DiFronzo L Andrew, Tsai Peter I, Hwang Julie M, Lee John J, Ryoo Monica C, Rahimian Javad, Tome Michael, Takasugi Jan K, Haigh Philip I
Departments of Surgical Oncology and Radiation Oncology, Kaiser Permanente Los Angeles Medical Center, 4760 Sunset Boulevard, Los Angeles, CA 90027, USA.
Arch Surg. 2005 Aug;140(8):787-94. doi: 10.1001/archsurg.140.8.787.
Balloon catheter-based accelerated partial breast irradiation (APBI) may result in desirable short-term outcomes in patients undergoing breast conserving surgery.
Prospective consecutive case series.
Tertiary multidisciplinary referral center.
Forty selected patients with invasive breast carcinoma undergoing breast conserving surgery and MammoSite device placement.
Breast conserving surgery, sentinel and/or axillary node dissection, placement of the new balloon catheter applicator (MammoSite device), and APBI.
Infection, early and late seroma, device explantation, time to initiating APBI, acute toxic effects on the skin, and cosmesis using the Harvard Scale.
Thirty-nine patients underwent MammoSite device placement at the time of lumpectomy; 1 patient underwent percutaneous device placement after lumpectomy. Nineteen patients (49%) had drainage catheters placed in the breast cavity at the time of lumpectomy. Wound infection developed in 3 patients (8%). Five devices (12%) were explanted because of unfavorable final pathological findings or infection. The mean time to the start of APBI in patients who did not undergo simultaneous drain placement was 7.2 days (range, 5-12 days), compared with 5.1 days (range, 3-8 days) in patients who did (P = .008). With a mean follow-up of 13.3 months (range, 2-28 months), patients completing APBI had limited toxic effects on the skin, with excellent or good cosmetic results in 39 patients (97%).
Use of the MammoSite system in APBI has favorable short-term outcomes. Infection and radiation treatment delay are common and may warrant use of perioperative antibiotics and drain placement, respectively. A small number of patients who have device placement at the time of lumpectomy will require explantation because of unfavorable final pathological findings. Short-term outcomes of MammoSite brachytherapy support further studies comparing APBI with standard whole breast irradiation in patients undergoing breast conserving surgery.
基于球囊导管的加速部分乳腺照射（APBI）可能会使接受保乳手术的患者获得理想的短期疗效。
前瞻性连续病例系列。
三级多学科转诊中心。
40例选定的浸润性乳腺癌患者接受保乳手术并植入MammoSite装置。
保乳手术、前哨淋巴结和/或腋窝淋巴结清扫、置入新型球囊导管施源器（MammoSite装置）以及APBI。
感染、早期和晚期血清肿、装置取出、开始APBI的时间、皮肤急性毒性反应以及使用哈佛量表评估的美容效果。
39例患者在肿块切除时植入MammoSite装置；1例患者在肿块切除后经皮植入装置。19例患者（49%）在肿块切除时在乳房腔内置入引流导管。3例患者（8%）发生伤口感染。5个装置（12%）因最终病理结果不理想或感染而被取出。未同时放置引流管的患者开始APBI的平均时间为7.2天（范围5 - 12天），而放置引流管的患者为5.1天（范围3 - 8天）（P = 0.008）。平均随访13.3个月（范围2 - 28个月），完成APBI的患者皮肤毒性反应有限，39例患者（97%）美容效果为优或良。
在APBI中使用MammoSite系统具有良好的短期疗效。感染和放疗延迟较为常见，可能分别需要围手术期使用抗生素和放置引流管。少数在肿块切除时植入装置的患者因最终病理结果不理想需要取出装置。MammoSite近距离放射治疗的短期疗效支持进一步开展研究，比较APBI与接受保乳手术患者的标准全乳照射。
