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Accelerated Partial Breast Irradiation

The present standard of care for the treatment of early-stage breast cancer is a lumpectomy followed by several weeks of whole breast radiation. However, ongoing research suggests that it may be safe to give radiation treatment to only part of the breast, which would allow the radiation to be delivered over a shorter period of time.

In clinical trials, doctors are studying if accelerated partial breast irradiation (or APBI)—where radiation is delivered to only part of the breast over four to five days—works as well as the present standard whole breast radiation. Because APBI is still being studied, it is used more selectively than whole breast radiation.

There are two different approaches to APBI:

  1. Breast brachytherapy involves placing flexible plastic tubes called catheters or a balloon directly into the cavity where the lump was taken from. After simulation, the catheters or the balloon are connected to a machine called a high-dose-rate afterloader, which stores a radioactive source. With a special computer, a small, radioactive seed is guided into the catheters or balloon near where the tumor was removed. The radioactive seed is left in place for several minutes, based upon the treatment plan designed by your radiation oncologist. After the end of the five days, the catheters or balloon are removed.
  2. External beam radiation with 3D-CRT can also treat part of the breast but it is more focused around the area of surgery. Treatment is delivered using the same machine (linear accelerator) and a similar technique as what is used for standard whole breast radiation.

Treatment with both approaches of APBI are typically given twice a day, five days a week. Treatment can be completed in one week. The long-term results of these techniques appear promising but are still being studied. Talk with your radiation oncologist for more information.

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