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Accelerated partial breast irradiation, Brachytherapy, Intra-operative, External beam, Local control, Cosmetic
Background: Accelerated partial breast irradiation (APBI) is defined as applying high doses of radiation with a shorter interval to the lumpectomy cavity in the setting of breast-conserving therapy for early-stage breast cancer. This treatment strategy is attractive to patients, and its utilization has increased during recent years because of the shorter treatment schedule, better cosmetic outcomes, and acceptable local control rates in selected patients undergoing breast-conserving therapy. Here we provide an overview of various APBI techniques in terms of clinical and cosmetic outcomes, quality of life, and cost of treatment. We also review the current guidelines for selecting suitable breast cancer patients for APBI strategy.
Methods: A comprehensive literature search of PubMed between 1996 -2019 that was made was made for case series and randomized studies with at least 2 years of follow-up in term of clinical and cosmetic outcomes, quality of life, and treatment costs.
Results: Technological advances have made various APBI modalities, including intracavitary and interstitial brachytherapy, intraoperative radiation therapy, and external-beam radiation therapy, more accessible in the community. Mature data from several randomized and prospective nonrandomized trials have contributed to the development of consensus guidelines for selecting the most appropriate candidates ABPI.
Conclusion: APBI represent an attractive treatment option for appropriately selected patients with early breast cancer. Irrespective to various techniques used for APBI it is very important to select the most appropriate patient population according to reliable guidelines for this treatment strategy that could be non-inferiority to whole breast irradiation especially in high-volume radiation centers with long waiting lists and for patients who live far away from the radiotherapy centers.
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