Irradiación parcial acelerada en cáncer de mama: revisión de las diferentes técnicas

Breast conservation therapy is the procedure of choice of early-stage breast cancer. Accelerated partial breast irradiation is an approach that treats only the lumpectomy bed plus a 1-2 cm margin, rather than the whole breast. Because of the small volume of irradiation, a higher dose can be delivered, thus reducing the total length of treatment. Growing interest in accelerated partial breast irradiation has prompted the development of phase i-iii clinical studies evaluating distinct techniques within this therapeutic modality; these techniques include multicatheter interstitial brachytherapy, balloon-catheter brachytherapy, conformal external beam radiation therapy, and intraoperative radiation therapy. Balloon-based brachytherapy approaches include MammoSite, Axxent and Contura electronic brachytherapy. Hybrid brachytherapy devices include SAVI and ClearPath. This article reviews the different techniques, identifying the weaknesses and strengths of each approach, and proposes a direction for future research and development. Although further follow-up and mature phase iii data are needed, it seems evident that accelerated partial breast irradiation will play a role in the management of a selected group of patients with early-stage breast cancer.