Indian Brachytherapy Society consensus recommendations for brachytherapy in breast cancer.

Abstract

Purpose: This consensus statement of Indian Brachytherapy Society (IBS) aims to generate practical and reproducible guidelines allowing for direct implementation in the Indian scenario.

Material and methods: IBS board of directors appointed a panel of physicians with expertise in breast cancer and, in particular, breast brachytherapy, to develop a consensus statement. First, a literature review on breast brachytherapy was conducted, focusing on randomized trials, prospective studies, and multi-institutional series. Then, guidelines were drafted based on authors' consensus according to Indian scenario.

Results: IBS advocate accelerated partial breast irradiation (APBI) with brachytherapy following breast conservation surgery (BCS) for suitable groups of patients. Also, IBS recommends brachytherapy as the preferred technique for patients requiring tumor bed boost. Multi-catheter interstitial brachytherapy (MIB) is suitable in most situations, except for a large tumor to breast ratio, and type 2 oncoplasty or higher performed. For best cosmesis, IBS recommends a minimum 3-week gap between chemotherapy and APBI.

Conclusions: Brachytherapy continues to be an established technique for APBI as well as boost in appropriately selected patients with early breast cancer (EBC). As breast brachytherapy is an underutilized therapy in the Indian context, this article will hopefully encourage the readers to use its clinical potential in the suitable groups of patients.