Table 3.
Patients “Suitable” for APBI if all criteria are present | “Cautionary” group: any of these criteria should invoke caution and concern when considering APBI | Patients “Unsuitable” for APBI outside of a clinical trial if any these criteria are present | |
---|---|---|---|
Factor | Criterion | Criterion | Criterion |
Patient factors | |||
Age | ≥60 y | 50–59 years | <50 years |
BRCA 1/2 mutation | Not present | Present | |
Pathologic factors | |||
Tumor size | ≤2 cm | 2.1–3.0 cm | >3 cm |
T stage | T1 | T0 or T2 | T3-4 |
Margins | Negative by at least 2 mm | Close (<2 mm) | Positive |
Grade | Any | ||
LVSI | No | Limited/focal | Extensive |
ER status | Positive | Negative† | |
Multicentricity | Unicentric only | Present | |
Multifocality | Clinically unifocal with total size ≤2.0 cm‡ | Clinical unifocal with total size 2.1–3.0 cm ‡ | If microscopically multifocal >3 cm in total size or if clicnically multifocal |
Histology | Invasive ductal or other favorable subtypes§ | Invasive lobular | |
Pure DCIS | Not allowed | ≤3 cm | If >3 cm in size |
EIC | Not allowed | ≤3 cm | If >3 cm in size |
Associated LCIS | Allowed | ||
Nodal factors | |||
N stage | pNO (¡-, ¡+) | pN1, pN2, pN3 | |
Nodal surgery | SN Bx or ALND׀׀ | None performed | |
Treatment factors | |||
Neoadjuvant therapy | Not allowed | If used |
Adaptation From: Smith BD, Arthur DW, Buchholz, TA, et al. “Accelerated partial breast consensus statement from the American Society for Radiation Oncology (ASTRO).” Int J Radiat Oncol Biol Phys 74, no. 4 (July 2009): 987–1001