Imaging for early stage breast cancer

Purpose: to evaluate 3D CRT APBI compared with standard WBI Inclusion: women operated with BCS, >40 yr, DCIS or invasive non-lobular cancer <3cm, pN0, microscopically clear margins, one tumor in one quadrant Active centres: 33 centres in Canada, Australia, New Zealand, 2006-2011 Inclusion: 2135 pts Median FU: 36 months APBI: 3-5 noncoplanar conformal fields, 95-107% CTV was tumor bed and surgical clips + 1 cm inside breast. PTV=CTV+1cm Breast vol planning goals: 0% to receive >107%, <25% (35% acceptable) to receive >95%, and <50% (60% acceptable) to receive >50% of prescription dose Randomized Trial of Accelerated Partial Breast Irradiation, The RAPID trial

3D CRT APBI 38.5 Gy/10 f/5 days

Randomization

WBI 42.5 Gy/16 f or 50 Gy/25 f

Olivotto et al, JCO 2013