Accelerated Partial Breast Irradiation: A New Strategy for Early-Stage Breast Cancer

Background: Accelerated partial breast irradiation (APBI) is defined asapplying high doses of radiation with a shorter interval to the lumpectomy cavity inthe setting of breast-conserving therapy for early-stage breast cancer. Thistreatment strategy is attractive to patients, and its utilization has increased duringrecent years because of the shorter treatment schedule, better cosmetic outcomes,and acceptable local control rates in selected patients undergoing breastconservingtherapy. Here we provide an overview of various APBI techniques interms of clinical and cosmetic outcomes, quality of life, and cost of treatment. Wealso review the current guidelines for selecting suitable breast cancer patients forAPBI strategy. Methods: A comprehensive literature search of PubMed between ۱۹۹۶ -۲۰۱۹that was made was made for case series and randomized studies with at least ۲years of follow-up in term of clinical and cosmetic outcomes, quality of life, andtreatment costs.Results: Technological advances have made various APBI modalities,including intracavitary and interstitial brachytherapy, intraoperative radiationtherapy, and external-beam radiation therapy, more accessible in the community.Mature data from several randomized and prospective nonrandomized trials havecontributed to the development of consensus guidelines for selecting the mostappropriate candidates ABPI. Conclusion: APBI represent an attractive treatment option for appropriatelyselected patients with early breast cancer. Irrespective to various techniques usedfor APBI it is very important to select the most appropriate patient populationaccording to reliable guidelines for this treatment strategy that could be noninferiorityto whole breast irradiation especially in high-volume radiation centerswith long waiting lists and for patients who live far away from the radiotherapycenters.

Keywords:

Accelerated partial breast irradiation , brachytherapy , intraoperative , external-beam , local control