• 1
    Bartelink H, Horiot JC, Poortmans P, et al. European Organization for Research and Treatment of Cancer Radiotherapy and Breast Cancer Groups. Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N Engl J Med. 2001; 345: 13781387.
  • 2
    Romestaing P, Lehingue Y, Carrie C, et al. Role of a 10-Gy boost in the conservative treatment of early breast cancer: results of a randomized clinical trial in Lyon, France. J Clin Oncol. 1997; 15: 963968.
  • 3
    Grabenbauer GG. Internal mammary nodes in invasive breast carcinoma: to treat or not to treat? Strahlenther Onkol. 2004; 180: 690694.
  • 4
    Gruber G, Berclaz G, Altermatt HJ, Greiner RH. Can the addition of regional radiotherapy counterbalance important risk factors in breast cancer patients with extracapsular invasion of axillary lymph node metastases? Strahlenther Onkol. 2003; 179: 661666.
  • 5
    Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005; 366: 20872106.
  • 6
    Huang E, Buchholz TA, Meric F, et al. Classifying local disease recurrences after breast conservation therapy based on location and histology: new primary tumors have more favorable outcomes than true local disease recurrences. Cancer. 2002; 95: 20592067.
  • 7
    Arthur DW, Vicini FA. Accelerated partial breast Irradiation as a part of breast conservation therapy. J Clin Oncol. 2005; 23: 17261735.
  • 8
    Baglan KL, Sharpe MB, Jaffray D, et al. Accelerated partial breast irradiation using 3D conformal radiation therapy (3D-CRT). Int J Radiat Oncol Biol Phys. 2003; 55: 302311.
  • 9
    Gatzemeier W, Orecchia R, Gatti G, Intra M, Veronesi U. Intraoperative radiotherapy (IORT) in treatment of breast carcinoma—a new therapeutic alternative within the scope of breast-saving therapy? Current status and future prospects. Report of experiences from the European Institute of Oncology (EIO), Mailand. Strahlenther Onkol. 2001; 177: 330337.
  • 10
    Keisch M, Vicini F, Kuske RR, et al. Initial clinical experience with the MammoSite breast brachytherapy applicator in women with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys. 2003; 55: 289293.
  • 11
    King TA, Bolton JS, Kuske RR, Fuhrman GM, Scroggins TG, Jiang XZ. Long-term results of wide-field brachytherapy as the sole method of radiation therapy after segmental mastectomy for T(is,1,2) breast cancer. Am J Surg. 2000; 180: 299304.
  • 12
    Kraus-Tiefenbacher U, Scheda A, Steil V, et al. Intraoperative radiotherapy for breast cancer using the Intrabeam system. Tumori. 2005; 91: 339345.
  • 13
    Magee B, Swindell R, Harris M, Banerjee SS. Prognostic factors for breast recurrence after conservative breast surgery and radiotherapy: results from a randomised trial. Radiother Oncol. 1996; 39: 223227.
  • 14
    Orecchia R, Ciocca M, Lazzari R, et al. Intraoperative radiation therapy with electrons (ELIOT) in early-stage breast cancer. Breast. 2003; 12: 483490.
  • 15
    Ott OJ, Potter R, Hammer J, et al. Accelerated partial breast irradiation with iridium-192 multicatheter PDR/HDR brachytherapy. Preliminary results of the German-Austrian Multicenter Trial. Strahlenther Onkol. 2004; 180: 642649.
  • 16
    Polgar C, Fodor J, Major T, et al. Radiotherapy confined to the tumor bed following breast conserving surgery current status, controversies, and future projects. Strahlenther Onkol. 2002; 178: 597606.
  • 17
    Strnad V, Ott O, Potter R, et al. Interstitial brachytherapy alone after breast conserving surgery: interim results of a German-Austrian multicenter phase II trial. Brachytherapy. 2004; 3: 115119.
  • 18
    Vaidya JS, Tobias JS, Baum M, et al. Intraoperative radiotherapy for breast cancer. Lancet Oncol. 2004; 5: 165173.
  • 19
    Vicini F, Winter K, Straube W, et al. A phase I/II trial to evaluate three-dimensional conformal radiation therapy confined to the region of the lumpectomy cavity for stage I/II breast carcinoma: initial report of feasibility and reproducibility of Radiation Therapy Oncology Group (RTOG) Study 0319. Int J Radiat Oncol Biol Phys. 2005; 63: 15311537.
  • 20
    Chen PY, Vicini FA, Benites P, et al. Long-term cosmetic results and toxicity after accelerated partial-breast irradiation: a method of radiation delivery by interstitial brachytherapy for the treatment of early-stage breast carcinoma. Cancer. 2006; 106: 991999.
  • 21
    Wazer DE, Berie L, Graham R, et al. Preliminary results of a phase I/II study of HDR brachytherapy alone for T1/T2 breast cancer. Int J Radiat Oncol Biol Phys. 2002; 53: 889897.
  • 22
    Poti Z, Nemeskeri C, Fekeshazy A, et al. Partial breast irradiation with interstitial 60CO brachytherapy results in frequent grade 3 or 4 toxicity. Evidence based on a 12-year follow-up of 70 patients. Int J Radiat Oncol Biol Phys. 2004; 58: 10221033.
  • 23
    Sanders ME, Scroggins T, Ampil FI, Li BD. Accelerated partial breast irradiation in early-stage breast cancer. J Clin Oncol. 2007; 25: 9961002.
  • 24
    Polgar C, Major T, Fodor J, et al. High-dose-rate brachytherapy alone versus whole breast radiotherapy with or without tumor bed boost after breast-conserving surgery: seven-year results of a comparative study. Int J Radiat Oncol Biol Phys. 2004; 60: 11731181.
  • 25
    Fentiman IS, Poole C, Tong D. Inadequacy of iridium implant as sole radiation treatment for operable breast cancer. Eur J Cancer. 1996; 32: 608611.
  • 26
    Perera F, Yu E, Engel J, et al. Patterns of breast recurrence in a pilot study of brachytherapy confined to the lumpectomy site for early breast cancer with six years minimum follow-up. Int J Radiat Oncol Biol Phys. 2003; 5: 12391246.
  • 27
    Krishnan L, Jewell WR, Tawfik OW, Krishnan EC. Breast conservation therapy with tumor bed irradiation alone in a selected group of patients with stage I breast cancer. Breast J. 2001; 2: 9196.
  • 28
    Vicini FA, Baglan KL, Kestin LL, et al. Accelerated treatment of breast cancer. J Clin Oncol. 2001; 19: 19932001.
  • 29
    Silverstein MJ. The University of Southern California/Van Nuys prognostic index for ductal carcinoma in situ of the breast. Am J Surg. 2003; 186: 337343.
  • 30
    Kuske RR, Winter K, Arthur DW, et al. Phase II trial of brachytherapy alone after lumpectomy for select breast cancer: toxicity analysis of RTOG 95–17. Int J Radiat Oncol Biol Phys. 2006; 65: 4551.
  • 31
    Polgar C, Strnad V, Major T. Brachytherapy for partial breast irradiation: the European experience. Semin Radiat Oncol. 2005; 15: 116122.
  • 32
    Dobelbower RR, Merrick HW, Eltaki A, et al. Intraoperative electron beam therapy and external photon beam therapy with lumpectomy as primary treatment for early breast cancer. Ann Radiol (Paris). 1989; 32: 497501.
  • 33
    Dubois JB, Hay M, Gely S, et al. IORT in breast carcinomas. Front Radiat Ther Oncol. 1997; 31: 131137.
  • 34
    Merrick HW3rd, Battle JA, Padgett BJ, Dobelbower RRJr. IORT for early breast cancer: a report on long-term results. Front Radiat Ther Oncol. 1997; 31: 126130.
  • 35
    Reitsamer R, Peintinger F, Kopp M, Menzel C, Kogelnik HD, Sedlmayer F. Local recurrence rates in breast cancer patients treated with intraoperative electron-boost radiotherapy versus postoperative external-beam electron-boost irradiation. A sequential intervention study. Strahlenther Onkol. 2004; 180: 3844.
  • 36
    Reitsamer R, Sedlmayer F, Kopp M, et al. The Salzburg concept of intraoperative radiotherapy for breast cancer: results and considerations. Int J Cancer. 2006; 118: 28822887.
  • 37
    Intra M, Leonardi C, Luini A, et al. Full-dose intraoperative radiotherapy with electrons in breast surgery: broadening the indications. Arch Surg. 2005; 140: 936939.
  • 38
    Herskind C, Steil V, Kraus-Tiefenbacher U, Wenz F. Radiobiological aspects of intraoperative radiotherapy (IORT) with isotropic low-energy X rays for early-stage breast cancer. Radiat Res. 2005; 163: 208215.
  • 39
    Kraus-Tiefenbacher U, Bauer L, Scheda A, et al. Long-term toxicity of an intraoperative radiotherapy boost using low energy X-rays during breast-conserving surgery. Int J Radiat Oncol Biol Phys. 2006; 66: 377381.
  • 40
    Vaidya JS, Baum M, Tobias JS, et al. Targeted intraoperative radiotherapy (TARGIT) yields very low recurrence rates when given as a boost. Int J Radiat Oncol Biol Phys. 2006; 661335661338.
  • 41
    Vaidya JS, Baum M, Tobias JS, et al. Targeted intra-operative radiotherapy (TARGIT): an innovative method of treatment for early breast cancer. Ann Oncol. 2001; 12: 10751080.
  • 42
    Gittleman M, Vigneri P, Carlson D, et al. Clinical evaluation of the Mammosite breast brachytherapy catheter: an analysis of technical reproducibility, acute toxicity, and patient demographics. Int J Radiat Oncol Biol Phys. 2003; 57: 365366.
  • 43
    Bartelink H. Commentary on the paper “A preliminary report of intraoperative radiotherapy (IORT) in limited-stage breast cancers that are conservatively treated.” A critical review of an innovative approach. Eur J Cancer. 2001; 37: 21432146.
  • 44
    Holland R, Connolly JL, Gelman R, et al. The presence of an extensive intraductal component following a limited excision correlates with prominent residual disease in the remainder of the breast. J Clin Oncol. 1990; 8: 113118.
  • 45
    Sinn HP, Anton HW, Magener A, von Fournier D, Bastert G, Otto HF. Extensive and predominant in situ component in breast carcinoma: their influence on treatment results after breast-conserving therapy. Eur J Cancer. 1998; 34: 646653.
  • 46
    Vicini FA, Beitsch PD, Quiet CA, et al. First analysis of patient demographics, technical reproducibility, cosmesis and early toxicity: results of the American Society of Breast Cancer Surgeons MammoSite breast Brachytherapy trial. Cancer. 2005; 104: 11381148.
  • 47
    Chao KK, Vicini FA, Wallace M, et al. Analysis of treatment efficacy, cosmesis, and toxicity using the MammoSite breast brachytherapy catheter to deliver accelerated partial-breast irradiation: the William Beaumont hospital experience. Int J Radiat Oncol Biol Phys. 2007 (in press).
  • 48
    NSABP B-39/ RTOG 0413. A randomized phase III study of conventional whole breast irradiation (WBI) versus partial breast irradiation (PBI) for women with stage 0, I or II breast cancer. Available at URL: Accessed January 2005.
  • 49
    Formenti SC, Truong MT, Goldberg JD, et al. Prone accelerated partial breast irradiation after breast-conserving surgery: preliminary clinical results and dose-volume histogram analysis. Int J Radiat Oncol Biol Phys. 2004; 60: 493504.
  • 50
    RAPID: randomized trial of accelerated partial breast irradiation. Available at URL:
  • 51
    Weed DW, Edmundson GK, Vicini FA, Chen PY, Martinez AA. Accelerated partial breast irradiation: a dosimetric comparison of three different techniques. Brachytherapy. 2005; 4: 121129.
  • 52
    Nairz O, Deutschmann H, Kopp M, et al. A dosimetric comparison of IORT techniques in limited stage breast cancer. Strahlenther Onkol. 2006; 182: 342348.
  • 53
    Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of radiotherapy and surgery in early breast cancer. An overview of the randomized trials. N Engl J Med. 1995; 333: 14441455.
  • 54
    Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials. Lancet. 2000; 355: 17571770.
  • 55
    Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002; 347: 12331241.
  • 56
    Rauschecker HF, Sauerbrei W, Gatzemeier W, et al. Eight-year results of a prospective non-randomised study on therapy of small breast cancer. The German Breast Cancer Study Group (GBSG). Eur J Cancer. 1998; 34: 315323.
  • 57
    Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002; 347: 12271232.
  • 58
    Fisher B, Bryant J, Dignam JJ, et al. Tamoxifen, radiation therapy, or both for prevention of ipsilateral breast tumor recurrence after lumpectomy in women with invasive breast cancers of one centimeter or less. J Clin Oncol. 2002; 20: 41414149.
  • 59
    Winzer KJ, Sauer R, Sauerbrei W, et al. Radiation therapy after breast-conserving surgery; first results of a randomised clinical trial in patients with low risk of recurrence. Eur J Cancer. 2004; 40: 9981005.
  • 60
    Fyles AW, McCready DR, Manchul LA, et al. Tamoxifen with or without breast irradiation in women 50 years of age or older with early breast cancer. N Engl J Med. 2004; 351: 963970.
  • 61
    Early Breast Cancer Trialist's Collaborative Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrences and 15-year survival: an overview of the randomised trials. Lancet. 2005; 365: 16871717.
  • 62
    American Society of breast cancer surgeons: consensus statement for accelerated breast irradiation. Available at URL:
  • 63
    Nag S, Kuske RR, Vicini FA, Arthur DW, Zwicker RD. Brachytherapy in the treatment of breast cancer. Oncology (Williston Park). 2001; 15: 195202.
  • 64
    Bentzen SM, Thames HD, Overgaard M. Latent-time estimation for late cutaneous and subcutaneous radiation reactions in a single-follow-up clinical study. Radiother Oncol. 1989; 15: 267274.
  • 65
    Rosenstein BS, Lymberis SC, Formenti SC. Biologic comparison of partial breast irradiation protocols. Int J Radiat Oncol Biol Phys. 2004; 60: 13931404.
  • 66
    Vaidya JS, Vyas JJ, Chinoy RF, Merchant N, Sharma OP, Mittra I. Multicentricity of breast cancer: whole-organ analysis and clinical implications. Br J Cancer. 1996; 74: 820824.
  • 67
    Suh W, Pierce L, Vicini F, Hayman JA. A cost comparison analysis of partial versus whole-breast irradiation after breast-conserving surgery for early-stage breast cancer. Int J Radiat Oncol Biol Phys. 2005; 62: 790796.
  • 68
    Wallner P, Arthur D, Bartelink H, et al. Workshop on partial breast irradiation: state of the art and the science, Bethesda, MD, December 8–10, 2002. J Natl Cancer Inst. 2004; 96: 175184.
  • 69
    Parkin DM, Bray F, Ferlay F, Pisani P. Global cancer statistics 2002. CA Cancer J Clin. 2005; 55: 74108.
  • 70
    Whelan T, Levine M. More evidence that locoregional radiation therapy improves survival: what should we do? J Natl Cancer Inst. 2005; 97: 8284.
  • 71
    Sauer R, Wenz F, Strnad V, Haase W, Souchon R, Sautter-Bihl ML. Teilbrustbestrahlung nach brusterhaltender Operation bei Brustkrebs. Strahlenther Onkol. 2005; 181: 417423.