Partial Breast Irradiation: An Alternative to Conventional Whole-Breast Irradiation

Theresa M. Kwiatkowski, R.T.(T)(ARRT)®, BS, CMD

^*Dawn & Jacques Lipson MD Cancer Center, Rochester General Hospital, Rochester New York.

Address correspondence to: Theresa M. Kwiatkowski, RT(T), BS, CMD, Dawn & Jacques Lipson MD Cancer Center, Rochester General Hospital, 1425 Portland Avenue, Rochester, NY, 14621. E-mail: tmkwiat@live.com.

Disclosures: The author reports having no significant financial or advisory relationships with corporate organizations related to this activity.

ABSTRACT

Breast conservation therapy is the treatment of choice for the management of patients with early stage breast cancer. Accelerated partial breast irradiation (PBI) is radiation therapy that is delivered to the tumor site, plus a margin after surgical resection, over a shorter period of time as compared to standard whole-breast radiation therapy. PBI can be delivered via an array of different technologies: 3-dimensional conformal radiation, interstitial multicatheter brachytherapy, intracavitary catheter brachytherapy, or by single-fraction intraoperative radiation therapy. These PBI technologies offer radiation oncologists additional options in customizing radiation therapy in order to optimize local control, cosmesis, dose distribution, and decrease the radiation dose to healthy tissue, all of which positively impact the patient's quality of life. The technological modalities of PBI and their favorable and unfavorable aspects are highlighted. Patient preparation and treatment planning and delivery via computed tomography (CT), as well as aspects of 3D conformal external beam radiation therapy (3D-CRT), intraoperative radiation therapy (IORT), and external beam radiation therapy (EBRT) will also be discussed.