According to a recent study, the use of accelerated partial breast irradiation using brachytherapy (APBIb) to treat breast cancer has significantly increased in the US in the last few years. This approach is used instead of whole-breast irradiation (WBI). The study appears in the Journal of the National Cancer Institute.
APBI includes delivering radiation, using interstitial catheters or balloon catheters, in a limited manner where only tumor cells are affected. This technique means more efficiency and less radiation delivered to the healthy tissues. However, if there is another spot in the breast with tumor cells it will not be affected, which means a possibility of local recurrence.
In their study, Jona Hattangadi, M.D., of the Department of Radiation Oncology at the Brigham and Women's Hospital and Harvard Medical School in Boston, and his team reviewed data from the Surveillance, Epidemiology, and End Results (SEER) database. The data base had details about women who underwent APBIb or WBI treatments between 2000 and 2007. As per the guidelines of American Society for Radiation Oncology (ASTRO), the research team divided the 138,815 women involved in the study into "suitable", "cautionary", or "unsuitable" for APBIb.
Analysis showed that 3,576 of the women underwent APBIb. 32% of them were suitable, 29.6% cautionary, and 36.2% unsuitable. It was noted that the use of APBIb was elevated to reach 6.6% in 2007 after being only 0.4% in 2000. A significant variation in the use of APBIb was noted between states and different races.
The researchers reported "the wide disparity in use of APBIb suggests that unwarranted variation - practice variation not explained by illness, patient preference, or evidence-based medicine - may be present. Future studies of APBIb use will help elucidate whether patterns change as [the ASTRO guidelines] diffuse into practice and whether the regional and temporal changes in APBIb cost, reimbursement, and insurance coverage affect utilization."