PURPOSE: To evaluate the long-term toxicity, cosmesis, and local control of accelerated
partial breast irradiation with implant brachytherapy after wide local excision for Stage T1N0
breast cancer (BCa). MATERIALS AND METHODS: Between 1997 and 2001, 50 patients
with Stage T1N0M0 BCa were treated in a Phase I-II protocol using low-dose-rate
accelerated partial breast irradiation with implant brachytherapy after wide local excision
and lymph node surgery. The total dose was escalated in three groups: 50 Gy (n= 20), 55 Gy …

Results Median follow-up was 10.5 years (range, 3–14). Patient and physician assessment
of cosmesis and toxicity were well correlated (τ 0.6–1; p< 0.0001). Patient satisfaction was
90% and 67% reported good-excellent cosmesis. Higher dose correlated with worse
cosmesis (τ 0.47; p= 0.0003) and lower patient satisfaction (τ 0.46; p< 0.001). Moderate-
severe fibrosis was noted in 55% of patients and correlated with higher dose (τ 0.56; p<
0.0001). Forty percent of patients had fat necrosis, 35% had telangiectasias≥ 2 cm and 46 …