title: First results of the preoperative accelerated partial breast irradiation (PAPBI) trial.
abstract: OBJECTIVE
  The aim of this study is to assess the toxicity and cosmetic outcome of preoperative accelerated partial breast irradiation (PAPBI) for breast cancer patients with low risk on local recurrence.
  
  
  METHODS
  Women aged ⩾60years with an invasive, unifocal ⩽3cm on MRI, (non-lobular) adenocarcinoma of the breast and a negative sentinel node received PAPBI (40Gray in 10 fractions over 2 weeks). Six weeks after radiotherapy a wide local excision was performed.
  
  
  RESULTS
  70 patients with a median follow-up of 23 months (3-44 months) were evaluated. The overall postoperative infection rate was 11%. At 1, 2 and 3 years of follow-up respectively 89%, 98% and 100% of patients had no or mild induration-fibrosis. Fibrosis was only found in a small volume of the breast. The global cosmetic outcome was good to excellent in 77% at 6 months to 100% at 3 years. Two patients developed a local recurrence.
  
  
  CONCLUSIONS
  Our first results show limited fibrosis in a small volume and good to excellent cosmetic outcome. In selected patients, preoperative radiotherapy appears to be a good option for breast conserving therapy.
authors.affiliation: Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Femke
authors.initials: F
authors.lastname: van der Leij
authors.affiliation: Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Sophie C J
authors.initials: SC
authors.lastname: Bosma
authors.affiliation: Academical Medical Center, Amsterdam, The Netherlands.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: van de Vijver
authors.affiliation: Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Jelle
authors.initials: J
authors.lastname: Wesseling
authors.affiliation: Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Sandra
authors.initials: S
authors.lastname: Vreeswijk
authors.affiliation: Institut Gustave-Roussy, Villejuif, France.
authors.forename: Sofia
authors.initials: S
authors.lastname: Rivera
authors.affiliation: Institut Gustave-Roussy, Villejuif, France.
authors.forename: Celine
authors.initials: C
authors.lastname: Bourgier
authors.affiliation: Institut Gustave-Roussy, Villejuif, France.
authors.forename: Jean-Rémi
authors.initials: JR
authors.lastname: Garbay
authors.affiliation: Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Foukakis
authors.affiliation: Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Tobias
authors.initials: T
authors.lastname: Lekberg
authors.affiliation: University Medical Center, Utrecht, The Netherlands.
authors.forename: Desiree H J G D
authors.initials: DH
authors.lastname: van den Bongard
authors.affiliation: Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Corine
authors.initials: C
authors.lastname: van Vliet-Vroegindeweij
authors.affiliation: Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Harry
authors.initials: H
authors.lastname: Bartelink
authors.affiliation: Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Emiel J
authors.initials: EJ
authors.lastname: Rutgers
authors.affiliation: Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: p.elkhuizen@nki.nl.
authors.forename: Paula H M
authors.initials: PH
authors.lastname: Elkhuizen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D005348:Fibrocystic Breast Disease / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011183:Postoperative Complications / Q000382:microbiology; D011300:Preoperative Care / Q000379:methods; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
keywords: Breast cancer; Partial breast irradiation; Preoperative