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Postsurgical Treatment of Early-stage Breast Cancer With Electronic Brachytherapy: Outcomes and Health-related Quality of Life at 1 Year

Patel, Rakesh R. MD*; Beitsch, Peter D. MD; Nichols, Timothy D. MD; Lorenzetti, John D. MD§; Wurzer, James C. MD, PhD; Tucker, James C. MD; Nunn, George W. MD; Laduzinsky, Susan J. MS, MD#; Kugler, Morris A. MD**; Simmons, Dwelvin L. MD††; Gilligan, Michael S. MD‡‡; Roy, Tapan MD§§; Foley, Jonathon K. MD∥∥; Thropay, John P. MD¶¶; Odou, Mark William MD##; Bornstein, Bruce A. MD, MBA***; Tito, Elizabeth P. MD†††; Chadha, Manjeet MD‡‡‡; Boolbol, Susan K. MD‡‡‡; Lane, Steven C. MD§§§; White, Julie G. MD§§§

American Journal of Clinical Oncology: October 2013 - Volume 36 - Issue 5 - p 430–435
doi: 10.1097/COC.0b013e31825493bb
Original Articles: Breast

Objectives: This multicenter registry followed up patients with early-stage breast cancer treated with breast-conserving surgery and electronic brachytherapy (EBT). This report provides 1- and 2-year updates to the initial publication.

Methods: Patients were of age 50 years or more with invasive carcinoma or ductal carcinoma in situ, tumor size ≤3 cm, and negative surgical margins. After lumpectomy, patients received EBT in 10 fractions over 5 days (34 Gy total).

Results: Of the 69 patients enrolled, 62 were evaluated at 1 year and 20 patients at 2 years after treatment. At 1 year, 28 (45.2%) patients reported adverse events that were possibly, probably, or definitely related to treatment. Most (90%) were grade 1: manageable and typical of radiation therapy. Four events were grade 2: induration/firmness (2), field contracture (1), and seroma (1). One event was grade 3: a draining fistula at the lumpectomy site due to residual effects of a breast infection at 1 month. No recurrences have been reported. Cosmetic ratings were excellent or good in 93.4% of patients at 1 year. Most patients (69%) were energetic most or all of the time. Most patients (69% to 98%) were not affected by individual symptoms of breast disease at 1 year. Generally patients who had an adverse event did not report the corresponding symptom on the quality-of-life questionnaire.

Conclusions: This registry followed up patients with early-stage breast cancer at 1 and 2 years after breast-conserving surgery and EBT. No recurrences have been reported, and adverse effects were acceptable.

¶¶Beverly Oncology & Imaging Medical Center

##Odou and Nugent MDs, Montebello

*Western Radiation Oncology Inc., Pleasanton, CA

Dallas Surgical Group

Northpoint Cancer Center, Dallas, TX

§Breast Specialists

AtlantiCare Regional Medical Center, Egg Harbor Township, NJ

DCH Regional Medical Center, Tuscaloosa, AL

#Memorial and St Elizabeth’s Cancer Treatment Center, Swansea

**Southern Illinois Surgical Consultants, Maryville, IL

††Florida Radiation Oncology

‡‡North Florida Surgeons, Orange Park, FL

§§Cancer Institute of Cape Girardeau

∥∥Cape Girardeau Surgical Clinic, Cape Girardeau, MO

***Shields Health Care Group, Quincy

†††Surgical Associates, Taunton

§§§Brockton Hospital, Brockton, MA

‡‡‡Beth Israel Medical Center, New York, NY

All of the authors declared that their respective institutions were compensated for data collection related to this study. This registry was funded in part by Xoft Inc. All authors have declared there are no financial conflicts of interest in regard to this work.

Reprints: Peter D. Beitsch, MD, Dallas Surgical Group, 7777 Forest Lane, Suite C760, Dallas, TX 75230. E-mail:

© 2013 by Lippincott Williams & Wilkins, Inc