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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2006

01-07-2006

Initial Outcomes for Patients Treated on the American Society of Breast Surgeons MammoSite Clinical Trial for Ductal Carcinoma-In-Situ of the Breast

Authors: Jacqueline S. Jeruss, MD, PhD, Frank A. Vicini, MD, FACR, Peter D. Beitsch, MD, FACS, Bruce G. Haffty, MD, Coral A. Quiet, MD, Victor J. Zannis, MD, Angela J. Keleher, MD, FACS, Delia M. Garcia, MD, FACR, Howard C. Snider, MD, Mark A. Gittleman, MD, Eric Whitacre, MD, Pat W. Whitworth, MD, Richard E. Fine, MD, Stacey Arrambide, MS, Henry M. Kuerer, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 7/2006

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Abstract

Background

The MammoSite device was designed as a breast brachytherapy applicator and is currently used to deliver accelerated partial breast irradiation (APBI). We hypothesized that APBI delivered with the MammoSite device would be well tolerated and be associated with a good cosmetic outcome in patients with ductal carcinoma-in-situ (DCIS).

Methods

From 2002 to 2004, 191 patients with DCIS were enrolled in a registry trial to assess the MammoSite applicator. Fifteen patients were excluded from analysis because of device- or patient-related factors; 7 patients were excluded after receiving a radiotherapy boost, thus leaving 169 patients available for study. Follow-up information was available for 158 patients. The average length of follow-up was 7.35 months. Forty-three patients had at least 1 year of follow-up.

Results

Skin spacing for the MammoSite applicator was as follows: < 5 mm, 3 patients (1.78%); 5 to 7 mm, 18 patients (10.65%); and ≥7 mm, 148 patients (87.57%). Patients with a device-to-skin distance of ≥7 mm had the best cosmetic result. Patients with a device-to-skin distance of ≥7 mm also had a lower incidence of radiation dermatitis. Data on 43 patients who were followed up for at least 1 year confirmed these findings. Additional adverse events were primarily related to skin changes, with breast infections occurring in five patients (3.16%). No patient in the study has experienced a recurrence.

Conclusions

APBI delivered via MammoSite is well tolerated in patients with DCIS, and the lowest toxicity was obtained in patients with the greatest device-to-skin distance. Long-term follow-up data regarding patient satisfaction, cosmesis, and efficacy are needed and will be determined from a recently opened large randomized study.
Literature
1.
Fisher B, Dignam J, Wolmark N, et al. Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17. J Clin Oncol 1998; 16:441–52PubMed
2.
Morrow M, Strom EA, Bassett LW, et al. Standard for the management of ductal carcinoma in situ of the breast (DCIS). CA Cancer J Clin 2002; 52:256–76PubMedCrossRef
3.
Kuerer HM, Julian TB, Strom EA, et al. Accelerated partial breast irradiation after conservative surgery for breast cancer. Ann Surg 2004; 239:338–51PubMedCrossRef
4.
Baxter NN, Virnig BA, Durham SB, Tuttle TM. Trends in the treatment of ductal carcinoma in situ of the breast. J Natl Cancer Inst 2004; 96:443–8PubMedCrossRef
5.
Pawlik TM, Buchholz TA, Kuerer HM. The biologic rationale for and emerging role of accelerated partial breast irradiation for breast cancer. J Am Coll Surg 2004; 199:479–92PubMedCrossRef
6.
Edmundson GK, Vicini FA, Chen PY, et al. Dosimetric characteristics of the MammoSite RTS, a new breast brachytherapy applicator. Int J Radiat Oncol Biol Phys 2002; 52:1132–9PubMedCrossRef
7.
Arthur DW, Vicini FA. MammoSite RTS: the reporting of initial experiences and how to interpret. Ann Surg Oncol 2004; 11:723–4PubMedCrossRef
8.
Richards GM, Berson AM, Rescigno J, et al. Acute toxicity of high-dose-rate intracavitary brachytherapy with the MammoSite applicator in patients with early-stage breast cancer. Ann Surg Oncol 2004; 11:739–46PubMedCrossRef
9.
Pawlik TM, Perry A, Strom EA, et al. Potential applicability of balloon catheter-based accelerated partial breast irradiation after conservative surgery for breast carcinoma. Cancer 2004; 100:490–8PubMedCrossRef
10.
Zannis VJ, Walker LC, Barclay-White B, Quiet CA. Postoperative ultrasound-guided percutaneous placement of a new breast brachytherapy balloon catheter. Am J Surg 2003; 186:383–5PubMedCrossRef
11.
Keisch M, Vicini F, Kuske RR, et al. Initial clinical experience with the MammoSite breast brachytherapy applicator in women with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 2003; 55:289–93PubMedCrossRef
12.
Vicini F, Baglan K, Kestin L, et al. The emerging role of brachytherapy in the management of patients with breast cancer. Semin Radiat Oncol 2002; 12:31–9PubMedCrossRef
13.
Rose MA, Olivotto I, Cady B, et al. Conservative surgery and radiation therapy for early breast cancer. Long-term cosmetic results. Arch Surg 1989; 124:153–7PubMed
14.
Image-detected breast cancer: state of the art diagnosis and treatment. International Breast Cancer Consensus Conference. J Am Coll Surg 2001; 193:297–302
15.
Mokbel K. Towards optimal management of ductal carcinoma in situ of the breast. Eur J Surg Oncol 2003; 29:191–7PubMedCrossRef
16.
Fisher ER, Dignam J, Tan-Chiu E, et al. Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) eight-year update of Protocol B-17: intraductal carcinoma. Cancer 1999; 86:429–38PubMedCrossRef
17.
Jensen RA, Page DL. Ductal carcinoma in situ of the breast: impact of pathology on therapeutic decisions. Am J Surg Pathol 2003; 27:828–31PubMedCrossRef
18.
Silverstein MJ. Not everyone with ductal carcinoma in situ of the breast treated with breast preservation needs post-excisional radiation therapy. Breast 2000; 9:189–93PubMedCrossRef
19.
Arthur DW, Koo D, Zwicker RD, et al. Partial breast brachytherapy after lumpectomy: low-dose-rate and high-dose-rate experience. Int J Radiat Oncol Biol Phys 2003; 56:681–9PubMedCrossRef
20.
Polgar C, Major T, Fodor J, et al. High-dose-rate brachytherapy alone versus whole breast radiotherapy with or without tumor bed boost after breast-conserving surgery: seven-year results of a comparative study. Int J Radiat Oncol Biol Phys 2004; 60:1173–81PubMedCrossRef
21.
Holland R, Hendriks JH, Vebeek AL, et al. Extent, distribution, and mammographic/histological correlations of breast ductal carcinoma in situ. Lancet 1990; 335:519–22PubMedCrossRef
22.
Holland R, Connolly JL, Gelman R, et al. The presence of an extensive intraductal component following a limited excision correlates with prominent residual disease in the remainder of the breast. J Clin Oncol 1990; 8:113–8PubMed
23.
Freedman GM, Anderson PR, Hanlon AL, et al. Pattern of local recurrence after conservative surgery and whole-breast irradiation. Int J Radiat Oncol Biol Phys 2005; 61:1328–36PubMedCrossRef
24.
Silverstein MJ. An argument against routine use of radiotherapy for ductal carcinoma in situ. Oncology (Williston Park) 2003; 17:1511–33; discussion 1533–4, 1539, 1542 passim
25.
Wood WC. The role of clinical trials in changing therapy for ductal carcinoma in situ. Ann Surg Oncol 2004; 11:24S–27SPubMed
26.
Cornfield DB, Palazzo JP, Schwartz GF, et al. The prognostic significance of multiple morphologic features and biologic markers in ductal carcinoma in situ of the breast: a study of a large cohort of patients treated with surgery alone. Cancer 2004; 100:2317–27PubMedCrossRef
27.
Recht A. Lessons of studies of breast-conserving therapy with and without whole-breast irradiation for patient selection for partial-breast irradiation. Semin Radiat Oncol 2005; 15:123–32PubMedCrossRef
Metadata
Title
Initial Outcomes for Patients Treated on the American Society of Breast Surgeons MammoSite Clinical Trial for Ductal Carcinoma-In-Situ of the Breast
Authors
Jacqueline S. Jeruss, MD, PhD
Frank A. Vicini, MD, FACR
Peter D. Beitsch, MD, FACS
Bruce G. Haffty, MD
Coral A. Quiet, MD
Victor J. Zannis, MD
Angela J. Keleher, MD, FACS
Delia M. Garcia, MD, FACR
Howard C. Snider, MD
Mark A. Gittleman, MD
Eric Whitacre, MD
Pat W. Whitworth, MD
Richard E. Fine, MD
Stacey Arrambide, MS
Henry M. Kuerer, MD, PhD, FACS
Publication date
01-07-2006
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 7/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2006.08.031

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