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Intraoperative high dose rate brachytherapy during breast-conserving surgery: A prospective pilot study
Åsa Wickberg1, Göran Liljegren2, Johan Ahlgren3
1Department of Surgery, Örebro University Hospital, S-701 85 Örebro, Sweden Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Summary
Intraoperative high dose rate brachytherapy is a feasible breast cancer treatment after breast-conserving surgery, showing good cosmetic outcomes and acceptable toxicity. Further trials are encouraged for early-stage breast cancer.
Area of Science:
- Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Breast-conserving surgery (BCS) is a standard treatment for early breast cancer.
- Optimizing adjuvant radiotherapy after BCS is crucial for local control and cosmesis.
- Intraoperative brachytherapy (IOBT) offers a potential method for targeted radiation delivery during surgery.
Purpose of the Study:
- To assess the feasibility, quality of life, toxicity, and cosmetic outcomes of IOBT using high dose rate (HDR) brachytherapy following BCS.
- To evaluate IOBT as a single-fraction radiotherapy boost delivered during the primary surgical procedure.
Main Methods:
- A pilot study involving 52 women (age ≥50) with unifocal, non-lobular breast cancer (≤3 cm, N0) undergoing BCS and sentinel node biopsy.
- Twenty-five women received IOBT pre-pathology; the remainder received it post-pathology in a second procedure.
- Quality of life, toxicity (LENT-SOMA scale), and cosmetic results (BCCT.core 2.0 software) were assessed.
Main Results:
- The IOBT procedure was logistically feasible with no serious adverse effects reported.
- Seven patients required supplementary external radiotherapy due to margins or applicator fit.
- Quality of life was comparable to the general Swedish population, with a majority reporting good cosmetic outcomes.
Conclusions:
- Intraoperative high dose rate brachytherapy is a feasible option for early breast cancer treatment post-BCS.
- The procedure demonstrates promising cosmetic results and acceptable toxicity.
- Further clinical trials are warranted to establish the role of IOBT in breast cancer management.
