Comparing cosmetic outcomes for external versus intraoperative radiotherapy in breast cancer patients

In this study, researchers examined two methods of delivering radiation therapy as a treatment for breast cancer. They compared the cosmetic outcomes of breasts treated with targeted intraoperative radiotherapy (TARGIT) or external beam radiotherapy (EBRT).

Medical and technological improvements have enhanced survival for breast cancer patients. Therefore, cosmetic outcome of the affected breast has become an important consideration of treatment. After surgery to remove a cancer (breast conserving surgery or lumpectomy), the breast can be exposed to radiation to reduce the risk of the cancer recurring. There are several forms of effective radiation therapy, including TARGIT and EBRT. EBRT uses a machine which aims the radiation beam to the cancer-affected area. Radiation from EBRT affects large areas of tissue and can cause disfiguring changes to the breast. TARGIT, on the other hand, delivers more focused radiation to the tissues surrounding the cancer in the operating room, immediately after the cancer has been removed. Therefore, it is reasonable to expect that TARGIT might cause fewer changes to the treated breast. In this study, researchers examined whether TARGIT leads to more cosmetically acceptable breasts than EBRT. 

This study included 342 patients diagnosed with early stage breast cancer who underwent breast conserving surgery. 178 of these patients received TARGIT and 164 received EBRT. Computer software analyzed breast symmetry and color to produce a score of excellent/good or EG (little or no disfiguration) and fair/poor or FP (substantial disfiguration). Photographs of patients’ breasts were analyzed 1 to 5 years after radiation. Overall, TARGIT patients were 61% more likely to have EG scores than EBRT patients. The benefits of TARGIT were especially clear 1 and 2 years after radiotherapy, where TARGIT patients were twice as likely to receive EG scores as EBRT patients.

In conclusion, TARGIT resulted in more cosmetically acceptable breasts than EBRT in breast cancer patients treated with breast conserving surgery.

This research was partly funded by the manufacturer of the equipment that performs TARGIT.

Ask your doctor whether TARGIT is a good radiation therapy option in your situation.