title: Accelerated partial breast irradiation: advances and controversies.
abstract: The management of localized breast cancer has changed dramatically over the past three to four decades. Breast-conserving therapy, which involved lumpectomy followed by adjuvant irradiation, is now widely considered the standard of care in women with early-stage breast cancer. Accelerated partial breast irradiation (APBI), which involves focal irradiation of the lumpectomy cavity over a short period of time, has developed over the past two decades as an alternative to whole breast irradiation (WBI). Multiple APBI modalities have been developed including brachytherapy, external beam irradiation, and intraoperative irradiation. These new techniques have provided early-stage breast cancer patients with shorter treatment duration and more focused irradiation, delivering very high biological doses to the region at a high risk of failures over a much shorter treatment course as compared with conventional radiotherapy. However, the advantages of APBI over conventional radiotherapy are controversial, including a higher risk of complications reported in retrospective literature and shorter follow-up duration in the intraoperative APBI trials. Nevertheless, APBI presents a valuable alternative to WBI for a selected population of women with early-stage breast cancer.
authors.affiliation: Department of Radiation Oncology, Houston Methodist Hospital, Cancer Center and Research Institute, Weil Cornell Medical College, 6565 Fannin, Ste#DB1-077, Houston, TX, 77030, USA.|Department of Radiation Oncology, The University of Texas Medical Branch at Galveston, Houston, TX, 77555, USA.
authors.forename: Mani
authors.initials: M
authors.lastname: Akhtari
authors.affiliation: Department of Radiation Oncology, Houston Methodist Hospital, Cancer Center and Research Institute, Weil Cornell Medical College, 6565 Fannin, Ste#DB1-077, Houston, TX, 77030, USA. bteh@houstonmethodist.org.
authors.forename: Bin S
authors.initials: BS
authors.lastname: Teh
mesh_terms: D001918:Brachytherapy / Q000379:methods; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Accelerated partial breast irradiation; Brachytherapy; Breast cancer