Intraoperative radiation therapy of breast cancer. Evidence-based status

The standard technique of postoperative radiotherapy after breast-conserving surgery is percutaneous irradiation of the entire breast which is usually followed by a tumor bed boost. Due to the increased detection of small breast carcinomas by mammographic screening, it is necessary to consider a possible change of the existing therapeutic practice. Since the majority of local recurrences occur close to the former tumor bed, the question arises whether a sole tumor bed irradiation might be a therapeutic alternative to total breast irradiation. At present prospective and randomized studies investigate for which patients an intraoperative radiotherapy is sufficient as the sole irradiation method after previous surgery. Intraoperative radiotherapy as a boost preceding percutaneous whole-breast irradiation is already possible according to a relevant statement of the DEGRO.