title: Fat necrosis in women with early-stage breast cancer treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy.
abstract: OBJECTIVE
  To report the incidence of clinical, pathological and radiological fat necrosis (FN) in women treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy (BRT) for early-stage breast cancer and to study certain variables associated with it.
  
  
  METHODS
  Between May 2000 and August 2008, 171 women were treated with APBI using high dose rate (HDR) BRT. Patients were treated to a dose of 34 Gy/10 fractions/1 week with two fractions/day after intraoperative/postoperative placement of catheters.
  
  
  RESULTS
  At a median follow up of 48 months (SD: 28) 20 women developed FN with median time to detection being 24 months (range: 4-62 months, SD: 20). Actuarial 5 and 7 year FN rate was 18% and 23%, respectively. Grade 1 FN was seen in 4, grade 2 in 8 and grade 4 in 8 women. Additional investigations such as aspiration/biopsy were done in 9 patients. Volume of excision was the only significant factor affecting FN (p=0.04).
  
  
  CONCLUSIONS
  Actuarial FN rate of 18% at 5 years in our study was comparable to other reported series of FN. Median time of detection of FN was 24 months. Higher volume of excision resulted in an increased incidence of fat necrosis.
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. ashwininb@yahoo.com
authors.forename: Ashwini
authors.initials: A
authors.lastname: Budrukkar
authors.forename: Vikas
authors.initials: V
authors.lastname: Jagtap
authors.forename: Seema
authors.initials: S
authors.lastname: Kembhavi
authors.forename: Anusheel
authors.initials: A
authors.lastname: Munshi
authors.forename: Rakesh
authors.initials: R
authors.lastname: Jalali
authors.forename: Tanuja
authors.initials: T
authors.lastname: Seth
authors.forename: Vani
authors.initials: V
authors.lastname: Parmar
authors.forename: Ritu Raj
authors.initials: RR
authors.lastname: Upreti
authors.forename: Rajendra
authors.initials: R
authors.lastname: Badwe
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sarin
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D005218:Fat Necrosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009367:Neoplasm Staging; D013997:Time Factors