APBI

Question 1

What is partial breast irradiation?

Answer 1

• hypofractionated treatment to a small fraction of the breast
• intraoperative techniques are classified as APBI

Question 2

What are the main techniques for APBI?

Answer 2

• EBRT
• mammosite
• brachytherapy
• TARGIT
• ELIOT

Question 3

What is the patient criteria for those suitable for APBI?

Answer 3

• over 60
• No BRCA 1/2 mutayion
• tumour <2cm, stage T1, no nodes

Question 4

What is a mammosite?

Answer 4

• inflatable balloon inserted and inflated then inserted with source
• 34Gy in 10# twice daily

Question 5

What are the concerns with mammosite?

Answer 5

• adequcey of tumour coverage and heterogeneity
• infection
• worse cosmetic outcome
• not suitable for cavitities near axillar or skin

Question 6

What is brachytherapy?

Answer 6

• interstitial using needles

- 34Gy overall bidaily

Question 7

What is TARGIT?

Answer 7

• low energy x-ray (50 kV)
• sphere shaped applicator is placed in surgical cavity
• 20Gy in 1# with 5-7Gy at 1cm
• breast tissue sututered after

Question 8

What are the limitations with TARGIT?

Answer 8

• require specialised techniques and equipment and high level of clinical expertise
• limited pathological information at time re margins and nodal
• not suitable for large irregular cavities

Question 9

What is ELIOT?

Answer 9

• Electron applicator connected to dedicated linac
• 1# of 21Gy using 3-10MeV
• limitations same as TARGIT

Question 10

What is the dose # for APBI EBRT?

Answer 10

• 38.5Gy with 3.85Gy/# bidaily