Intraoperative Radiotherapy for Breast Cancer: Long-Term Experience

Area of Science:

• Oncology
• Radiation Oncology
• Surgical Oncology

Background:

• Targeted intraoperative radiation therapy (TARGIT-IORT) is an alternative to whole-breast external beam radiation for early-stage breast cancer.
• Current guidelines restrict TARGIT-IORT use, necessitating long-term outcome data in specific patient populations.
• This study evaluates long-term results of TARGIT-IORT in a carefully selected group of early breast cancer patients.

Purpose of the Study:

• To present long-term outcomes of TARGIT-IORT in a restricted population of early-stage breast cancer patients.
• To assess the efficacy and safety of TARGIT-IORT as a treatment option.
• To provide evidence supporting the use of TARGIT-IORT in suitable candidates.

Main Methods:

• Retrospective search of electronic records for women diagnosed with invasive ductal carcinoma (2014-2023).
• Inclusion criteria: age >50, unifocal disease, tumor size <3 cm, ER-positive, HER2-non-amplified.
• TARGIT-IORT (20 Gy single dose) delivered via applicator post-lumpectomy and SLNB, followed by clinical and imaging follow-up.

Main Results:

• 219 patients included (median age 66 years).
• Median follow-up of 85 months revealed low recurrence rates: 0.45% ipsilateral breast, 0.45% axillary lymph node, and 0.45% liver metastasis.
• Low toxicity: 9.1% minor wound complications, 1.4% fat necrosis, all self-limiting.

Conclusions:

• TARGIT-IORT demonstrates excellent local control and high survival rates in low-risk early breast cancer.
• The treatment exhibits a very low toxicity profile, consistent with previous trial data.
• TARGIT-IORT should be considered for suitable patients with early-stage, low-risk breast cancer.