title: Accelerated partial breast irradiation using the strut-adjusted volume implant single-entry hybrid catheter in brachytherapy for breast cancer in the setting of breast augmentation.
abstract: OBJECTIVE
  Accelerated partial breast irradiation (APBI) has gained popularity as an alternative to adjuvant whole breast irradiation; however, owing to limitations of delivery devices for brachytherapy, APBI has not been a suitable option for all the patients. This report evaluates APBI using the strut-adjusted volume implant (SAVI) single-entry catheter to deliver brachytherapy for breast cancer in the setting of an augmented breast.
  
  
  METHODS
  The patient previously had placed bilateral subpectoral saline implants; stereotactic core biopsy revealed estrogen receptor- and progesterone receptor-positive ductal carcinoma in situ of intermediate nuclear grade. The patient underwent needle-localized segmental mastectomy of her left breast; pathologic specimen revealed no residual malignancy. An SAVI 8-1 device was placed within the segmental resection cavity. Treatment consisted of 3.4 Gy delivered twice a day for 5 days for a total dose of 34 Gy. Treatments were delivered with a high-dose-rate (192)Ir remote afterloader.
  
  
  RESULTS
  Conformance of the device to the lumpectomy cavity was excellent at 99.2%. Dosimetric values of percentage of the planning target volume for evaluation receiving 90% of the prescribed dose, percentage of the planning target volume for evaluation receiving 95% of the prescribed dose, volume receiving 150% of the prescribed dose, and volume receiving 200% of the prescribed dose were 97.1%, 94.6%, 22.7 cc, and 11.6 cc, respectively. Maximum skin dose was 115% of the prescribed dose. The patient tolerated treatment well with excellent cosmetic results, and limited acute and late toxicity at 8 weeks and 6 months, respectively.
  
  
  CONCLUSIONS
  Breast augmentation should not be an exclusion criterion for the option of APBI. The SAVI single-entry catheter is another option to successfully complete APBI using brachytherapy for breast cancer in the setting of an augmented breast.
authors: Division of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77081, USA. ebloom@mdanderson.org
authors: Elizabeth S
authors: ES
authors: Bloom
authors: Steve
authors: S
authors: Kirsner
authors: Bryan E
authors: BE
authors: Mason
authors: Chris L
authors: CL
authors: Nelson
authors: Kelly K
authors: KK
authors: Hunt
authors: Donald P
authors: DP
authors: Baumann
authors: Kent A
authors: KA
authors: Gifford
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation* / Q000379:methods*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008875:Middle Aged; D016896:Treatment Outcome