Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May;24(5):829-835.
doi: 10.1007/s12094-021-02728-0. Epub 2021 Nov 18.

Intraoperative irradiation in breast cancer: preliminary results in 80 patients as partial breast irradiation or anticipated boost prior to hypo-fractionated whole breast irradiation

X Li  1 , J Sanz  2   3   4 , N Argudo  5 , M Vernet-Tomas  5 , N Rodríguez  6   7   8 , L Torrent  5 , E Fernández-Velilla  7 , O Pera  7 , Y Huang  1 , P Nicolau  5 , M Jiménez  5 , M Segura  5 , M Algara  1   7   8
Affiliations

Intraoperative irradiation in breast cancer: preliminary results in 80 patients as partial breast irradiation or anticipated boost prior to hypo-fractionated whole breast irradiation

X Li et al. Clin Transl Oncol. 2022 May.

Abstract

Purpose: To present the first results of intraoperative irradiation (IORT) in breast cancer with a low-energy photon system used as partial breast irradiation (PBI) or as an anticipated boost before whole breast hypo-fractionated irradiation (IORT + WBI), concerning tolerance, side effects, quality of life, and patient-reported outcomes.

Materials and methods: Eighty patients treated with an Intrabeam® system of 50 kV X-rays received a 20 Gy dose intraoperatively were included. Moderate daily hypofractionation of 2.7 Gy in 15 fractions up to 40.5 Gy was administered if high-risk factors were present. Acute post-operative toxicity, surgery complications, chronic toxicity, patient-reported cosmesis and Breast-Q questionnaire were performed at follow-up visits.

Results: Thirty-one patients were treated as PBI and the remaining 49 as IORT + WBI. Only the IORT + WBI group presented acute toxicity, mainly mild acute dermatitis (11 patients) and one subacute mastitis. A total of 20 patients presented fibrosis (18 patients grade I, 2 patients grade II), 15 (30.5%) patients in the IORT + WBI group and 3 (9.6%) patients in the group of PBI. The cosmesis evaluation in 73 patients resulted poor, fair, good or excellent in 2, 7, 38 and 26 patients, respectively. In PBI group Breast-Q scored higher, especially in terms of their psychosocial well-being (78 vs 65) and satisfaction with radiation-induced toxicity (77 vs 72, respectively) compared to IORT + WBI group.

Conclusion: IORT is a well-tolerated procedure with low toxicity, good cosmesis and favorable patient-reported outcomes mainly when administered as PBI.

Keywords: Boost; Breast cancer; Hypofractionation; Intraoperative irradiation; Partial breast irradiation; Patient reported outcomes.

PubMed Disclaimer

Conflict of interest statement

All authors declare they have no conflict of interest except Dr Algara that has received consulting honoraria from Sysmex and Aristo and speaking honoraria from Siemens and Roche.

Figures

Fig. 1
Fig. 1
Percentages of different utilized applicators
Fig. 2
Fig. 2
Breast-Q results for whole series and groups of PBI or IORT + WBI
See this image and copyright information in PMC

References

    1. Wild CP, Weiderpass E, Stewart BW. World Cancer Report: Cancer Research for Cancer Prevention. Lyon, France: International Agency for Research on Cancer. 2020. http://publications.iarc.fr/586. Accessed 1 May 2021.
    1. Fisher B, Anderson S, Bryant J, Margolese RG, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy and lumpectomy plus irradiation for the treatment of invasive breast cancer. New Eng J Med. 2002;16:1233–1241. doi: 10.1056/NEJMoa022152. - DOI - PubMed
    1. Veronesi U, Cascinelli N, Mariani L, Marco G, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;16:1227–1232. doi: 10.1056/NEJMoa020989. - DOI - PubMed
    1. Almahariq M, Quinn T, Siddiqui Z, et al. Breast conserving therapy is associated with improved overall survival compared to mastectomy in early-stage, lymph node-negative breast cancer. Radiother Oncol. 2020;142:186–194. doi: 10.1016/j.radonc.2019.09.018. - DOI - PubMed
    1. Fisher ER, Anderson S, Redmond C, Fisher B. Ipsilateral breast tumor recurrence and survival following lumpectomy and irradiation: pathological findings from NSABP protocol B-06. Semin Surg Oncol. 1992;8:161–166. - PubMed