title: External beam accelerated partial breast irradiation yields favorable outcomes in patients with prior breast augmentation.
abstract: OBJECTIVE
  To report outcomes in breast cancer patients with prior breast augmentation treated with external beam accelerated partial breast irradiation (EB-APBI) utilizing intensity-modulated radiotherapy or 3-dimensional conformal radiotherapy, both with IGRT.
  
  
  METHODS
  Sixteen stage 0/1 breast cancer patients with previous elective bilateral augmentation were treated post-lumpectomy on institutional EB-APBI trials (01185132 and 01185145 on clinicaltrials.gov). Patients received 38.5 Gy in 10 fractions over five consecutive days. Breast/chest wall pain and cosmesis were rated by patient; cosmesis was additionally evaluated by physician per RTOG criteria.
  
  
  RESULTS
  The median follow-up from accelerated partial breast irradiation (APBI) completion was 23.9 months (range, 1.2-58.6). Little to no change in cosmesis or pain from baseline was reported. Cosmetic outcomes at last follow-up were judged by patients as excellent/good in 81.2% (13/16), and by physicians as excellent/good in 93.8% (15/16). Ten patients (62.5%) reported no breast/chest wall pain, five (31.2%) reported mild pain, and one (6.2%) reported moderate pain. All patients remain disease free at last follow-up. The median ipsilateral breast, planning target volume (PTV), and implant volumes were 614, 57, and 333 cm(3). The median ratios of PTV/ipsilateral breast volume (implant excluded) and PTV/total volume (implant included) were 9 and 6%.
  
  
  CONCLUSIONS
  These 16 breast cancer cases with prior bilateral augmentation treated with EB-APBI demonstrate favorable clinical outcomes. Further exploration of EB-APBI as a treatment option for this patient population is warranted.
authors.affiliation: Radiation Oncology, Rocky Mountain Cancer Centers , Littleton, CO , USA ; Radiation Oncology, Rocky Mountain Cancer Centers , Aurora, CO , USA.
authors.forename: Rachel Y
authors.initials: RY
authors.lastname: Lei
authors.affiliation: Radiation Oncology, Rocky Mountain Cancer Centers , Littleton, CO , USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Leonard
authors.affiliation: Radiation Oncology, Rocky Mountain Cancer Centers , Littleton, CO , USA.
authors.forename: Kathryn T
authors.initials: KT
authors.lastname: Howell
authors.affiliation: Radiation Oncology, Rocky Mountain Cancer Centers , Littleton, CO , USA.
authors.forename: Phyllis L
authors.initials: PL
authors.lastname: Henkenberns
authors.affiliation: Radiation Oncology, Rocky Mountain Cancer Centers , Littleton, CO , USA.
authors.forename: Timothy K
authors.initials: TK
authors.lastname: Johnson
authors.affiliation: Radiation Oncology, Rocky Mountain Cancer Centers , Littleton, CO , USA.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Hobart
authors.affiliation: SurgOne , Littleton, CO , USA.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Kercher
authors.affiliation: SurgOne , Littleton, CO , USA.
authors.forename: Jodi L
authors.initials: JL
authors.lastname: Widner
authors.affiliation: Invision Sally Jobe Diagnostic Breast Center , Greenwood Village, CO , USA.
authors.forename: Terese
authors.initials: T
authors.lastname: Kaske
authors.affiliation: Invision Sally Jobe Diagnostic Breast Center , Greenwood Village, CO , USA.
authors.forename: Lora D
authors.initials: LD
authors.lastname: Barke
authors.affiliation: Radiation Oncology, Rocky Mountain Cancer Centers , Aurora, CO , USA.
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Carter
keywords: accelerated partial breast irradiation; breast augmentation mammoplasty; external beam radiotherapy; image-guided radiotherapy; intensity-modulated radiotherapy