Case report and dosimetric analysis of an axillary recurrence after partial breast irradiation with mammosite catheter.
Partial breast irradiation (PBI) was designed in part to decrease overall treatment times associated with whole breast radiation therapy (WBRT). WBRT treats the entire breast and usually portions of the axilla. The goal of PBI is to treat a smaller volume of breast tissue in less time, focusing the dose around the lumpectomy cavity. The following is a case of a 64-year-old woman with early-stage breast cancer treated with PBI who failed regionally in the ipsilateral axilla. With our dosimetric analysis, we found that the entire area of this axillary failure would have likely received at least 45 Gy if WBRT had been used, enough to sterilize microscopic disease. With PBI, this area received a mean dose of only 2.8 Gy, which raises the possibility that this regional failure may have been prevented had WBRT been used instead of PBI.
Shah
Anand P
AP
Department of Radiation Oncology, Rush University Medical Center, Chicago, IL 60612, USA. anand_shah@rush.edu
Dickler
Adam
A
Kirk
Michael C
MC
Chen
Sea S
SS
Strauss
Jonathan B
JB
Coon
Alan B
AB
Turian
Julius V
JV
Siziopikou
Kalliopi
K
Dowlat
Kambiz
K
Griem
Katherine L
KL
D001365:Axilla / Q000473:pathology*; D001918:Brachytherapy / Q000379:methods; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D017211:Treatment Failure
D007496:Iridium Radioisotopes