Brachytherapy and Breast Cancer: Best Practices in Imaging-Based Patient Selection, Treatment Planning, and Future Trends

Brachytherapy and Breast Cancer: Best Practices in Imaging-Based Patient Selection, Treatment Planning, and Future Trends is organized by eRADIMAGING.

Release Date: 7/30/2019
Expiration Date: 8/1/2025

Course Description:
Mortality rates for patients with breast cancer have trended downward over the past several decades due in part to the heightened use of breast-conserving therapy (BCT) in women with early-stage or noninvasive disease. Central to the BCT strategy has been adjuvant radiotherapy, particularly via brachytherapy accelerated partial breast irradiation (APBI). In brachytherapy, radioactive isotopes are inserted into or near the tumor bed, minimizing exposure to normal surrounding tissue and organs at risk. Low-dose brachytherapy regimens were the standard for many years, but recently, high dose-rate (HDR) sources and fractionations have become preferable, as they have been shown to be safer, more convenient, and offer comparable or superior efficacy. Brachytherapy APBI has also become a more sophisticated treatment delivery approach with new software algorithms and imaging modalities yielding more refined and optimized treatment plans. Questions remain, however, about cosmetic outcomes using HDR isotopes, while the most effective delivery techniques and dose fractionations for specific populations, as well as the optimal approaches to achieve maximum local control and minimal toxicity, are yet to be determined.

Abstract:
Mortality rates for patients with breast cancer have trended downward over the past several decades due in part to the heightened use of breast-conserving therapy (BCT) in women with the early-stage or noninvasive disease. Central to the BCT strategy has been adjuvant radiotherapy, particularly via brachytherapy accelerated partial breast irradiation (APBI). In brachytherapy, radioactive isotopes are inserted into or near the tumor bed, minimizing exposure to normal surrounding tissue and organs at risk. Low-dose brachytherapy regimens were the standard for many years, but recently, high dose-rate (HDR) sources and fractionations have become preferable, as they have been shown to be safer, more convenient, and offer comparable or superior efficacy. Brachytherapy APBI has also become a more sophisticated treatment delivery approach with new software algorithms and imaging modalities yielding more refined and optimized treatment plans. Questions remain, however, about cosmetic outcomes using HDR isotopes, while the most effective delivery techniques and dose fractionations for specific populations, as well as the optimal approaches to achieve maximum local control and minimal toxicity, are yet to be determined.

Learning Objectives:
After reading this article, the participant should be able to:     
• Explain the advantages and disadvantages of high-dose-rate brachytherapy as a radiotherapeutic option in patients with breast cancer.
• Define the primary imaging and brachytherapy modalities and their roles in treatment planning and patient selection.
• Assess the merits of potential advances now in development and proposed refinements to current practices.

1.0 Credit