Partial vs. whole breast irradiation in a community hospital: A retrospective cohort analysis of 200 patients

Ko, Eric C.; Koprowski, Christopher D.; Dickson-Witmer, Diana; Penman, Emily; Sorensen, Michael; Hanlon, Alexandra L.; Sammons, Sarah; Farach, Andrew; Strasser, Jon

doi:10.1016/j.brachy.2009.12.002

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Volume 9, Issue 3 , Pages 248-253, July 2010

Partial vs. whole breast irradiation in a community hospital: A retrospective cohort analysis of 200 patients

Eric C. Ko
- Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE
Christopher D. Koprowski
- Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE
- 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.
Diana Dickson-Witmer
- Department of Surgery, Christiana Care Breast Center, Christiana Care Health System, Newark, DE
Emily Penman
- Department of Surgery, Christiana Care Breast Center, Christiana Care Health System, Newark, DE
Michael Sorensen
- Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE
Alexandra L. Hanlon
- Department of Statistics, University of Pennsylvania, Philadelphia, PA
Sarah Sammons
- Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE
Andrew Farach
- Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE
Jon Strasser
- Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE

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.

Keywords: MammoSite, Accelerated partial breast irradiation, High-dose-rate radiation, External beam radiotherapy, Breast cancer, Brachytherapy, Breast-conserving therapy

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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.

PII: S1538-4721(09)00368-7

doi:10.1016/j.brachy.2009.12.002

« Previous Next »Brachytherapy
Volume 9, Issue 3 , Pages 248-253, July 2010

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