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Review
. 2020 Jan;9(Suppl 1):S29-S36.
doi: 10.21037/tcr.2019.07.03.

Accelerated partial breast irradiation in elderly breast cancer patients

Igor Sirák  1 , Miroslav Hodek  1 , Pavel Jandík  2 , Jakub Grepl  1 , Petr Paluska  1 , Jiří Petera  1
Affiliations
Review

Accelerated partial breast irradiation in elderly breast cancer patients

Igor Sirák et al. Transl Cancer Res. 2020 Jan.

Abstract

Breast-conserving surgery with adjuvant whole-breast irradiation has become the standard treatment for early breast cancer (EBC) patients. Partial breast irradiation, which targets only the postoperative cavity, has been established as an alternative to whole-breast therapy in selected patients. The treatment of elderly breast cancer patients differs from the therapeutic approach in younger ones, as elderly patients are prone to geriatric frailty and comorbid conditions, the incidence and severity of which increase with age. A review of the evidence, process, techniques, and results of accelerated partial breast irradiation (APBI) in elderly EBC patients, seems to indicate that APBI is an advisable postoperative approach in properly selected elderly EBC patients, combining advantages of a radical approach that minimizes the risk of undertreatment with efficient reduction of redundant irradiated volume, treatment toxicity, overall treatment time, staff workload, radiation technique workflow, patient transportation, and the potential for non-compliance. There is no "one size fits all" technique of APBI, the best technique always depending on willing patients, individual anatomy, performance status, patient frailty and comorbid conditions, and tumour location.

Keywords: Accelerated; brachytherapy; breast cancer; elderly; radiotherapy.

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Figures

Figure 1
Figure 1
Intrabeam applicator being placed in the tumour bed.
Figure 2
Figure 2
Accelerated partial breast irradiation (APBI): high-precision external beam 3D-conformal radiotherapy. University Hospital in Hradec Kralove, Czech Republic.
Figure 3
Figure 3
Accelerated partial breast irradiation (APBI): multi-catheter interstitial brachytherapy (MIB). University Hospital in Hradec Kralove, Czech Republic.
Figure 4
Figure 4
Perioperative open-cavity multi-catheter interstitial implantation. University Hospital in Hradec Kralove, Czech Republic.
See this image and copyright information in PMC

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