Intraoperative radiation therapy for breast cancer—Immediate and 30‐month oncological outcomes. Issue 5 (26th December 2019)

• Record Type: Journal Article
• Authors: Melnik, Idit; Yerushalmi, Rinat; Sobol, Yael; Magen, Ada; Givon‐Madhala, Osnat; Birinbaum, Yehudit; Fenig, Eyal; Sharon, Eran
• Is Part Of: Breast journal. Volume 26:Issue 5(2020)
• Page Start: 946
• Page End: 951
• Publication Date: 2019-12-26
• Subjects: early breast cancer -- electronic brachytherapy -- intraoperative radiation -- radiation -- recurrence score -- targeted radiotherapy; Breast -- Diseases -- Periodicals; Breast -- Cancer -- Periodicals; 618.19
• DOI: 10.1111/tbj.13708
• Languages: English
• ISSNs: 1075-122X

Abstract

Abstract: There is growing evidence that intraoperative radiation therapy (IORT) may be a viable option in selected patients with early breast cancer. This study reports our 4‐year experience with IORT. The perioperative outcome and imaging data of all patients who underwent IORT for early breast cancer at a tertiary medical center in 2014‐2018 were retrospectively retrieved. The cohort included 158 patients aged 52‐84 years (mean 68) with stage I (n = 137) or II (n = 21) breast cancer. Mean applicator size was 4.13 cm; IORT added a mean of 29 minutes to the operative time. Minor wound infections (n = 18, 11.4%) requiring antibiotics and drainage were the only postoperative complication. In 25 patients (15%), postoperative mammography demonstrated a seroma (n = 22) or fat necrosis (n = 3). The risk of wound infection or a new postoperative imaging finding was unrelated to patient age, operative time, tumor size, or comorbid diabetes or obesity. After a mean of 30 months' follow‐up, none of the patients who met the institutional criteria for IORT had local recurrence, regardless of age, histology, tumor grade, KI67 proliferation index, pathologic stage, Recurrence Score, or additional whole‐breast irradiation or adjuvant treatment. Patients for whom a Recurrence Score was determined (n = 55, 35%) had a significantly higher tumor grade, pathologic stage, and whole‐breast irradiation/adjuvant chemotherapy rate than the remaining patients. IORT may be a safe alternative to traditional external beam radiation in well‐selected patients with early breast cancer, with few minor complications and good 30‐month outcome.