News | Radiation Therapy | November 22, 2016

New Standard of Care Offers Lower Toxicity, Shorter Treatment Times and Improved Cosmetic Outcomes for Women with Early Stage Breast Cancer

ASTRO updates clinical guidance on accelerated radiation therapy for breast cancer 

Breast brachytherapy, partial breast irratiation

Accelerated Partial Breast Irradiation (APBI) brachytherapy for breast cancer. Image courtesy of Elekta.

 

The American Society for Radiation Oncology (ASTRO) today announced an update to its Evidence-Based Consensus Statement for the use of Accelerated Partial Breast Irradiation (APBI) brachytherapy to include younger patients and those with low-risk ductal carcinoma in situ (DCIS).

APBI brachytherapy is a targeted form of radiation that is delivered after surgical excision of the tumor (lumpectomy) to only the area of the breast where the cancer was removed. This is accomplished by introducing a radiation source through a series of narrow tubes or struts that are placed inside the tumor cavity. APBI brachytherapy offers less radiation exposure, reduced treatment time, better cosmetic outcomes and more flexibility with respect to future treatment options.

ASTRO updated its APBI Consensus Statement to reflect data from three large-scale randomized trials evaluating APBI vs. WBI. The data from these trials were sufficiently robust that the committee voted unanimously to change the guidelines, expanding the group of patients for whom APBI brachytherapy is suitable, which now includes patients ≥50 years of age (previously, patients ≥60 years of age were included).

“Evidence-based guidelines have the potential to fundamentally alter clinical practice. These important changes to ASTRO’s guidelines were based on a systematic review of 45 published clinical studies, significantly expanding the eligible patient population,” said Atif J. Khan, MD, Director of Brachytherapy Services at the Rutgers Cancer Institute of New Jersey in New Brunswick.  “Several recent clinical studies, including well-designed randomized trials directly comparing APBI to WBI, demonstrate that APBI brachytherapy offers potential advantages over WBI including a shorter course of treatment and decreased radiation while maintaining similarly low rates of cancer recurrence. We anticipate that ASTRO’s recommendations will drive significant changes in how clinicians approach early stage breast cancer treatment.”

Two decades of data have established breast conservation therapy (BCT) as the standard of care in early stage breast cancer. The traditional approach for radiation therapy as part of BCT has been a full course of whole breast irradiation (WBI), which exposes the entire breast and surrounding critical structures to radiation and requires daily treatments for four to six-and-a-half weeks.

“APBI brachytherapy is an attractive treatment option for many women with early stage breast cancer. It offers several advantages over WBI, while maintaining similar clinical outcomes, including the possibility of less radiation exposure to critical organs such as the heart, and improved cosmetic outcomes,” said Julie A. Margenthaler, M.D., FACS, professor, division of general surgery at Washington University School of Medicine, chair of American Society of Breast Surgeons communications committee. “With the wide body of evidence supporting the safety and efficacy of APBI for women with early stage breast cancer and the guidelines update from ASTRO, we should soon see more widespread adoption of this clinically proven and convenient approach that targets only the tissue at risk and is kinder to patients. Indeed, treating these women with WBI may represent overtreatment.”

Elekta and Cianna Medical support ASTRO’s APBI guidelines update and are committed to improving cancer care through developing innovative medical technologies and educating women about their options. The companies encourage women to learn more about their treatment options and talk to their doctors about selecting the best individualized care plan. Additional information about APBI is also available on the ASTRO website and at bc5project.com.

“After being diagnosed with an invasive ductal carcinoma in my left breast, I underwent six weeks of radiation therapy with many unpleasant side effects,” said Rochelle Colon, a breast cancer survivor. “I remained cancer free for 15 years and then it came back on my opposite breast. Fortunately, this time my cancer was treated with APBI brachytherapy in only five short days and I experienced none of the pain or discomfort that I had previously with a longer course of radiation.”

 

For more information: www.astro.org

Related Content

Stereotactic Radiosurgery Effective for Pediatric Arteriovenous Malformation Patients
News | Radiation Therapy | April 19, 2019
Ching-Jen Chen, M.D., of the neurosurgery department at the University of Virginia (UVA) Health System, was the winner...
In a demonstration on the exhibit floor of the SBI symposium, Koios software identified suspicious lesions in ultrasound images

In a demonstration on the exhibit floor of the SBI symposium, Koios software identified suspicious lesions in ultrasound images. Photo by Greg Freiherr

Feature | Artificial Intelligence | April 19, 2019 | By Greg Freiherr
Commercial efforts to develop...
Videos | Breast Imaging | April 18, 2019
In a keynote lecture at the Society of Breast Imaging (SBI)/American College of Radiology (ACR) 2019 Symposium, ...
Surgically Guided Brachytherapy Improves Outcomes for Intracranial Neoplasms
News | Brachytherapy Systems | April 18, 2019
Peter Nakaji, M.D., FAANS, general practice neurosurgeon at Barrow Neurological Institute, presented new research on...
Fatty tissue and breast density may be considered in the context of many factors that affect the occurrence and detection of breast cancer

Fatty tissue and breast density may be considered in the context of many factors that affect the occurrence and detection of breast cancer. Permission to publish provided by DenseBreast-info.org

Feature | Breast Imaging | April 18, 2019 | By Greg Freiherr
When planning a screening program to detect the early signs of breast cancer, age is a major consideration.
iCAD Appoints Stacey Stevens as President
News | Radiology Business | April 16, 2019
iCAD Inc. recently announced that Stacey Stevens has been named president. As president, Stevens will have expanded...
compressed breast during mammography.
360 Photos | 360 View Photos | April 16, 2019
A 360 view of a simulated breast compression for a...
ASTRO Applauds Introduction of PIMA Patient Protection Bill
News | Radiology Business | April 15, 2019
The American Society for Radiation Oncology (ASTRO) hailed the introduction of federal legislation that would...
A smart algorithm has been trained on a neural network to recognize the appearance of breast cancer in MR images

A smart algorithm has been trained on a neural network to recognize the appearance of breast cancer in MR images. The algorithm, described at the SBI/ACR Breast Imaging Symposium, used “Deep Learning,“ a form of machine learning, which is a type of artificial intelligence. Graphic courtesy of Sarah Eskreis-Winkler, M.D.

Feature | Artificial Intelligence | April 12, 2019 | By Greg Freiherr
The use of smart algorithms has the potential to make healthcare more efficient.