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Potential applicability of balloon catheter-based accelerated partial breast irradiation after conservative surgery for breast carcinoma.
Cancer. 2004 Feb 01; 100(3):490-8.C

Abstract

BACKGROUND

Balloon catheter-based accelerated partial breast irradiation (APBI) is an alternative to whole-breast external-beam irradiation during breast-conserving therapy (BCT) for breast carcinoma, but it is limited by the size of the segmental mastectomy cavity. There are scant data on the average or optimal volume of resection (VR) in BCT. The objective of the current study was to evaluate the percentage of patients who would be eligible for balloon catheter-based APBI based on the selection criteria of the American Society of Breast Surgeons and the surgical VR.

METHODS

The authors reviewed the medical records of 443 patients with ductal carcinoma in situ (DCIS) or invasive carcinoma treated with BCT. Patient treatment and pathologic data were analyzed to assess VR and eligibility for APBI.

RESULTS

BCT was performed for 178 patients with DCIS and 267 patients with invasive breast carcinoma. The majority of invasive carcinomas (63.3%) were infiltrating ductal carcinomas. The median overall lumpectomy volume was 67.61 cm3, with no significant difference between DCIS and invasive carcinoma (P>0.05). Although the majority (62.9-82.0%) of patients met the individual selection criteria for APBI, only 27.4% of the cohort was found to be eligible for any type of APBI when the selection criteria were considered together. Based on VR, only approximately one-half of the patients initially eligible for APBI would be candidates for immediate balloon catheter-based APBI using the 70 cm3 balloon device (13.3%). However, with the new, larger 125 cm3 balloon device, approximately three-fourths of patients initially eligible for APBI would be eligible for balloon catheter-based APBI at the time of the initial surgical procedure (20.7%). Although not evaluated in the current study, shrinkage of the lumpectomy cavity with time may increase the number of patients eligible based strictly on VR criteria. Patients with a very large VR (> or =125 cm3) were more likely to have invasive carcinoma (P=0.02; hazard ratio [HR], 7.4) and tumors > or =5 cm on final pathology (P<0.01; HR, 22.0).

CONCLUSIONS

Approximately one-fifth to one-fourth of patients presenting for BCT may be eligible for balloon catheter-based APBI according to accepted national guidelines and VR. VR must be considered when selecting patients for balloon catheter-based APBI, because a minority of patients will have a lumpectomy cavity that exceeds the size limit of the current balloon device.

Authors+Show Affiliations

Department of Surgical Oncology, The University of Texas M D Anderson Cancer Center, Houston, Texas 77030, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14745864

Citation

Pawlik, Timothy M., et al. "Potential Applicability of Balloon Catheter-based Accelerated Partial Breast Irradiation After Conservative Surgery for Breast Carcinoma." Cancer, vol. 100, no. 3, 2004, pp. 490-8.
Pawlik TM, Perry A, Strom EA, et al. Potential applicability of balloon catheter-based accelerated partial breast irradiation after conservative surgery for breast carcinoma. Cancer. 2004;100(3):490-8.
Pawlik, T. M., Perry, A., Strom, E. A., Babiera, G. V., Buchholz, T. A., Singletary, E., Perkins, G. H., Ross, M. I., Schecter, N. R., Meric-Bernstam, F., Ames, F. C., Hunt, K. K., & Kuerer, H. M. (2004). Potential applicability of balloon catheter-based accelerated partial breast irradiation after conservative surgery for breast carcinoma. Cancer, 100(3), 490-8.
Pawlik TM, et al. Potential Applicability of Balloon Catheter-based Accelerated Partial Breast Irradiation After Conservative Surgery for Breast Carcinoma. Cancer. 2004 Feb 1;100(3):490-8. PubMed PMID: 14745864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potential applicability of balloon catheter-based accelerated partial breast irradiation after conservative surgery for breast carcinoma. AU - Pawlik,Timothy M, AU - Perry,Allison, AU - Strom,Eric A, AU - Babiera,Gildy V, AU - Buchholz,Thomas A, AU - Singletary,Eva, AU - Perkins,George H, AU - Ross,Merrick I, AU - Schecter,Naomi R, AU - Meric-Bernstam,Funda, AU - Ames,Frederick C, AU - Hunt,Kelly K, AU - Kuerer,Henry M, PY - 2004/1/28/pubmed PY - 2004/2/20/medline PY - 2004/1/28/entrez SP - 490 EP - 8 JF - Cancer JO - Cancer VL - 100 IS - 3 N2 - BACKGROUND: Balloon catheter-based accelerated partial breast irradiation (APBI) is an alternative to whole-breast external-beam irradiation during breast-conserving therapy (BCT) for breast carcinoma, but it is limited by the size of the segmental mastectomy cavity. There are scant data on the average or optimal volume of resection (VR) in BCT. The objective of the current study was to evaluate the percentage of patients who would be eligible for balloon catheter-based APBI based on the selection criteria of the American Society of Breast Surgeons and the surgical VR. METHODS: The authors reviewed the medical records of 443 patients with ductal carcinoma in situ (DCIS) or invasive carcinoma treated with BCT. Patient treatment and pathologic data were analyzed to assess VR and eligibility for APBI. RESULTS: BCT was performed for 178 patients with DCIS and 267 patients with invasive breast carcinoma. The majority of invasive carcinomas (63.3%) were infiltrating ductal carcinomas. The median overall lumpectomy volume was 67.61 cm3, with no significant difference between DCIS and invasive carcinoma (P>0.05). Although the majority (62.9-82.0%) of patients met the individual selection criteria for APBI, only 27.4% of the cohort was found to be eligible for any type of APBI when the selection criteria were considered together. Based on VR, only approximately one-half of the patients initially eligible for APBI would be candidates for immediate balloon catheter-based APBI using the 70 cm3 balloon device (13.3%). However, with the new, larger 125 cm3 balloon device, approximately three-fourths of patients initially eligible for APBI would be eligible for balloon catheter-based APBI at the time of the initial surgical procedure (20.7%). Although not evaluated in the current study, shrinkage of the lumpectomy cavity with time may increase the number of patients eligible based strictly on VR criteria. Patients with a very large VR (> or =125 cm3) were more likely to have invasive carcinoma (P=0.02; hazard ratio [HR], 7.4) and tumors > or =5 cm on final pathology (P<0.01; HR, 22.0). CONCLUSIONS: Approximately one-fifth to one-fourth of patients presenting for BCT may be eligible for balloon catheter-based APBI according to accepted national guidelines and VR. VR must be considered when selecting patients for balloon catheter-based APBI, because a minority of patients will have a lumpectomy cavity that exceeds the size limit of the current balloon device. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/14745864/Potential_applicability_of_balloon_catheter_based_accelerated_partial_breast_irradiation_after_conservative_surgery_for_breast_carcinoma_ L2 - https://doi.org/10.1002/cncr.11939 DB - PRIME DP - Unbound Medicine ER -