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Partial, Whole Breast Irradiation Outcomes Comparable After Breast-Conserving Surgery

For women undergoing breast-conserving surgery, accelerated partial breast irradiation offers acceptable survival and recurrence rates
17 Dec 2019
Breast Cancer;  Radiation Oncology;  Surgical Oncology

Author: By Lynda Williams, Senior medwireNews Reporter

medwireNews: Accelerated partial breast irradiation (APBI) achieves comparable survival to whole-breast irradiation (WBI) for low-risk women who have undergone breast-conserving surgery, with less toxicity, demonstrate the 10-year results of the APBI IMRT study. 

The phase III trial findings were presented at the San Antonio Breast Cancer Symposium by Icro Meattini, from the University of Florence in Italy, who explained that the 5-year findings for the study had earlier indicated comparable risk of recurrence and survival with the two treatment approaches. 

The 520 participants aged 40 years or older had undergone breast conserving surgery for a stage I or II primary tumour of less than 25 mm in diameter that resulted in a final surgical margin of 5 mm or more.  

At 10 years, the primary endpoint of ipsilateral tumour recurrence (IBTR) occurred in a comparable 3.9% of the 246 APBI patients who had received 30 Gy to the tumour bed in five daily fractions versus 2.6% of the 274 WBI patients who instead were given 50 Gy over 25 daily fractions plus a 10-Gy boost to the tumour bed over five fractions.  

APBI and WBI also achieved comparable 10-year rates of the secondary endpoints of locoregional recurrence (3.9 vs 3.0%), contralateral breast cancer (0.9 vs 3.5%) and distant metastases (3.1 vs 3.1%).  

And the two treatment approaches did not differ significantly at 10 years with regard to breast cancer-specific survival (97.6 vs 97.5%) or overall survival (92.7 vs 93.3%). 

However, APBI was associated with a significantly lower rate of acute skin toxicity (21.1 vs 66.5%) including grade 2 and more severe skin events (2.0 vs 37.3%) and this was also true for late skin toxicity at any grade (4.5 vs 30.0%) and grade 2 or worse (0.0 vs 2.7%). 

Furthermore, patients who received APBI were more likely than the WBI group to describe their outcome as good (81.3 vs 84.6%) or excellent (17.9 vs 5.4%) on the Harvard Breast Cosmesis scale. This was also true for physician ratings of good (4.5 vs 26.9%) and excellent (95.5 vs 76.5%).  

“APBI might be considered a standard alternative to WBI in low risk early breast cancer patients”, the presenter therefore concluded. 

 

Reference 

Meattini I, Saieva C, Lucidi S, et alAccelerated partial breast or whole breast irradiation after breast conservation surgery for patients with early breast cancer. 10-year follow up results of the APBI IMRT Florence randomized phase 3 trial. San Antonio Breast Cancer Symposium 2019, abstract GS4-06.  

medwireNews (www.medwireNews.com ) is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

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