In This Issue
BrachyBytes Editorial Advisory Board

Robert Kuske, M.D.

Jay Reiff, Ph.D.
Dan Scanderbeg, Ph.D.
Catheryn Yashar, M.D.
Vic Zannis, M.D.
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Breast Cancer Symposium 2015
September 25-27, 2015
San Francisco Marriott Marquis
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Annals of Surgical Oncology

Radiation Oncology UCLA

JAMA Surgery

University of Texas MD Anderson Cancer Center

National Institute of Health and Care Excellence

British Medical Journal

July 2015 

The “PROMIS” of APBI Safety and Efficacy

Mitchell Kamrava, MD
One of the largest reports of outcomes in the history of partial breast


irradiation therapy was published in the April issue of the Annals of Surgical Oncology. The study, entitled Outcomes of Breast Cancer Patients Treated with Accelerated Partial Breast Irradiation Via Multicatheter Interstitial Brachytherapy: The Pooled Registry of 

Multicatheter Interstitial Sites (PROMIS) Experience, was co-authored by Mitchell Kamrava, MD, Assistant Clinical Professor, Department of Radiation Oncology, University of California, Los Angeles.


The two decade-long study found that women diagnosed with breast cancer and treated with a one-week regimen of radiation after lumpectomy saw no increase in cancer recurrence or cosmetic outcomes, compared to treatments where the whole breast is irradiated for up to six weeks after surgery.


The PROMIS study was recently featured in an article on Medscape Daily News, as well as a news segment on CBS 2 News Los Angeles

Dr. Kamrava discusses the results of the PROMIS study, and also shares his thoughts on using brachytherapy as an alternative to whole breast irradiation (WBI) for early stage breast cancer treatment. 


Keep Reading…

Rising Percentage of Women Opt for Lumpectomies, Study Shows
Research shows that in recent years, more woman with breast cancer have been choosing to have breast-conserving lumpectomies. While in 1998, 55% of woman chose lumpectomies, in 2011 that statistic passed the 60% mark. The study, published in JAMA Surgery on June 17th, draws from a more complete database that what has been used in previous studies, and captures about 70% of newly diagnosed cancer cases in the United States. Researchers looked into influencing factors for these 728,000 woman, and noted woman aged 52 – 61, with higher education, and higher income, were more likely to choose a lumpectomy. 

Certain barriers to breast-conserving treatment, such as lack of insurance and long travel distances, were noted. Since whole breast radiation takes 6 weeks, woman who lack transportation or can’t take time off work are discouraged from breast-conserving treatment, not realizing there are options that allow for a shorter duration of radiation treatment. Study author Isabelle Bedrosian, Associate Professor, Surgical Oncology, University of Texas MD Anderson Cancer Center, says it’s important to address these remaining barriers so women who are eligible and want breast-conserving surgery can get it.
To read the full article, click here.

IORT Controversy Continues in Europe and US

In 2014, the UK National Institute of Health and Care Excellence (NICE) delayed publishing guidance recommending the use of Intrabeam radiotherapy after receiving comments from what NICE referred to as professional organizations.

In May 2015, British Medical Journal (BMJ) published two articles, one discussing the “terrible and shameful” situation of IORT adoption being delayed in the UK; as well as a rapid response which discusses the immaturity of the TARGIT-A trial follow-up data, and it’s failed use of standard statistical methods to adjust for patients with short follow-up, thereby underestimating the relapse risk. The writers state that until international trust is restored in the trial, one cannot confidently conclude to the convenience of IORT being worth the possible risks.


Two leading advocacy groups representing patient rights recently requested California Attorney General Kamala Harris act on her commitment to protect consumer rights and investigate the increased use and advertising of IORT.