{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T16:47:31Z","timestamp":1775753251516,"version":"3.50.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T00:00:00Z","timestamp":1764979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Partial breast irradiation (PBI) is an effective treatment for early-stage breast cancer. However, evidence comparing different PBI modalities is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This trial emulation uses electronic health records from a multi-state large tertiary health system. Three PBI modalities were compared: proton radiation therapy, photon radiation therapy, and applicator-based brachytherapy. Inverse probability weighting (IPW) was used to balance confounders. The primary outcome was ipsilateral breast recurrence (IBR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 2013 and 2023, 1041 women with early-stage breast cancer were treated with PBI. Of these, 1026 patients were included in the analyses. The median age was 66\u2009years; 22.51% had ductal carcinoma in situ (DCIS), and 97.56% were estrogen receptor positive. With median follow-up of 38.2\u2009months, the rate of IBR in the overall group was 3.05% (95% confidence interval [CI] = 1.99% to 4.65%) at 3\u2009years. After IPW, compared with photon PBI, the hazard ratio for IBR for proton PBI was 2.11 (95% CI = 0.70 to 6.33) and for brachytherapy, 3.86 (95% CI = 1.39 to 10.69). Compared with proton PBI, the hazard ratio for IBR for brachytherapy was 1.83 (95% CI = 0.88 to 3.81). IBR risk was similar across PBI modalities for patients with tumor size \u2264 10\u2009mm and in patients treated for DCIS. Among patients with tumor size &amp;gt;10\u2009mm, the hazard ratio for IBR for brachytherapy was 7.64 (95% CI = 1.64 to 35.58) and 3.59 (95% CI = 1.22 to 10.56) relative to photons and protons, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PBI with applicator-based brachytherapy was associated with higher IBR than photon or proton PBI in patients with tumor size &amp;gt; 10\u2009mm, suggesting the need for more careful PBI patient selection for this modality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djaf346","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T13:44:03Z","timestamp":1764942243000},"page":"691-698","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of partial breast radiation modalities in women with early-stage breast cancer: a target trial emulation"],"prefix":"10.1093","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7758-8891","authenticated-orcid":false,"given":"Dean A","family":"Shumway","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly S","family":"Corbin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9522-014X","authenticated-orcid":false,"given":"Satomi","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9700-737X","authenticated-orcid":false,"given":"Magdoleen H","family":"Farah","sequence":"additional","affiliation":[{"name":"Mayo Clinic Evidence-Based Practice Center , Rochester, MN,","place":["United States"]},{"name":"Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0058-1875","authenticated-orcid":false,"given":"Farah","family":"Fleti","sequence":"additional","affiliation":[{"name":"Mayo Clinic Evidence-Based Practice Center , Rochester, MN,","place":["United States"]},{"name":"Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9531-4990","authenticated-orcid":false,"given":"Bashar","family":"Hasan","sequence":"additional","affiliation":[{"name":"Mayo Clinic Evidence-Based Practice Center , Rochester, MN,","place":["United States"]},{"name":"Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4713-624X","authenticated-orcid":false,"given":"Mohammed M","family":"Firwana","sequence":"additional","affiliation":[{"name":"Mayo Clinic Evidence-Based Practice Center , Rochester, MN,","place":["United States"]},{"name":"Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9225-1197","authenticated-orcid":false,"given":"Samer","family":"Saadi","sequence":"additional","affiliation":[{"name":"Mayo Clinic Evidence-Based Practice Center , Rochester, MN,","place":["United States"]},{"name":"Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9052-5537","authenticated-orcid":false,"given":"Tarek","family":"Nayfeh","sequence":"additional","affiliation":[{"name":"Mayo Clinic Evidence-Based Practice Center , Rochester, MN,","place":["United States"]},{"name":"Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8190-3915","authenticated-orcid":false,"given":"Moustafa","family":"Hegazi","sequence":"additional","affiliation":[{"name":"Mayo Clinic Evidence-Based Practice Center , Rochester, MN,","place":["United States"]},{"name":"Mayo Clinic Robert D. and Patricia E. 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