
authors.forename: Jan
authors.initials: J
authors.lastname: Takasugi
authors.forename: Philip
authors.initials: P
authors.lastname: Haigh
authors.forename: L Andrew
authors.initials: LA
authors.lastname: Difronzo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D001932:Brain Neoplasms / Q000556:secondary; D001940:Breast / Q000528:radiation effects*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D002423:Cause of Death; D004322:Drainage; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D012867:Skin / Q000528:radiation effects; D013997:Time Factors; D016896:Treatment Outcome