Accelerated partial breast irradiation for pure ductal carcinoma in situ

Sean S Park, Inga Siiner Grills, Peter Y. Chen, Larry L. Kestin, Michel I. Ghilezan, Michelle Wallace, Alvaro M. Martinez, Frank A. Vicini

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: To report outcomes for ductal carcinoma in situ (DCIS) treated with breast-conserving therapy using accelerated partial breast irradiation (APBI). Methods and Materials: From March 2001 to February 2009, 53 patients with Stage 0 breast cancer were treated with breast conserving surgery and adjuvant APBI. Median age was 62 years. All patients underwent excision with margins negative by ≥1 mm before adjuvant radiotherapy (RT). A total of 39 MammoSite brachytherapy (MS) patients and 14 three-dimensional conformal external beam RT (3DCRT) patients were treated to the lumpectomy bed alone with 34 Gy and 38.5 Gy, respectively. Of the DCIS cases, 94% were mammographically detected. All patients with calcifications had either specimen radiography or postsurgical mammography confirmation of clearance. Median tumor size was 6 mm, and median margin distance was 5 mm. There were no statistically significant differences according to APBI method for race/ethnicity, tumor detection method, tumor grade, estrogen receptor (ER) status, or use of tamoxifen (p = NS). Recurrence and survival were calculated using the Kaplan-Meier method. Cosmesis was scored by the Harvard criteria. Results: With a median follow-up of 3.6 years (range, 0.4-6.3 years), the overall and cause-specific survival rates were 98% and 100%, respectively. Three-year actuarial ipsilateral breast tumor recurrence was 2%. One failure was observed at the resection bed 11 months post-RT. No other elsewhere breast failures, regional recurrences, or distant metastases were noted. Cosmesis was excellent or good in 92.4% of cases, with no statistically significant differences according to the APBI method (92.3% with MammoSite and 92.8% with 3DCRT; p = 0.649). Conclusions: APBI as part of breast-conserving therapy for pure DCIS was associated with excellent local control and survival rates, with the vast majority of patients having good to excellent cosmesis. This finding supports the recent analysis by the American Society of Breast Surgeons on a subset of DCIS patients treated efficaciously with APBI.

Original languageEnglish (US)
Pages (from-to)403-408
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume81
Issue number2
DOIs
StatePublished - Oct 1 2011
Externally publishedYes

Fingerprint

Carcinoma, Intraductal, Noninfiltrating
breast
Breast
cancer
irradiation
tumors
Segmental Mastectomy
Recurrence
radiation therapy
Radiotherapy
Survival Rate
Breast Neoplasms
beds
margins
therapy
Neoplasms
Adjuvant Radiotherapy
Brachytherapy
Mammography
Tamoxifen

Keywords

  • Accelerated partial breast irradiation
  • Breast cancer
  • Ductal carcinoma in situ

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Accelerated partial breast irradiation for pure ductal carcinoma in situ. / Park, Sean S; Grills, Inga Siiner; Chen, Peter Y.; Kestin, Larry L.; Ghilezan, Michel I.; Wallace, Michelle; Martinez, Alvaro M.; Vicini, Frank A.

In: International Journal of Radiation Oncology Biology Physics, Vol. 81, No. 2, 01.10.2011, p. 403-408.

Research output: Contribution to journalArticle

Park, SS, Grills, IS, Chen, PY, Kestin, LL, Ghilezan, MI, Wallace, M, Martinez, AM & Vicini, FA 2011, 'Accelerated partial breast irradiation for pure ductal carcinoma in situ', International Journal of Radiation Oncology Biology Physics, vol. 81, no. 2, pp. 403-408. https://doi.org/10.1016/j.ijrobp.2010.05.030
Park, Sean S ; Grills, Inga Siiner ; Chen, Peter Y. ; Kestin, Larry L. ; Ghilezan, Michel I. ; Wallace, Michelle ; Martinez, Alvaro M. ; Vicini, Frank A. / Accelerated partial breast irradiation for pure ductal carcinoma in situ. In: International Journal of Radiation Oncology Biology Physics. 2011 ; Vol. 81, No. 2. pp. 403-408.
@article{087de51f6fd84c8dab23f55c2731caad,
title = "Accelerated partial breast irradiation for pure ductal carcinoma in situ",
abstract = "Purpose: To report outcomes for ductal carcinoma in situ (DCIS) treated with breast-conserving therapy using accelerated partial breast irradiation (APBI). Methods and Materials: From March 2001 to February 2009, 53 patients with Stage 0 breast cancer were treated with breast conserving surgery and adjuvant APBI. Median age was 62 years. All patients underwent excision with margins negative by ≥1 mm before adjuvant radiotherapy (RT). A total of 39 MammoSite brachytherapy (MS) patients and 14 three-dimensional conformal external beam RT (3DCRT) patients were treated to the lumpectomy bed alone with 34 Gy and 38.5 Gy, respectively. Of the DCIS cases, 94{\%} were mammographically detected. All patients with calcifications had either specimen radiography or postsurgical mammography confirmation of clearance. Median tumor size was 6 mm, and median margin distance was 5 mm. There were no statistically significant differences according to APBI method for race/ethnicity, tumor detection method, tumor grade, estrogen receptor (ER) status, or use of tamoxifen (p = NS). Recurrence and survival were calculated using the Kaplan-Meier method. Cosmesis was scored by the Harvard criteria. Results: With a median follow-up of 3.6 years (range, 0.4-6.3 years), the overall and cause-specific survival rates were 98{\%} and 100{\%}, respectively. Three-year actuarial ipsilateral breast tumor recurrence was 2{\%}. One failure was observed at the resection bed 11 months post-RT. No other elsewhere breast failures, regional recurrences, or distant metastases were noted. Cosmesis was excellent or good in 92.4{\%} of cases, with no statistically significant differences according to the APBI method (92.3{\%} with MammoSite and 92.8{\%} with 3DCRT; p = 0.649). Conclusions: APBI as part of breast-conserving therapy for pure DCIS was associated with excellent local control and survival rates, with the vast majority of patients having good to excellent cosmesis. This finding supports the recent analysis by the American Society of Breast Surgeons on a subset of DCIS patients treated efficaciously with APBI.",
keywords = "Accelerated partial breast irradiation, Breast cancer, Ductal carcinoma in situ",
author = "Park, {Sean S} and Grills, {Inga Siiner} and Chen, {Peter Y.} and Kestin, {Larry L.} and Ghilezan, {Michel I.} and Michelle Wallace and Martinez, {Alvaro M.} and Vicini, {Frank A.}",
year = "2011",
month = "10",
day = "1",
doi = "10.1016/j.ijrobp.2010.05.030",
language = "English (US)",
volume = "81",
pages = "403--408",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Accelerated partial breast irradiation for pure ductal carcinoma in situ

AU - Park, Sean S

AU - Grills, Inga Siiner

AU - Chen, Peter Y.

AU - Kestin, Larry L.

AU - Ghilezan, Michel I.

AU - Wallace, Michelle

AU - Martinez, Alvaro M.

AU - Vicini, Frank A.

PY - 2011/10/1

Y1 - 2011/10/1

N2 - Purpose: To report outcomes for ductal carcinoma in situ (DCIS) treated with breast-conserving therapy using accelerated partial breast irradiation (APBI). Methods and Materials: From March 2001 to February 2009, 53 patients with Stage 0 breast cancer were treated with breast conserving surgery and adjuvant APBI. Median age was 62 years. All patients underwent excision with margins negative by ≥1 mm before adjuvant radiotherapy (RT). A total of 39 MammoSite brachytherapy (MS) patients and 14 three-dimensional conformal external beam RT (3DCRT) patients were treated to the lumpectomy bed alone with 34 Gy and 38.5 Gy, respectively. Of the DCIS cases, 94% were mammographically detected. All patients with calcifications had either specimen radiography or postsurgical mammography confirmation of clearance. Median tumor size was 6 mm, and median margin distance was 5 mm. There were no statistically significant differences according to APBI method for race/ethnicity, tumor detection method, tumor grade, estrogen receptor (ER) status, or use of tamoxifen (p = NS). Recurrence and survival were calculated using the Kaplan-Meier method. Cosmesis was scored by the Harvard criteria. Results: With a median follow-up of 3.6 years (range, 0.4-6.3 years), the overall and cause-specific survival rates were 98% and 100%, respectively. Three-year actuarial ipsilateral breast tumor recurrence was 2%. One failure was observed at the resection bed 11 months post-RT. No other elsewhere breast failures, regional recurrences, or distant metastases were noted. Cosmesis was excellent or good in 92.4% of cases, with no statistically significant differences according to the APBI method (92.3% with MammoSite and 92.8% with 3DCRT; p = 0.649). Conclusions: APBI as part of breast-conserving therapy for pure DCIS was associated with excellent local control and survival rates, with the vast majority of patients having good to excellent cosmesis. This finding supports the recent analysis by the American Society of Breast Surgeons on a subset of DCIS patients treated efficaciously with APBI.

AB - Purpose: To report outcomes for ductal carcinoma in situ (DCIS) treated with breast-conserving therapy using accelerated partial breast irradiation (APBI). Methods and Materials: From March 2001 to February 2009, 53 patients with Stage 0 breast cancer were treated with breast conserving surgery and adjuvant APBI. Median age was 62 years. All patients underwent excision with margins negative by ≥1 mm before adjuvant radiotherapy (RT). A total of 39 MammoSite brachytherapy (MS) patients and 14 three-dimensional conformal external beam RT (3DCRT) patients were treated to the lumpectomy bed alone with 34 Gy and 38.5 Gy, respectively. Of the DCIS cases, 94% were mammographically detected. All patients with calcifications had either specimen radiography or postsurgical mammography confirmation of clearance. Median tumor size was 6 mm, and median margin distance was 5 mm. There were no statistically significant differences according to APBI method for race/ethnicity, tumor detection method, tumor grade, estrogen receptor (ER) status, or use of tamoxifen (p = NS). Recurrence and survival were calculated using the Kaplan-Meier method. Cosmesis was scored by the Harvard criteria. Results: With a median follow-up of 3.6 years (range, 0.4-6.3 years), the overall and cause-specific survival rates were 98% and 100%, respectively. Three-year actuarial ipsilateral breast tumor recurrence was 2%. One failure was observed at the resection bed 11 months post-RT. No other elsewhere breast failures, regional recurrences, or distant metastases were noted. Cosmesis was excellent or good in 92.4% of cases, with no statistically significant differences according to the APBI method (92.3% with MammoSite and 92.8% with 3DCRT; p = 0.649). Conclusions: APBI as part of breast-conserving therapy for pure DCIS was associated with excellent local control and survival rates, with the vast majority of patients having good to excellent cosmesis. This finding supports the recent analysis by the American Society of Breast Surgeons on a subset of DCIS patients treated efficaciously with APBI.

KW - Accelerated partial breast irradiation

KW - Breast cancer

KW - Ductal carcinoma in situ

UR - http://www.scopus.com/inward/record.url?scp=80052798171&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052798171&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2010.05.030

DO - 10.1016/j.ijrobp.2010.05.030

M3 - Article

C2 - 20800374

AN - SCOPUS:80052798171

VL - 81

SP - 403

EP - 408

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 2

ER -