Partial Breast Irradiation: Is This a Viable Option?

In the treatment of early invasive and in situ breast carcinomas, lumpectomy followed by whole breast radiation are generally accepted as standard of care in breast conservation. Long-term data from early breast conservation trials has shown that most local failures occur in close proximity to the tumor bed. This has been observed in both radiated and unradiated breasts treated with breast conservation techniques, suggesting that occult multifocal disease is less ominous than once believed. Improvements in breast imaging and radiation treatment planning and delivery allow the experienced radiation oncologist to deliver high doses of radiation to the region of the tumor bed alone in less than 2 weeks. Preliminary data suggests that this abbreviated course of radiation offers cosmetic and disease control outcomes equal to that of traditional whole breast radiation in selected populations. This article reviews current techniques, outcomes of clinical trials, and novel techniques in partial breast radiation for early and locally recurrent breast carcinomas.