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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2011

01-01-2011 | Breast Oncology

Update on DCIS Outcomes from the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

Authors: Jacqueline S. Jeruss, MD, PhD, FACS, Henry M. Kuerer, MD, PhD, FACS, Peter D. Beitsch, MD, FACS, Frank A. Vicini, MD, FACR, Martin Keisch, MD

Published in: Annals of Surgical Oncology | Issue 1/2011

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Abstract

Background

Since the initial reports on use of MammoSite accelerated partial breast irradiation (APBI) for treatment of ductal carcinoma in situ (DCIS), additional follow-up data were collected. We hypothesized that APBI delivered via MammoSite would continue to be well tolerated, associated with a good cosmetic outcome, and carry a low risk for recurrence in patients with DCIS.

Materials and Methods

From 2002–2004, 194 patients with DCIS were enrolled in a registry trial to assess the MammoSite. Follow-up data were available for all 194 patients. Median follow-up was 54.4 months; 63 patients had at least 5 years of follow-up. Data obtained included patient-, tumor-, and treatment-related factors, and recurrence incidence.

Results

Of the 194 patients, 87 (45%) had the MammoSite placed at lumpectomy; 107 patients (55%) had the device placed postlumpectomy. In the first year of follow-up, 16 patients developed a breast infection, though the method of device placement was not associated with infection risk. Also, 46 patients developed a seroma that was associated with applicator placement at the time of lumpectomy (P = 0.001). For patients with at least 5 years of follow-up, 92% had favorable cosmetic results. There were 6 patients (3.1%) who had an ipsilateral breast recurrence, with 1 (0.5%) experiencing recurrence in the breast and axilla, for a 5-year actuarial local recurrence rate of 3.39%.

Conclusions

During an extended follow-up period, APBI delivered via MammoSite continued to be well tolerated for patients with DCIS. Use of this device may make lumpectomy possible for patients who would otherwise choose mastectomy because of barriers associated with standard radiation therapy.
Literature
1.
Buchholz TA, Theriault RL, Niland JC, Hughes ME, Ottesen R, Edge SB, et al. The use of radiation as a component of breast conservation therapy in National Comprehensive Cancer Network Centers. J Clin Oncol. 2006;24:361–9.CrossRefPubMed
2.
Virnig BA, Tuttle TM, Shamliyan T, Kane RL. Ductal carcinoma in situ of the breast: a systematic review of incidence, treatment, and outcomes. J Natl Cancer Inst. 2010;102:170–8.CrossRefPubMed
3.
Winchester DP, Cox JD. Standards for breast-conservation treatment. CA Cancer J Clin. 1992;42:134–62.CrossRefPubMed
4.
Leonard GD, Swain SM. Ductal carcinoma in situ, complexities and challenges. J Natl Cancer Inst. 2004;96:906–20.CrossRefPubMed
5.
Emdin SO, Granstrand B, Ringberg A, Sandelin K, Arnesson LG, Nordgren H, et al. SweDCIS: Radiotherapy after sector resection for ductal carcinoma in situ of the breast. Results of a randomised trial in a population offered mammography screening. Acta Oncol. 2006;45:536–43.CrossRefPubMed
6.
Sakorafas GH, Farley DR, Peros G. Recent advances and current controversies in the management of DCIS of the breast. Cancer Treat Rev. 2008;34:483–97.CrossRefPubMed
7.
Taghian AG, Powell SN. The role of radiation therapy for primary breast cancer. Surg Clin North Am. 1999;79:1091–115.CrossRefPubMed
8.
Taghian A, de Vathaire F, Terrier P, Le M, Auquier A, Mouriesse H, et al. Long-term risk of sarcoma following radiation treatment for breast cancer. Int J Radiat Oncol Biol Phys. 1991;21:361–7.CrossRefPubMed
9.
Berrington de Gonzalez A, Curtis RE, Gilbert E, Berg CD, Smith SA, Stovall M, et al. Second solid cancers after radiotherapy for breast cancer in SEER cancer registries. Br J Cancer. 2010;102:220–6.CrossRefPubMed
10.
Kuerer HM, Julian TB, Strom EA, Lyerly HK, Giuliano AE, Mamounas EP, et al. Accelerated partial breast irradiation after conservative surgery for breast cancer. Ann Surg. 2004;239:338–51.CrossRefPubMed
11.
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;199:479–92.CrossRefPubMed
12.
Smith BD, Arthur DW, Buchholz TA, Haffty BG, Hahn CA, Hardenbergh PH, et al. Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO). Int J Radiat Oncol Biol Phys. 2009;74:987–1001.CrossRefPubMed
13.
Jeruss JS, Vicini FA, Beitsch PD, Haffty BG, Quiet CA, Zannis VJ, et al. Initial outcomes for patients treated on the American Society of Breast Surgeons MammoSite clinical trial for ductal carcinoma-in situ of the breast. Ann Surg Oncol. 2006;13:967–76.CrossRefPubMed
14.
Keisch M, Vicini F, Kuske RR, Hebert M, White J, Quiet C, 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;55:289–93.CrossRefPubMed
15.
Vicini F, Baglan K, Kestin L, Chen P, Edmundson G, Martinez A. The emerging role of brachytherapy in the management of patients with breast cancer. Semin Radiat Oncol. 2002;12:31–9.CrossRefPubMed
16.
Rose MA, Olivotto I, Cady B, Koufman C, Osteen R, Silver B, et al. Conservative surgery and radiation therapy for early breast cancer. Long-term cosmetic results. Arch Surg. 1989;124:153–7.PubMed
17.
Benitez PR, Keisch ME, Vicini F, Stolier A, Scroggins T, Walker A, et al. Five-year results: the initial clinical trial of MammoSite balloon brachytherapy for partial breast irradiation in early-stage breast cancer. Am J Surg. 2007;194:456–62.CrossRefPubMed
18.
Vicini F, Beitsch PD, Quiet CA, Keleher AJ, Garcia D, Snider HC Jr, et al. Three-year analysis of treatment efficacy, cosmesis, and toxicity by the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial in patients treated with accelerated partial breast irradiation (APBI). Cancer. 2008;112:758–66.CrossRefPubMed
19.
Keisch M, Vicini F, Beitsch P, Quiet C, Keleher A, Garcia D, et al. American Society of Breast Surgeons MammoSite Radiation Therapy System Registry Trial: ductal carcinoma-in situ subset analysis–4-year data in 194 treated lesions. Am J Surg. 2009;198:505–7.CrossRefPubMed
20.
Dragun AE, Harper JL, Jenrette JM, Sinha D, Cole DJ. Predictors of cosmetic outcome following MammoSite breast brachytherapy: a single-institution experience of 100 patients with two years of follow-up. Int J Radiat Oncol Biol Phys. 2007;68:354–8.CrossRefPubMed
21.
Guenzi M, Giannelli F, Azinwi C, Ricchetti F, Vagge S, Canavese G, et al. Accelerated partial breast irradiation via the mammosite catheter: preliminary reports of a single-institution experience. Breast J. 2009;15:603–9.CrossRefPubMed
22.
Ko EC, Koprowski CD, Dickson-Witmer D, Penman E, Sorensen M, Hanlon AL, et al. Partial vs. whole breast irradiation in a community hospital: A retrospective cohort analysis of 200 patients. Brachytherapy. 2010 [Epub ahead of print].
23.
Evans SB, Kaufman SA, Price LL, Cardarelli G, Dipetrillo TA, Wazer DE. Persistent seroma after intraoperative placement of MammoSite for accelerated partial breast irradiation: incidence, pathologic anatomy, and contributing factors. Int J Radiat Oncol Biol Phys. 2006;65:333–9.CrossRefPubMed
24.
Watkins JM, Harper JL, Dragun AE, Ashenafi MS, Sinha D, Li J, et al. Incidence and prognostic factors for seroma development after MammoSite breast brachytherapy. Brachytherapy. 2008;7:305–9.CrossRefPubMed
25.
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;186:383–5.CrossRefPubMed
26.
Voti L, Richardson LC, Reis IM, Fleming LE, Mackinnon J, Coebergh JW. Treatment of local breast carcinoma in Florida: the role of the distance to radiation therapy facilities. Cancer. 2006;106:201–7.CrossRefPubMed
27.
Bickell NA, LePar F, Wang JJ, Leventhal H. Lost opportunities: physicians’ reasons and disparities in breast cancer treatment. J Clin Oncol. 2007;25:2516–21.CrossRefPubMed
Metadata
Title
Update on DCIS Outcomes from the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial
Authors
Jacqueline S. Jeruss, MD, PhD, FACS
Henry M. Kuerer, MD, PhD, FACS
Peter D. Beitsch, MD, FACS
Frank A. Vicini, MD, FACR
Martin Keisch, MD
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1192-z

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