The use of high-dose-rate brachytherapy alone after lumpectomy in patientswith early-stage breast cancer treated with breast-conserving therapy

Purpose: We present the preliminary results of our in-house protocol using outpatient high-dose-rate (HDR) brachytherapy as the sole radiation modalit y following lumpectomy in patients with early-stage breast cancer. Methods and Materials: Thirty-seven patients with 38 Stage I-II breast canc ers received radiation to the lumpectomy cavity alone using an HDR intersti tial implant with Ir-192. A minimum dose of 32 Gy was delivered on an outpa tient basis in 8 fractions of 4 Gy to the lumpectomy cavity plus a 1- to 2- cm margin over consecutive 4 days, Results: Median follow-up is 31 months. There has been one ipsilateral brea st recurrence for a crude failure rate of 2.6% and no regional or distant f ailures. Wound healing was not impaired in patients undergoing an open-cavi ty implant. Three minor breast infections occurred, and all resolved with o ral antibiotics. The cosmetic outcome was good to excellent in all patients . Conclusion: In selected patients with early-stage breast cancer, treatment of the lumpectomy cavity alone with outpatient HDR brachytherapy is both te chnically feasible and well tolerated. Early results are encouraging, howev er, longer follow-up is necessary before equivalence to standard whole-brea st irradiation can be established and to determine the most optimal radiati on therapy technique to be employed. (C) 2001 Elsevier Science Inc.