ECRI publishes report on APBI to treat breast cancer

Nonprofit technology research firm ECRI Institute has published a report on the use of accelerated partial-breast irradiation (APBI) using intracavitary brachytherapy as a treatment for early-stage breast cancer.

The report is designed to provide a snapshot of the current status, efficacy, and use of APBI technology. It describes the technology, manufacturers of APBI products, clinical practice guidelines, necessary credentialing and training of clinicians, and considerations and requirements that hospitals should know about before offering the treatment. Costs and reimbursement, as well as cost-effectiveness considerations, also are discussed.

The report includes current review of peer-published outcomes of patients with respect to local control, toxicities, and other side effects. It does not make any assessment comparing APBI treatment to conventional external-beam radiation therapy (EBRT), citing lack of data.

"Although EBRT of the whole breast after lumpectomy remains the standard of care for treating early-stage breast cancer, including DCIS and invasive breast carcinoma, APBI is being used increasingly as an alternative option for carefully selected patients. ... Clinicians are likely to prefer the newer intracavitary brachytherapy techniques to perform APBI because these methods are less invasive and less technically demanding than interstitial techniques," the report concluded.

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