- 作者：Kari M. Rosenkranz ; Edmund Tsui ; Elizabeth B. McCabe ; Jiang Gui ; Kelly Underhill ; Richard J. Barth Jr.
- 关键词：APBI ; accelerated partial breast irradiation ; BCT ; breast conservation therapy ; WBRT ; whole breast radiation therapy
- 刊名：Journal of the American College of Surgeons
- 出版年：2013
- 出版时间：September, 2013
- 年：2013
- 卷：217
- 期：3
- 页码：497-502
- 全文大小：155 K
Background
Due to its short duration of therapy and low rates of local recurrence, women undergoing breast conservation are increasingly opting for partial breast irradiation with the MammoSite (Cytyc/Hologic) catheter. In early follow-up studies, few complications were reported. Few data, however, exist regarding longer-term complications. We compared the long-term local toxicities of MammoSite partial breast irradiation with those resulting from whole breast radiation.Study Design
This was a retrospective study performed in a single academic medical center. All patients who underwent breast-conserving surgery between 2003 and 2008, who met institutional criteria for brachytherapy, were included. We compared women treated with MammoSite with patients treated with whole breast radiation therapy (WBRT). Endpoints included incidence of palpable masses at the lumpectomy site, telangiectasias, and local recurrence.
Results
Seventy-one MammoSite patients and 245 WBRT patients were well matched with regard to clinical characteristics. Median follow-up was 4 years. A palpable mass developed at the site of lumpectomy in 27 % of the MammoSite patients compared with 7 % of the WBRT patients (p < 0.0001). Telangiectasias developed more frequently in the MammoSite group than in the WBRT group (24 % vs 4 % , p < 0.001). Forty-two percent of patients treated with MammoSite developed a palpable mass, telangectasia, or both.
Conclusions
Palpable masses and telangiectasias are frequent long-term complications after MammoSite brachytherapy and occur at a significantly higher rate after MammoSite brachytherapy than after WBRT. This increased rate of long-term local toxicity should be considered when counseling women on options for adjuvant radiation therapy after breast-conserving surgery.