By Thomas A. Buchholz, Eric A. Strom (auth.), David E. Wazer, Douglas W. Arthur, Frank A. Vicini (eds.)
Accelerated partial breast irradiation (APBI) is being quickly brought into the medical administration of early breast melanoma. APBI, in truth, incorporates a variety of diverse thoughts and ways that come with brachytherapy, intraoperative, and exterior beam suggestions. there's at present no unmarried resource that describes those options and their scientific implementation. this article is a concise instruction manual designed to help the clinician within the implementation of APBI. This contains a evaluate of the rules that underlie APBI, a realistic and precise description of every approach for APBI, a overview of present scientific result of APBI, and a evaluation of the occurrence and administration of therapy similar complications.
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Extra info for Accelerated Partial Breast Irradiation: Techniques and Clinical Implementation
The conclusion drawn from these data is that “elsewhere failures” likely represent a new primary tumor, and that the primary beneﬁt of whole breast radiotherapy is to prevent breast cancer recurrence in the lumpectomy bed (Morrow 2002). This is compelling evidence to support the view that equivalent rates of local control may be achieved if radiotherapy is directed to the lumpectomy cavity plus a 1–2 cm margin. If a partial breast target can be appropriately deﬁned, a direct follow-on question would ask if comparable local control could be achieved with a wider local excision and no radiotherapy.
The importance of achieving all four of these components is further highlighted when considering the recent meta-analysis data, which clearly demonstrate the importance of optimal local control on survival (Clarke and Darby 2005). This chapter will focus on a review of the supporting background data and appropriate patient selection criteria. Subsequent chapters will review treatment techniques and outcome data. 2 Pathologic Data There are no data that unequivocally demonstrate that radiotherapy to the entire breast is required to achieve local control in patients with early-stage breast cancer.
The formation of selection criteria for APBI has to date been a careful exercise of choosing speciﬁc patient and tumor characteristics to minimize the risk of tumor recurrence or complications. The goal of current criteria are to identify patients where the tissue at risk postlumpectomy is most likely to be in immediate proximity to the excision cavity, and the risk of harboring residual microscopic disease at remote locations “elsewhere” within the breast is limited (Recht and Houlihan 1995). All selection criteria must include patients who, ﬁrst and foremost, are appropriate candidates for breast conservation therapy.
Accelerated Partial Breast Irradiation: Techniques and Clinical Implementation by Thomas A. Buchholz, Eric A. Strom (auth.), David E. Wazer, Douglas W. Arthur, Frank A. Vicini (eds.)