title: Accelerated Partial Breast Irradiation: Executive summary for the update of an ASTRO Evidence-Based Consensus Statement.
abstract: OBJECTIVE
  To update the accelerated partial breast irradiation Consensus Statement published in 2009 and provide guidance on use of intraoperative radiation therapy (IORT) for partial breast irradiation in early-stage breast cancer, based on published evidence complemented by expert opinion.
  
  
  METHODS
  A systematic PubMed search using the same terms as the original Consensus Statement yielded 419 articles; 44 articles were selected. The authors synthesized the published evidence and, through a series of conference calls and e-mails, reached consensus regarding the recommendations.
  
  
  RESULTS
  The new recommendations include lowering the age in the "suitability group" from 60 to 50 years and in the "cautionary group" to 40 years for patients who meet all other elements of suitability (Table 1). Patients with low-risk ductal carcinoma in situ, as per Radiation Therapy Oncology Group 9804 criteria, were categorized in the "suitable" group. The task force agreed to maintain the current criteria based on margin status. Recommendations for the use of IORT for breast cancer patients include: counseling patients regarding the higher risk of ipsilateral breast tumor recurrence with IORT compared with whole breast irradiation; the need for prospective monitoring of long-term local control and toxicity with low-energy radiograph IORT given limited follow-up; and restriction of IORT to women with invasive cancer considered "suitable."
  
  
  CONCLUSIONS
  These recommendations will provide updated clinical guidance regarding use of accelerated partial breast irradiation for radiation oncologists and other specialists participating in the care of breast cancer patients.
authors.affiliation: Department of Radiation Oncology, Faxton St. Luke's Healthcare, Utica, New York.
authors.forename: Candace
authors.initials: C
authors.lastname: Correa
authors.affiliation: Department of Radiation Oncology, East Carolina University, Greenville, North Carolina.
authors.forename: Eleanor E
authors.initials: EE
authors.lastname: Harris
authors.affiliation: Department of Radiation Oncology, European Institute of Oncology, Milan, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Leonardi
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Smith
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Alphonse G
authors.initials: AG
authors.lastname: Taghian
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Alastair M
authors.initials: AM
authors.lastname: Thompson
authors.affiliation: Department of Radiation Oncology, Ohio State University Cancer Center, Columbus, Ohio.
authors.forename: Julia
authors.initials: J
authors.lastname: White
authors.affiliation: Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts. Electronic address: jay_harris@dfci.harvard.edu.
authors.forename: Jay R
authors.initials: JR
authors.lastname: Harris
mesh_terms: D000328:Adult; D001918:Brachytherapy / Q000379:methods* / Q000592:standards*; D001943:Breast Neoplasms / Q000532:radiotherapy*; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D014481:United States