Dr. Robert EbelingRadiation Oncology

Accelerated Partial Breast Irradiation (APBI)

2 min read
APBI rationale is based on data showing 75% of in breast recurrences are within 2cm of original cancer.
Using APBI we do not need to treat the whole breast, this in turn, reduces the side effects of treatment WITHOUT compromising tumor control.
APBI can be done with external beam or with several types of brachytherapy applicators.
Treatments are typically twice a day for 5 days. Each treatment lasts somewhere between 5-15 minutes.
Suitable Patients (need all of these)
Age of 50 or older 
Invasive ductal disease up to 2cm
No positive lymph nodes
Surgical margins negative 
Suitable Patients:
DCIS is allowed IF:
  Screening detected 
  2.5cm or smaller
  Grade 1 or 2
  Surgical margins of 3mm or greater
Cautionary Patients:
Age 40-49 if they meet ALL Suitable criteria
Age 50+ with ANY of these:
  Tumor 2.1-3.0cm
  Surgical margins <2mm
  Lobular histology 
  Lymphovascular invasion (limited)
  Pure DCIS 3cm or smaller
Unsuitable (ANY of these):
Age <40
Age 40-49 and do not meet Cautionary
Surgical margins positive 
Node +, or not sampled 
DCIS >3cm
APBI provides a better quality of life than whole breast treatment.
Fewer and less severe side effects.
Treatment is complete in 5 days.
APBI has better cosmetic outcomes than does whole breast treatment.
Good/Excellent cosmetic outcome >90%.
APBI does NOT compromise tumor control.
5 year local failure of 0-5%.