News | December 14, 2009

APBI Reduced Recurrence in Low-Risk DCIS Patients

External Beam APBI

December 14, 2009 - Patients with low-risk ductal carcinoma in situ (DCIS) who receive accelerated partial breast irradiation (APBI) after a lumpectomy had a lower rate of local recurrence, according to new research presented this week at the 32nd Annual CTRC-AACR San Antonio Breast Cancer Symposium by an investigator at The Cancer Institute of New Jersey (CINJ).

In DCIS, the cancer cells are inside the milk ducts of the breast, but have not spread to surrounding breast tissue. A previous study (Intergroup Study E5194) by the Eastern Cooperative Oncology Group and the North Central Cancer Treatment Group withheld radiation therapy from a low-risk subset of patients with DCIS after removal of the cancer. At five years, the local recurrence rate for low- and intermediate-grade patients was 6.8 percent, and 13.7 percent for high-grade patients.

In study, conducted by Sharad Goyal, M.D., instructor of radiation oncology at UMDNJ-Robert Wood Johnson Medical School, and senior author Bruce G. Haffty, M.D., chair of radiation oncology at CINJ and professor and chair of the department of radiation oncology at UMDNJ-Robert Wood Johnson Medical School, researchers looked at 69 patients between 2002 and 2004, who met the enrollment criteria for the previous study.

Following lumpectomy, patients in the new study were offered APBI, which is a one-week course of treatment that targets the specific area of the breast cavity where the cancer was removed. Investigators found that compared to the previous study, where radiation therapy was withheld, APBI greatly reduced the rate of local recurrence for low-risk DCIS patients (zero percent compared to 6.8 percent for low- to intermediate-grade patients and 5.3 percent compared to 13.7 percent for high-grade patients). Considering the shortened course of radiation (one week of APBI versus the traditional seven or eight), Dr. Goyal noted such treatment not only lessens the chance of recurrence but also could have great benefit to a patient’s quality of life in not having to travel continuously to the treatment site.

CINJ is a Center of Excellence of UMDNJ-Robert Wood Johnson Medical School.

Co-authors of the study include Frank Vicini, William Beaumont Hospital, Mich.; Peter D. Beitsch, Dallas Breast Center, Texas; Martin Keisch, Miami Brachytherapy Center, Fla.; and Maureen Lyden, M.D., Anderson Cancer Center, Texas.

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