Case Report and Dosimetric Analysis of an Axillary Recurrence After Partial Breast Irradiation with Mammosite Catheter

Shah, Anand P.; Dickler, Adam; Kirk, Michael C.; Chen, Sea S.; Strauss, Jonathan B.; Coon, Alan B.; Turian, Julius V.; Siziopikou, Kalliopi; Dowlat, Kambiz; Griem, Katherine L.

doi:10.1016/j.meddos.2007.11.002

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Volume 33, Issue 3 , Pages 222-225, Autumn 2008

Case Report and Dosimetric Analysis of an Axillary Recurrence After Partial Breast Irradiation with Mammosite Catheter

Presented at the American College of Radiation Oncology (ACRO) Annual Meeting, February 22, 2007, San Diego, CA.

Department of Radiation Oncology, Department of Pathology, and Department of General Surgery, Rush University Medical Center, Chicago, IL

Received 22 June 2007; accepted 10 November 2007. published online 20 May 2008.

Abstract

Partial breast irradiation (PBI) was designed in part to decrease overall treatment times associated with whole breast radiation therapy (WBRT). WBRT treats the entire breast and usually portions of the axilla. The goal of PBI is to treat a smaller volume of breast tissue in less time, focusing the dose around the lumpectomy cavity. The following is a case of a 64-year-old woman with early-stage breast cancer treated with PBI who failed regionally in the ipsilateral axilla. With our dosimetric analysis, we found that the entire area of this axillary failure would have likely received at least 45 Gy if WBRT had been used, enough to sterilize microscopic disease. With PBI, this area received a mean dose of only 2.8 Gy, which raises the possibility that this regional failure may have been prevented had WBRT been used instead of PBI.

Key Words: Brachytherapy, Partial breast irradiation, Mammosite, Axilla