Partial vs. whole breast irradiation in a community hospital: A retrospective cohort analysis of 200 patients
Received 15 October 2009; received in revised form 2 December 2009; accepted 3 December 2009. published online 15 February 2010.
Abstract
Purpose
We compared patients undergoing partial breast irradiation (PBI) with the MammoSite applicator (Cytyc Corp., Marlborough, MA) to a similar group of patients who underwent whole breast irradiation with external beam radiotherapy.
Methods and Materials
Stage 0–IIA breast cancer patients satisfying American Brachytherapy Society selection criteria and receiving accelerated PBI with the MammoSite system (n=100) were compared for toxicities with similarly staged patients receiving whole breast irradiation using tangential portals (n=100). The MammoSite applicator treatment was prescribed to a total dose of 34Gy. External beam doses generally ranged from 60 to 66Gy.
Results
Based on common toxicity criteria scores for acute toxicities, MammoSite patients experienced less cutaneous toxicity, fatigue, and breast pain and had higher Karnofsky performance status scores during the acute period than external beam patients but experienced more seroma pain during followup. These results were both statistically significant and clinically meaningful.
Conclusions
In our institutional experience, PBI using the MammoSite applicator produces less acute toxicity than external beam radiotherapy of the whole breast but is associated with an increased incidence of seroma pain. The rate of disease recurrence in both cohorts was low.
1Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE
2Department of Surgery, Christiana Care Breast Center, Christiana Care Health System, Newark, DE
3Department of Statistics, University of Pennsylvania, Philadelphia, PA
Corresponding author. Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, 4701 Ogletown-Stanton Road, Newark, DE 19713. Tel.: +302-623-4800; fax: +302-623-4821.
Financial disclosure/conflict of interest: Drs Koprowski and Dickson-Witmer were previously on the national faculty of Cytyc Corp. and were paid honoraria for lecturing.
ABSTRACT