title: Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial.
abstract: To assess the feasibility of utilizing 3-dimensional conformal accelerated partial-breast irradiation (APBI) in the preoperative setting followed by standard breast-conserving therapy.
  
  
  
  This was a prospective trial testing the feasibility of preoperative APBI followed by lumpectomy for patients with early-stage invasive ductal breast cancer. Eligible patients had T1-T2 (<3 cm), N0 tumors. Patients received 38.5 Gy in 3.85-Gy fractions delivered twice daily. Surgery was performed >21 days after radiation therapy. Adjuvant therapy was given as per standard of care.
  
  
  
  Twenty-seven patients completed treatment. With a median follow-up of 3.6 years (range, 0.5-5 years), there have been no local or regional failures. A complete pathologic response according to hematoxylin and eosin stains was seen in 4 patients (15%). There were 4 grade 3 seromas. Patient-reported cosmetic outcome was rated as good to excellent in 79% of patients after treatment.
  
  
  
  Preoperative 3-dimensional conformal radiation therapy-APBI is feasible and well tolerated in select patients with early-stage breast cancer, with no reported local recurrences and good to excellent cosmetic results. The pathologic response rates associated with this nonablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.
authors.affiliation: Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address: Enichols1@umm.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Nichols
authors.affiliation: Department of Surgical Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Kesmodel
authors.affiliation: Department of Surgical Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Emily
authors.initials: E
authors.lastname: Bellavance
authors.affiliation: Department of Surgical Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Drogula
authors.affiliation: Department of Medical Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Katherine
authors.initials: K
authors.lastname: Tkaczuk
authors.affiliation: Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Randi J
authors.initials: RJ
authors.lastname: Cohen
authors.affiliation: Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Wendla
authors.initials: W
authors.lastname: Citron
authors.affiliation: Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Michelle
authors.initials: M
authors.lastname: Morgan
authors.affiliation: Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Paul
authors.initials: P
authors.lastname: Staats
authors.affiliation: Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Steven
authors.initials: S
authors.lastname: Feigenberg
authors.affiliation: Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: William F
authors.initials: WF
authors.lastname: Regine
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control*; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods; D017785:Photons / Q000627:therapeutic use; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D000069473:Radiation Dose Hypofractionation; D011832:Radiation Injuries / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D018714:Radiotherapy, Adjuvant / Q000379:methods; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D016896:Treatment Outcome