Intraoperative radiotherapy (IORT) in early stage breast cancer. Preliminary results in 77 patients

Purpose: To verify feasibility and effectiveness of IORT (intraoperative radiotherapy) in patients with early stage breast cancer, especially in regard to prevention of recurrence and treatment toxicity. Methods: From october 2000 to november 2006 we operated on 77patients with stage I breast cancer. We have selected these patients on the basis of a preestablished experimental IORT protocol, participing in a national research project. All these patients underwent a surgical procedure including quadrantectomy of the breast and IORT (average dose 23 Gy). Results: The median follow-up is 69 months (range 18-94 months). We didn't detected local relapses in any patient. One patients developed further cancer in the other breast. Two patients developed metastasis (one dead). The wound-healing average time was 8 days. We evalueted the treatment late toxicity at 36 months in 64patients: we detected circumscribedf ibrosis (grade 2) in 19 patients; fibrosis with skin retraction (grade 3) in 2 patients; symptomless fat-necrosis in 39 patients (mammographic finding). Conclusions: In our experience, concerning conservative treatment of early breast cancer, IORT proved to be a feasible procedure, causing poor morbidity. However, in spite of valuable preliminary results, a longer follow-up is required to establish the impact of IORT on relapse control and final cosmetic result.