Accelerated Partial Breast Irradiation in elderly patients with early-stage breast cancer

Abstract

Standard treatment of patients with early-stage breast cancer is breast-conserving surgery followed by whole-breast irradiation. De-escalation of treatment for patients with a low recurrence risk with the aim to mnimize treatment burden has become an area of interest. One strategy to de-escalate radiotherapy is the application of Accelerated Partial Breast Irradiation (APBI) in stead of whole-breast irradiation, limiting the irradiated volume of the breast tot he tumour bed, facilitating a reduced amount of fractions needed. This thesis describes the toxicity, health-related quality of life, and oncological outcomes of patients with early-stage breast cancer treated with Accelerated Partial Breast Irradiation given either intra-operatively with electrons or using external-beam radiotherapy. The results show that after both treatment options, toxicity is acceptable and health-related quality of life is good. When compared to whole-breast irradiation, patients treated with APBI experience less breast symptoms. Five years after treatment, local recurrence rate after IORT is relatively high compared to EB-APBI. APBI using external-beam radiotherapy can justly be put into practice as a treatment option for these selected patients. Registrational studies are extremely important when novel treatment techiques are introduced into real-world practice outside of clinical studies.