Breast Cancer Coverage from Every Angle

Accelerated Partial-Breast Versus Whole-Breast Irradiation in Early Breast Cancer

By: Hillary Ojeda
Posted: Wednesday, February 10, 2021

According to a study conducted by Icro Meattini, MD, of the University of Florence, Italy, and colleagues, patients with early breast cancer had similar long-term outcomes when treated with either external accelerated partial-breast or whole-breast irradiation (WBI). The results of the randomized phase III APBI-IMRT-Florence Trial were published in the Journal of Clinical Oncology. The authors suggested additional ongoing studies may help to determine the best candidates for accelerated partial-breast irradiation.

“The long-term update of our trial confirmed the previously published promising findings at a 5-year median follow-up,” commented the investigators. “We observed few in-breast tumor recurrence events at a median follow-up of 10 years and an absolute cumulative difference of 1.2% at 10 years nonsignificantly in favor of the WBI arm.”

For the study, a total of 520 patients were randomly assigned to accelerated partial-breast irradiation or WBI treatments between 2005 and 2013. The partial-breast treatment group received 30 Gy in five once-daily fractions, and the WBI group received 50 Gy in 25 fractions, with a tumor bed boost after breast-conserving surgery. The median follow-up was 10.7 years.

The 10-year incidence of in-breast tumor recurrence was 2.5% with WBI and 3.7% with accelerated partial-breast irradiation. The 10-year incidence of in-breast tumor recurrence did not reach statistical significance. For both groups, the 10-year overall survival rate was 91.9%. As for breast cancer–specific survival at 10 years, it was 96.7% with WBI and 97.8% with accelerated partial-breast irradiation.

Those treated with accelerated partial-breast irradiation had less acute toxicity and late toxicity. Compared with the WBI group, those given accelerated partial-breast irradiation had a better cosmetic outcome as well. Although the group receiving accelerated partial-breast irradiation had less toxicity, patients in both groups had similar long-term outcomes.

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