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Annals of Surgical Oncology

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01-11-2011 | Radiation Oncology

Avoiding Mastectomy: Accelerated Partial Breast Irradiation for Breast Cancer Patients with Pacemakers or Defibrillators

Authors: Randal Croshaw, MD, Yongbok Kim, PhD, Erik Lappinen, MD, Thomas Julian, MD, Mark Trombetta, MD

Published in: Annals of Surgical Oncology | Issue 12/2011

Abstract

Introduction

The objective of this study was to evaluate the safety, toxicity, and planning concerns involved in accelerated partial breast irradiation (APBI) for patients with breast cancer who have a pacemaker or an automatic implantable cardioverter-defibrillator (AICD) and who desire breast conservation.

Methods

We performed a review of prospectively obtained data for patients with early-stage breast cancer with a pacemaker or AICD treated between April 2007 and July 2010. Patients were treated with either 3D conformal external beam irradiation (3D-CRT) or high-dose rate balloon brachytherapy (HDRBB) as performed in the National Surgical Adjuvant Breast and Nowel Project (NSABP) B-39/Radiation Therapy Oncology Group (RTOG) 0413 protocol. Device interrogation was performed after the first and last radiation treatment, with comparative cardiac monitoring performed before and after the first three treatments.

Results

Eight patients were treated and have a mean follow-up of 6 months. Three patients received HDRBB delivering 34 Gy in 10 fractions. Mean planning target volume for evaluation (PTV_EVAL) coverage was 93.6%. The maximum radiation dose delivered to any device was 1.03 Gy, with a mean pacemaker distance to lumpectomy cavity (DLC) of 9.1 cm. Five patients received 3D-CRT consisting of 38.5 Gy in 10 fractions. The mean 90% PTV_EVAL coverage was 97.3%. Maximum dose delivered to any device was 1.68 Gy at a DLC of 9 cm. Local toxicity did not exceed grade 1, and no adverse device events were noted.

Conclusions

APBI in patients with pacemakers or AICDs who desire breast preservation seems to be a technically safe and reasonable application of targeted radiation therapy.

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Title: Avoiding Mastectomy: Accelerated Partial Breast Irradiation for Breast Cancer Patients with Pacemakers or Defibrillators
Authors: Randal Croshaw, MD
Yongbok Kim, PhD
Erik Lappinen, MD
Thomas Julian, MD
Mark Trombetta, MD
Publication date: 01-11-2011
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 12/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-011-1784-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Avoiding Mastectomy: Accelerated Partial Breast Irradiation for Breast Cancer Patients with Pacemakers or Defibrillators

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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