Feasibility of Accelerated Partial Breast Irradiation in a Large Inner-City Public Hospital |
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Authors: | Miral Amin MD Sheryl Gabram MD Harvey Bumpers MD Jerome Landry MD Ashesh B Jani MD Roberto Diaz MD Monica Rizzo MD FACS |
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Institution: | 1. Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA 2. Avon Comprehensive Breast Center at Grady, Atlanta, GA, USA 3. Morehouse School of Medicine, Atlanta, GA, USA 4. Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA 5. Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
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Abstract: | Background Breast conserving therapy (BCT) that include breast conserving surgery followed by adjuvant radiation therapy has revolutioned medicine by allowing women to avoid mastectomy. Accelerated partial breast irradiation (APBI) has emerged as a valid alternative to whole-breast irradiation that requires a shorter time commitment. We report our novel experience with APBI at a large public hospital that serves low-income and potentially noncompliant patients. Methods A retrospective chart review was conducted of women who underwent BCT for stage 0?CIIA breast cancer from August 2007 to August 2010 treated with APBI with a brachytherapy catheter. Results Twenty-four patients (20 African American) were considered for APBI. Average age was 61?years. Four patients could not undergo APBI for technical reasons and completed whole-breast irradiation over a 5?week period. Median follow-up was 19?months. Nine patients (37.5?%) had ductal carcinoma-in-situ, and 15 patients (62.5?%) had invasive ductal carcinoma with an average tumor size of 1.1?cm. All patients had negative margins of >2?mm. Two patients (8?%) treated with the brachytherapy catheter had in-breast tumor recurrence. Thus, all 24 patients initially identified for APBI successfully completed adjuvant radiotherapy. Conclusions Patient compliance with postoperative irradiation is key to minimize local recurrence after BCT for breast cancer. This success with a brachytherapy catheter in underserved women in a U.S. public hospital setting indicates that outcomes of compliance and complications are comparable to nationally published results. |
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