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01.11.2010 | Breast Oncology | Ausgabe 11/2010

Annals of Surgical Oncology 11/2010

Ductal Carcinoma in Situ of the Breast Treated with Accelerated Partial Breast Irradiation Using Balloon-Based Brachytherapy

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 11/2010
Autoren:
MD Philip Z. Israel, MD Frank Vicini, MD Angela B. Robbins, MD Paulomi Shroff, MD Mark McLaughlin, Keri Grier, MS Maureen Lyden

Abstract

Background

We reviewed our institution’s experience treating patients with ductal carcinoma in situ (DCIS) of the breast with balloon-based accelerated partial breast irradiation (APBI) to determine the efficacy of this treatment approach in this group of patients.

Materials and Methods

A total of 126 cases of DCIS seen and treated with APBI using balloon-based brachytherapy constitute the study population. The median age at diagnosis was 59 years (range, 37–82) with 21% younger than age 50. Nuclear grade distribution was 52.5, 41.4, and 6.1% high, intermediate and low, respectively. Of these patients, 86% had estrogen receptor positive DCIS. The median tumor size was 6 mm (range, 1–26). Margins of excision were negative in 98.4% of patients. All patients were treated with 34 Gy in 10 fractions using either the MammoSite™ or Contura™ breast brachytherapy catheter. A total of 87 patients (73.1%) were placed on adjuvant tamoxifen or arimedex.

Results

With a median follow-up of 24 months (range, 0.7–73.9), three (2.4%) ipsilateral breast tumor recurrences (IBTRs) developed for a 2-year actuarial rate of 0.81%. Recurrences developed 4.8, 24.7, and 24.9 months after treatment. On univariate analysis, no variable was associated with IBTR. A subset analysis of the first 50 consecutive patients treated was also performed. With a median follow-up of 40 months (range, 15.6–73.9), one IBTR developed for a 3-year actuarial rate of 2.15%.

Conclusions

Early results in patients with DCIS treated with APBI using balloon-based brachytherapy produced results similar to those with invasive cancer treated with APBI or DCIS treated with whole breast irradiation.

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