News | Brachytherapy Systems, Women's Healthcare | October 31, 2017

Cleveland Clinic Leads Development of New Guidelines for Radiation in Breast Cancer

Consensus statement guides clinicians on appropriate and safe utilization of accelerated partial-breast irradiation

Cleveland Clinic Leads Development of New Guidelines for Radiation in Breast Cancer

October 31, 2017 — Cleveland Clinic researcher Chirag Shah, M.D., recently led the development of updated guidelines for the appropriate and safe utilization of accelerated partial-breast irradiation (APBI). The guidelines are published online in the journal Brachytherapy.

APBI is a breast radiation therapy technique in which targeted radiation is delivered, either via brachytherapy (applicator devices or multiple catheters) or through external radiation, specifically to the part of the breast where the tumor was removed without treating the whole breast.

For patients with ductal carcinoma in situ (DCIS) and early-stage invasive breast cancer, APBI has been shown to be an alternative to standard whole-breast irradiation, allowing for a reduction in the duration of radiation therapy. The technique, by reducing the amount of normal healthy breast tissue treated with radiation, may also reduce side effects of treatment and improve cosmetic outcomes.

In updating the guidelines, Shah led a group of physicians — appointed by the American Brachytherapy Society, with expertise in breast cancer and breast brachytherapy — to develop a consensus statement. The new guidelines recommend the technique for a broader group of patient by allowing younger patients to be eligible as well as those with DCIS. The authors' consensus is that the appropriate candidates for APBI include patients aged 45 years or older; all invasive histologies and ductal carcinoma in situ; tumors 3 cm or less; node negative; estrogen receptor positive/negative; no lymphovascular space invasion; and negative margins.

"The updated guidelines support clinicians by offering them the ability to appropriately select patients for APBI, and data that supports the techniques," said Shah. "Guidelines allow for the selection of patients who can finish radiation treatment in one week or less, compared to the traditional period of three to six weeks, and potentially a reduction in side effects depending on the APBI technique."

The previous APBI guidelines, also led by Shah, were developed in 2013. Since then, multiple randomized trials have been published which have increased the amount of data available to develop the updated guidelines. The authors' recommendation was based on review of literature including randomized trials, prospective studies, multi-institutional series, and single-institution reports addressing clinical outcomes and toxicities with APBI.

For more information: www.journals.elsevier.com/brachytherapy

Related Content

breast screening
News | Clinical Trials | September 13, 2018
Fewer and fewer women die from breast cancer in recent years but, surprisingly, the decline is just as large in the a
Amar Kishan, M.D.

Amar Kishan, M.D.

News | Prostate Cancer | September 11, 2018
UCLA researchers have discovered that a combination of high doses of...
Lightvision near-infrared fluorescence imaging system
News | Women's Health | September 11, 2018
Shimadzu Corp.
Videos | Radiation Therapy | September 07, 2018
A discussion with Ehsan Samei, Ph.D., DABR, FAAPM, FSPIE, director of the Duke University Clinical Imaging Physics Gr
Feature | Breast Imaging | September 07, 2018 | By JoAnn Pushkin
If you are confused about the conflicting advice surrounding mammography screening guidelines, welcome to the club.
Boston Scientific to Acquire Augmenix Inc.
News | Patient Positioning Radiation Therapy | September 07, 2018
Boston Scientific has entered into a definitive agreement to acquire Augmenix Inc., a privately-held company which has...
Non-Canonical Strategy May Improve Cancer Radiotherapy
News | Radiation Therapy | August 29, 2018
August 29, 2018 — Although the success or failure of...
Videos | Treatment Planning | August 28, 2018
A discussion with...
Sponsored Content | Webinar | Radiation Therapy | August 28, 2018
Respiratory tumor motion often complicates the delivery of precision radiation treatment.