“When the original ASTRO consensus statement was issued there was very little actual data on breast brachytherapy to deliver APBI. These guidelines have been updated based upon Phase III trial data, and results from more mature APBI trials. I think we should congratulate ASTRO for updating the guidelines, making them more applicable to the actual results obtained using APBI. I believe that 20-30% more patients will be suitable for APBI simply by reducing the age criteria and including patients with DCIS.”
Atif J. Khan MD, Director of Brachytherapy Services at the Rutgers Cancer Institute of New Jersey
“Evidence-based guidelines, such as those issued by ASTRO, have the potential to fundamentally alter
clinical practice. These important changes to ASTRO’s guidelines were based on a systematic review of 45 published clinical studies, resulting in a consensus decision to lower the recommended age group for APBI candidates from 60 to 50, significantly expanding the eligible patient population. Several recent clinical studies, including well-designed randomized trials directly comparing APBI to WBI, demonstrate that APBI brachytherapy offers potential advantages over WBI including a shorter course of treatment and decreased radiation while maintaining similarly low rates of cancer recurrence. We anticipate that ASTRO’s recommendations will drive significant changes in how clinicians approach early stage breast cancer treatment.”
Julie A. Margenthaler
MD, FACS, professor, division of general surgery at Washington University School of Medicine, chair of American Society of Breast Surgeons communications committee.
“APBI brachytherapy is an attractive treatment option for many women with early stage breast cancer. It offers several advantages over WBI, while maintaining similar clinical outcomes, including the possibility of less radiation exposure to critical organs such as the heart, and improved cosmetic outcomes. With the wide body of evidence supporting the safety and efficacy of APBI for women with early stage breast cancer and the guidelines update from ASTRO, we should soon see more widespread adoption of this clinically proven and convenient approach that targets only the tissue at risk and is kinder to patients. Indeed, treating these women with whole breast radiation may represent overtreatment.”