title: Brachytherapy-based partial breast irradiation is associated with low rates of complications and excellent cosmesis.
abstract: BACKGROUND
  Recent retrospective, claims-based analyses have suggested a potential increased rate of toxicities associated with brachytherapy-based accelerated partial breast irradiation (APBI). The purpose of this analysis was to examine cosmesis and toxicity data from the prospective American Society of Breast Surgeons (ASBS) breast brachytherapy registry trial to compare to the findings from the claims analyses.
  
  
  METHODS
  The ASBS breast brachytherapy registry is a prospective nonblinded multi-institutional registry trial. Patients with Stage 0-II breast cancer undergoing breast conserving therapy were eligible. A total of 1665 patients were enrolled and 1449 treated between 2002 and 2004 with a median followup of 63 months. All patients were treated with the MammoSite (Hologic, Inc.) single-lumen device to deliver adjuvant APBI (34Gy in 3.4Gy fractions).
  
  
  RESULTS
  The rate of excellent/good cosmesis was 90.6% at 84 months. The rate of a complication (symptomatic seroma, infection, fat necrosis, telangiectasias) at 1 year/any time point was 24.2%/38.5%, whereas the rate of noninfectious complications at 1 year/any time point was 14.8%/28.9%. The rate of symptomatic seroma, fat necrosis, infection, and telangiectasia at any time was 13.4%, 2.5%, 9.6%, and 13.0%, respectively.
  
  
  CONCLUSIONS
  The final toxicity analysis from ASBS breast brachytherapy registry trial confirms the previously noted excellent cosmesis and toxicity profiles and fails to confirm retrospective claims analyses that have suggested higher rates of toxicity for brachytherapy-based APBI.
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA.
authors.forename: Chirag
authors.initials: C
authors.lastname: Shah
authors.forename: Shariq
authors.initials: S
authors.lastname: Khwaja
authors.forename: Shahed
authors.initials: S
authors.lastname: Badiyan
authors.forename: J Ben
authors.initials: JB
authors.lastname: Wilkinson
authors.forename: Frank A
authors.initials: FA
authors.lastname: Vicini
authors.forename: Peter
authors.initials: P
authors.lastname: Beitsch
authors.forename: Martin
authors.initials: M
authors.lastname: Keisch
authors.forename: Douglas
authors.initials: D
authors.lastname: Arthur
authors.forename: Maureen
authors.initials: M
authors.lastname: Lyden
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000628:therapy; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004954:Esthetics; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data*
chemical_list: D018931:Antineoplastic Agents, Hormonal