title: Timing of infectious complications following breast-conserving therapy with catheter-based accelerated partial breast irradiation.
abstract: BACKGROUND
  Accelerated partial breast irradiation (APBI) has been used as an alternative to whole-breast irradiation as part of breast-conserving therapy. Indications and outcomes are topics of ongoing investigation. Previous publications have focused on early postoperative infections and reported low rates of delayed infection. We investigated the pattern of infection after catheter-based APBI at our institution.
  
  
  METHODS
  Patients who underwent single-entry catheter-based APBI were identified from an institutional prospective registry including data regarding comorbidities and outcomes. Time of infection was calculated from the date of definitive catheter insertion and classified as early (≤30 days) or delayed.
  
  
  RESULTS
  A total of 91 breast cancer patients were treated with APBI and enrolled in the registry from 2009 to 2011. The median follow-up was 484 days. Breast infection occurred in 13 (14.3 %), with 3 (3.3 %) occurring within 30 days of catheter placement and 10 (11.0 %) in a delayed fashion. Four patients required hospital admission, five underwent percutaneous aspiration, and one underwent incision and drainage. Eight were treated as outpatients with oral antibiotics alone.
  
  
  CONCLUSIONS
  Consistent with other reports, we found an overall infection rate of 14.3 % with single-entry catheter-based APBI. There were substantially fewer infections in the early postoperative period than reported elsewhere, but there were more delayed infections. The intensive follow-up in our study likely identified late infections that may not have otherwise been recognized. Vigilance for infectious complications must continue beyond the immediate treatment period in patients undergoing catheter-based APBI. These infections can range in severity but typically can be managed in an outpatient setting.
authors.affiliation: Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Alex B
authors.initials: AB
authors.lastname: Haynes
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Bloom
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bedrosian
authors.forename: Henry M
authors.initials: HM
authors.lastname: Kuerer
authors.forename: Rosa F
authors.initials: RF
authors.lastname: Hwang
authors.forename: Mark F
authors.initials: MF
authors.lastname: Munsell
authors.forename: Roy F
authors.initials: RF
authors.lastname: Chemaly
authors.forename: Linda S
authors.initials: LS
authors.lastname: Graviss
authors.forename: Abigail S
authors.initials: AS
authors.lastname: Caudle
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Hunt
authors.forename: Welela
authors.initials: W
authors.lastname: Tereffe
authors.forename: Simona F
authors.initials: SF
authors.lastname: Shaitelman
authors.forename: Gildy V
authors.initials: GV
authors.lastname: Babiera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000601:surgery*; D002404:Catheterization / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D013530:Surgical Wound Infection / Q000209:etiology*; D013997:Time Factors