Cosmetic Outcomes of a Phase 1 Dose Escalation Study of 5-Fraction Stereotactic Partial Breast Irradiation for Early Stage Breast Cancer

Abstract

Purpose: Our purpose was to evaluate cosmetic changes after 5-fraction adjuvant stereotactic partial breast irradiation (S-PBI). Methods and Materials: Seventy-five women with in situ or invasive breast cancer stage 0, I, or II, with tumor size 3 cm, were enrolled after lumpectomy in a phase 1 dose escalation trial of S-PBI into cohorts receiving 30, 32.5, 35, 37.5,

Delivery of Adjuvant Radiation in 5 Days or Less After Lumpectomy for Breast Cancer: A Systematic Review

“…49,50 Similar outcomes have been reported in additional prospective series, though they are limited by small numbers of patients and/or short follow-up. [48][49][50] Studies are currently underway evaluating these approaches further. [51][52][53][54] Proton therapy has also been used to deliver EBRT APBI regimens.…”

“…[41][42][43][44][45][46][47] More recently, stereotactic APBI approaches have been considered to allow for further dose escalation. [48][49][50] A prospective dose escalation study with 75 patients beginning with 30 Gy/5 fractions and increasing to 40 Gy/5 fractions was performed; initial results were promising, with high rates of excellent/ good cosmetic outcomes and only 3 grade 3 toxicities reported with cosmetic outcomes stable at 3 years. 49,50 Similar outcomes have been reported in additional prospective series, though they are limited by small numbers of patients and/or short follow-up.…”

Stereotactic partial breast irradiation in primary breast cancer: A comprehensive review of the current status and future directions

“…The first results regarding cosmesis evaluated through the Harvard Breast Cosmesis Scale were published in 2021 ( 34 ): most patients reported excellent/good cosmesis at both baseline (86.3%) and year 3 (89.8%), and no cosmetic subdomain (telangiectasia, skin atrophy, scarring, pigment change, erythema, fat necrosis, and fibrosis) had significant worsening by year 3.…”

Five Fraction External Beam Partial Breast Irradiation

“…20 Excellent results have also been published for robotic stereotactic radiotherapy and proton PBI, with reduced heart and lung doses. [21][22][23] It is important to balance the additional resources required for these advanced techniques with the gain in long-term toxicity.…”