Adverse Cosmesis with Accelerated Partial-Breast Irradiation

Poor or fair cosmetic scores were more common with 3D external-beam APBI than with longer-fractionation whole-breast irradiation.

Accelerated partial-breast irradiation (APBI) delivers a much shorter course of radiotherapy than whole-breast irradiation (WBI; ≤1 week and 3–6 weeks, respectively). To compare cosmetic and toxicity results in patients who received WBI versus one type of APBI — 3D external beam conformal irradiation (3DI) delivered to the initial tumor bed — after breast-conserving surgery, investigators conducted an international, randomized, noninferiority trial (RAPID) involving 2135 women (age, >40) with invasive (nonlobular) or in situ breast cancers ≤3 cm in size.

Patients received either 3DI (38.5 Gy in 10 fractions twice daily) or WBI (42.5 Gy in 16 daily fractions or 50 Gy in 25 daily fractions, with boost irradiation in 21% of patients). Cosmesis …

Reviewing Author

Henry Mark Kuerer, MD, PhD, FACS

Disclosures

Speaker's BureauPhysicians’ Education Resource, LLC

RoyaltiesMcGraw-Hill Professional; UpToDate, Inc.

Editorial BoardsAnnals of Surgical Oncology

Leadership Positions in Professional SocietiesAmerican Society of Breast Surgeons (Chair, Publications Committee)