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Permanent low-dose-rate seed implantation as single-session partial breast irradiation: Long-term outcomes using a modified institutional protocol.

Created on 06 Oct 2026

Authors

Uri Amit, Tyler Meyer, Michael Roumeliotis, Karen Long, Siraj Husain

Published in

Brachytherapy. Oct 05, 2026. Epub Oct 05, 2026.

Abstract

To report long-term oncologic, cosmetic, and toxicity outcomes of permanent breast seed implantation (PBSI) using palladium-103 as accelerated partial breast irradiation (APBI) for early-stage breast cancer.
This prospective, single-institution study enrolled 27 patients in 2013-2015. Our protocol modified the Sunnybrook approach by incorporating general anesthesia, a side-mounted stepper, and immediate postimplant CT verification. Eligibility criteria included age ≥50 years, tumor ≤3 cm, margins ≥2 mm, node-negative invasive or in situ ductal carcinoma, and no lymphovascular invasion. Ultrasound-guided implants were prescribed to deliver 90 Gy to the planning target volume (PTV). Cosmesis (Harvard Scale) and toxicity (CTCAE v3.0) were assessed.
At median follow-up of 10.0 years, no local recurrences, distant recurrences, or breast cancer deaths occurred. Overall survival was 96.3% at 5 years and 88.3% at 10 years. Median CTV V100 was 100%, PTV V90 97%, and PTV V100 94%. No Grade ≥3 toxicity occurred. Cosmesis remained excellent or good in ≥90% of evaluable patients through 5 years.
This adapted PBSI protocol achieved 10-year local control and breast cancer-specific survival of 100%, with preserved cosmesis and minimal toxicity, supporting PBSI as a safe, effective single-session APBI option for selected patients with favorable early-stage disease.

PMID:
42833954
Bibliographic data and abstract were imported from PubMed on 06 Oct 2026.

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