Many patients diagnosed with early-stage breast cancer undergo lumpectomy followed by radiotherapy. The study's lead author, Dr. “Post-operative (post-operative) radiation still represents the mainstay of adjuvant therapy for breast cancer, which can significantly reduce regional breast cancer incidence,” explained Icro Meattini. In recent years, researchers have tried to determine whether partial breast irradiation is as effective as whole breast irradiation in preventing cancer recurrence.
A 10-year follow-up study of breast cancer patients treated with adjuvant partial-breast irradiation (APBI) after breast cancer surgery found that cancer recurrence (re) breast irradiation, WBI). This study was presented by Meattini et al at the 2019 San Antonio Breast Cancer Symposium (Abstract GS4-06). Study results show that partial breast radiotherapy, which is easier to administer and tolerated by the patient, may be an acceptable option for patients with early-stage breast cancer.
Made works
Meattini's study examined 10-year follow-up data for women participating in the APBI IMRT study, a randomized phase III clinical trial. The 5-year follow-up results of this study showed no significant difference in tumor recurrence or survival rates.
The APBI IMRT study included 520 women over 40 years of age with stage I or II breast cancer. Between 2005 and 2013, patients were randomly assigned to two groups in a 1:1 ratio to receive either APBI or WBI. Patients in the APBI arm received a total of 30 Gy of radiation to the tumor bed in 5-day fractions; Those in the WBI arm received an additional 5 days of 10 Gy irradiation to the entire breast for a total of 25 days, plus 50 Gy to the tumor bed.
Both treatment arms were comparable in age, tumor size, tumor type, and adjuvant endocrine therapy, and both provided a mean follow-up of 10 years. Most patients had hormone receptor positive, HER2 negative breast cancer, and most were over 50 years of age.
Research Findings
• After 10 years, 3.3% of patients in the APBI group and 2.6% of the WBI group experienced a breast cancer recurrence.
• Overall 10-year survival was similar between the two groups: 92.7% in women taking APBI and 93.3% in women taking WBI. Both differences were not statistically significant.
These findings reinforce the promising results of the 5-year study and show that partial breast irradiation provides very good disease control. In well-selected cases, there is no difference in the outcome of patients whether they are treated with partial or whole breast irradiation. Partial breast irradiation is less likely to cause cosmetic changes, but is a more costly treatment. The partial breast irradiation regimen can also provide an increased quality of life with fewer side effects and significantly reduce overall treatment time.
Partial breast irradiation is one of the most basic examples of effective de-escalation of treatment in breast oncology. For many patients, partial breast irradiation may be an optimal option that is relatively cost-effective, safe, and effective.
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