BrUOG 351: PRE-OPERATIVE APBI USING NIBB (351)

Inclusion Criteria:

• Confirmed histological diagnosis of invasive breast carcinoma and/or DCIS (Invasive lobular carcinoma excluded);
• Age greater or equal to 60 years old;
• Life expectancy > 6 months;
• Candidate for breast conserving surgery who intends to undergo breast conserving surgery as confirmed in writing by treating physician in consultation with surgeon
• Clinically lymph node negative (cN0) as confirmed in writing by patient's treating physician. If patient has suspicious lymphadenopathy on imaging it is required that patient undergo a biopsy to confirm cN0.
• Tumor size by imaging ≤ 2cm; (Tis or T1)
• Estrogen receptor positive if invasive disease (DCIS can be ER negative);
• Her2neu negative if invasive disease;
• Nuclear Grade 1 or 2 if invasive disease (DCIS can be Grade 3);
• ECOG performance status of 0-2 (Appendix 1);
• Informed consent signed.

Exclusion Criteria:

• Excisional biopsy or ipsilateral breast surgery within 6 months;
• Invasive lobular histology;
• Definitive LVSI on biopsy;
• Suspicious imaging findings suggesting multi-focal or multi-centric disease, unless biopsy proven benign;
• Paget's disease of the nipple
• Distant metastases;
• Known BRCA 1/2 Mutation
• Active lupus or scleroderma,;
• Psychiatric or addictive disorder that would preclude attending follow-up;
• Neoadjuvant chemotherapy or endocrine therapy (adjuvant therapy is permitted);
• Breast Implants;
• Tumor not well visualized on AccuBoost imaging;
• Breast separation with compression > 8cm at time of simulation.