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Posted by on Jan 23, 2017 in Breast cancer | 0 comments

In a nutshell

This study investigated the complications that occur after intraoperative radiation therapy (IORT) treatment. The authors concluded that IORT is generally a safe treatment to use with BCS.

Some background

Breast-conserving surgery (BCS) treats breast cancer by removing just the tumor from the affected breast. IORT is sometimes used during BCS. If cancer returns it is usually near the site of the original tumor. Because of this, IORT delivers a high dose of radiation to the site where the tumor is being removed. 

IORT is an alternative to whole-breast radiation therapy, which is often inconvenient, and has many side effects. Information on the side effects of IORT is limited.

Methods & findings

This study examined 702 patients who underwent BCS and IORT. They were followed up after 1 week, 1 month, 6 months, 1 year, and then yearly. Complications following surgery were examined.

Acute complications are those that occurred within the 1st month after surgery. 23% of patients experienced acute complications. The most common was erythema (reddening of skin), experienced by 21% of patients. Erythema was mild in 84% of these patients. More serious acute complications like hematoma (collection of blood outside the blood vessels), seromas (fluid build-up under the skin), infections, and necrosis (tissue death), occurred in less than 1.5% of patients.

Chronic complications are those that are still present after 6 months. 18% of patients experienced chronic complications. Fibrosis (thickening of tissue), occurring in 10% of patients, and darkening of patches of skin, occurring in 7.7%, were the most common. The majority of these complications were minor. Chronic seromas occurred in 2.3% of patients.

In total 33% of patients experienced at least one form of complication. The majority of these were minor, with only 4.6% experiencing significant complications. Most patients who developed complications had more than one. No patients were hospitalized for either acute or chronic complications. 

12 patients experienced local recurrences, and 1 experienced a regional nodal recurrence. 4 of the patients experiencing local recurrences had been recommended whole-breast radiation therapy as well as IORT, but refused. 

The bottom line

This study concluded that IORT is generally a safe treatment to use with BCS. Some patients who are treated with IORT do experience complications, but most of these are minor. 

The fine print

While this study indicates that IORT is a relatively safe treatment option, the follow-up period was very short, and conclusive evidence about recurrence and breast cancer survival, when IORT is used, is difficult to draw from this study. Furthermore, this study did not examine patients undergoing any other form of treatment for comparison.

What’s next?

If your physician is recommending BCS, discuss the safety and use of IORT instead of, or in addition to, whole-breast radiation therapy.
Published By :

Annals of Surgical Oncology

Date :

Jun 22, 2016

Original Title :

Acute and Chronic Complications in Breast Cancer Patients Treated with Intraoperative Radiation Therapy.

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