The emerging role of brachytherapy in the management of patients with breast cancer.

Brachytherapy remains an important treatment option in the overall management of patients with breast cancer. In patients treated with breast conserving therapy (BCT), prospective randomized trials have established the advantage of a boost in most patients. Interstitial brachytherapy has consistently been shown to provide an important option to boost patients, and in certain clinical settings it may provide a more appropriate means of dose delivery. The concept of delivering partial breast irradiation with accelerated treatment schedules has now provided brachytherapy a new and exciting role in the management of patients treated with BCT. There are now data available from several phase I/II studies suggesting that brachytherapy alone can be used safely and reproducibly in this setting in order to reduce the time, inconvenience, and toxicity associated with traditional radiation therapy. Although preliminary results with brachytherapy alone are encouraging, proper patient selection and optimal dosimetric guidelines must be employed in order to achieve success when used in this setting.