Adjuvant partial breast radiotherapy for early breast cancer--ready for a change?
Partial breast radiotherapy (PBRT) has recently gained an optional place as local adjuvant treatment after breast-conserving surgery (BCS) for selected early-stage breast cancer. With high-dose-rate (HDR) interstitial multicatheter brachytherapy (BT) performed under strict quality assurance criteria, there is level B evidence derived from one single randomized study with follow-up longer than 5 years and level C from several mature prospective non-randomized studies. For intra-lumpectomy cavity Mammosite HDR-BT and for external beam RT, as well as 3-dimensional (3D)-conformal or intra-operative therapy by electrons or photons, there is only level D evidence with no mature enough prospective data. Large phase III trials are ongoing for each PBRT technique, but their results might offer a level A evidence no earlier than 5 years.
Department of Brachytherapy, Ion Chiricuta Cancer Center, 34-36 Gh. Bilascu Street, Cluj-Napoca, Romania. gabi.kacso@gmail.com
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D001918:Brachytherapy; D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D018714:Radiotherapy, Adjuvant