Purpose of Technology: Following breast-conserving surgery in patients with early-stage breast cancer, accelerated partial breast irradiation (APBI) is an alternative to standard whole-breast irradiation (WBI) performed to reduce the risk of tumor recurrence. APBI using 3-dimensional conformal radiation therapy (3DCRT) or intensity-modulated radiation therapy (IMRT) delivers a greater radiation fraction size over a shorter period of time to a reduced target volume, sparing the dose to normal surrounding tissues.
Controversy: While 3DCRT or IMRT may be a reasonable alternative to WBI in select patients at low risk for recurrence of breast cancer at the primary site, since these therapies target the surgical site and not the entire breast as does WBI, they do not treat any existing cancer cells in the remaining quadrants of the breast or in regional lymph nodes. APBI may carry an increased risk of complications, and it is still unclear as to whether it actually improves quality of life, and if it is as efficacious as standard WBI over time.
Does APBI using 3DCRT or IMRT reduce breast cancer recurrence and mortality and improve survival?
Does APBI using 3DCRT or IMRT have acceptable cosmetic results?
Is APBI using 3DCRT or IMRT at least as safe as WBI in terms of morbidity, including toxicity?
Have definitive patient selection criteria been established for APBI delivered with 3DCRT or IMRT for the treatment of early-stage breast cancer?
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