Surgical Preparation for Accelerated Partial Breast Irradiation

Accelerated partial breast irradiation (APBI) techniques include interstitial multi-plane catheter applications, the utilization of lumpectomy cavity indwelling devices, and ultra-focused external beam radiation (either three-dimensional conformal or intraoperative delivery). The importance of the breast surgeon's role in APBI varies with the radiation application mode that is used, with the surgeon being instrumental in the delivery of both lumpectomy cavity indwelling device-based therapy and intraoperative irradiation, but minimally involved in the applications of multicatheter interstitial and three-dimensional conformal techniques. Surgical techniques and principals have evolved during recent experiences with APBI, and these are described in this review. By partnering with radiation oncology colleagues during APBI, surgeons optimize the success of this style of irradiation and improve the outcomes of therapy for women with breast cancer.