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Breast Cancer Treatment (APBI)
Accelerated Partial Breast Irradiation
What You Should Know about Accelerated Partial Breast Irradiation
Rationale for APBI
The barriers of time and travel associated with about 6 weeks of standard whole breast radiation have influenced numerous women to pursue either mastectomy (where radiation is only indication in certain situations) or forgoing radiation altogether after a lumpectomy. APBI is a treatment option, for appropriately selected women, which delivers the entire course of radiation treatment in 5 days. This shortened duration of treatment helps reduce issues with time and travel and will allow more women to have access to the important proven benefits of radiation following lumpectomy.
Reducing the treatment time relative to whole breast radiation is only one motivation for APBI. Another is questioning whether the whole breast actually needs to be treated with radiation. It turns out that the majority of times women develop a recurrence in the breast that it occurs in or near where it originated. Also, elsewhere (ie not near the original site of the tumor) failures don’t appear to be reduced by whole breast radiation. So it appears that the major benefit of radiation is to reduce the risk of recurrence around where the tumor started.
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Examples show how the radiation dose (the colored lines, with the white lines representing 50% of the dose) is targeted to the area where the original tumor was using three different partial breast radiation techniques (SAVI, Contura, Tube and Button). |
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This is in contrast to these examples of standard whole breast radiation where the entire breast is considered the target. |
In Summary:
APBI advantages:
- shorter treatment duration (5 days instead of 6 weeks)
- deliver the radiation therapy to where there is most likely to be a recurrence
- reduce toxicity (side effects from radiation) by sparing normal tissues
Potential APBI disadvantages:
- while the current literature in appropriately selected women (see below literature review) does not support this there is a possible increased risk of recurrence in parts of the breast that are not treated with radiation
- whether the long term cosmetic changes to the breast are different between partial breast and whole breast radiation (see below literature review for a discussion about cosmetic outcomes following partial breast treatment)
The content on this site was developed by Mitchell Kamrava, MD. Please email any questions/comments about this site or APBI in general to mkamrava@mednet.ucla.edu
