By Thomas A. Buchholz, Eric A. Strom (auth.), David E. Wazer, Douglas W. Arthur, Frank A. Vicini (eds.)
Accelerated partial breast irradiation (APBI) is being quickly brought into the medical administration of early breast melanoma. APBI, actually, incorporates a variety of assorted options and techniques that come with brachytherapy, intraoperative, and exterior beam ideas. there's at present no unmarried resource that describes those options and their scientific implementation. this article is a concise guide designed to aid the clinician within the implementation of APBI. This encompasses a overview of the rules that underlie APBI, a pragmatic and specific description of every method for APBI, a overview of present medical result of APBI, and a assessment of the occurrence and administration of remedy comparable complications.
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Additional info for Accelerated Partial Breast Irradiation: Techniques and Clinical Implementation
In response to this interest, two professional societies have issued recommendations regarding patient selection criteria. Both societies seek to incorporate the lessons learned from accumulated clinical experience and to provide the broader medical community with guidance in the selection of potentially eligible patients. The American Brachytherapy Society (ABS) and the American Society of Breast Surgeons (ASBS) have independently developed patient selection criteria that are generally viewed as both cautious and reasonable (Arthur et al.
N Engl J Med 347:1270–1271 Nattinger AB, Hoffmann RG, Kneusel RT, et al. (2000) Relation between appropriateness of primary therapy for early-stage breast carcinoma and increased use of breast-conserving surgery. Lancet 356:1148–1153 NIH (1990) Consensus statement: treatment of early-stage breast cancer. NIH Consensus Dev Conf, Bethesda, MD, 18–21 June 1990, 8:1–9 Ohtake T, Abe R, Kimijima I, et al. (1995) Intraductal extension of primary invasive breast carcinoma treated by breast-conservative surgery.
In general, it appears that when the excision cavity volume exceeds 20% of the ipsilateral breast volume, 3D-CRT will exceed acceptable normal tissue dose–volume constraints. W. Arthur et al. the breast. When the cavity is located in the lower, inner aspect of the left breast, the resultant dose to the heart may exceed acceptable constraints. In the upper portions of the breast, cavity location may limit the choice of beam arrangements that result in excessive radiation doses to normal ipsilateral breast tissue.