title: Partial breast irradiation for locally recurrent breast cancer within a second breast conserving treatment: alternative to mastectomy? Results from a prospective trial.
abstract: OBJECTIVE
  To assess the outcome of multi-catheter pulse dose rate (PDR) brachytherapy of re-irradiation for local ipsilateral breast tumour recurrence (IBTR) in regard to local control, survival, morbidity and quality of life (QoL).
  
  
  METHODS
  Between 1999 and 2006, 39 patients were included with histologically confirmed IBTR, Karnofsky index ≥80% and refusal of mastectomy. Exclusion criteria were multicentric invasive growth pattern, unclear surgical margins, distant metastasis and a postoperative breast not suitable for interstitial brachytherapy. Primary endpoint was local tumour control. Morbidity, cosmetic outcome and QoL were assessed in 24/39 patients.
  
  
  RESULTS
  The five year actuarial local control rate was 93% after a mean follow up of 57 (±30) months with two second local relapses. Overall survival and disease free survival, both at 5 years, were 87% and 77%, respectively. Late side effects Grade 1-2 were observed in 20/24 patients after a mean follow-up of 30 (±18) months. Late side effects ≥Grade 3 occurred in 4/24 patients. Cosmetic outcome was excellent to fair in 76% of women. Overall QoL was comparable to a healthy control group. Mean scores of scales and items of QLQ-BR23 were comparable to primary breast conserving therapy.
  
  
  CONCLUSIONS
  Accelerated PDR-brachytherapy following breast conserving surgery (BCS) for local IBTR results in local tumour control comparable to mastectomy. Morbidity is moderate; the cosmetic outcome is good and hardly any impairment on QoL is observed.
authors: Department of Radiotherapy, Medical University of Vienna, Austria. daniela.kauer-dorner@akhwien.at
authors: Daniela
authors: D
authors: Kauer-Dorner
authors: Richard
authors: R
authors: Pötter
authors: Alexandra
authors: A
authors: Resch
authors: Leonore
authors: L
authors: Handl-Zeller
authors: Kathrin
authors: K
authors: Kirchheiner
authors: Katja
authors: K
authors: Meyer-Schell
authors: Wolfgang
authors: W
authors: Dörr
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy* / Q000601:surgery*; D009367:Neoplasm Staging; D011446:Prospective Studies; D011788:Quality of Life; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome