Skip to main content
SpringerLink
Log in

Breast Cancer

  • Chapter
  • First Online:
Intraoperative Irradiation

Part of the book series: Current Clinical Oncology ((CCO))

Abstract

Globally, breast cancer incidence rates are highest in North America and northern Europe, and lowest in Asia and Africa [1]. Incidence rates in Japan and urban China have been rising in recent years. In the USA, breast cancer is the most common female cancer, the second most common cause of cancer death in women, and the main cause of death in women aged 45–55 years. Breast cancer mortality rates have declined since 1975, attributed to the increased use of screening mammography and greater use of adjuvant treatments including radiotherapy. For locoregional treatment, breast-conserving therapy is regarded as standard of care, comprising breast-conserving surgery followed by ipsilateral whole-breast radiotherapy (WBRT) as an integral component.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Costanza ME, Chen WY. Epidemiology and risk factors for breast cancer. UptoDate version 17.02, July 2009 online version.

    Google Scholar 

  2. Sautter-Bihl ML, Budach W, Dunst J. DEGRO practical guidelines for radiotherapy of breast cancer I: breast-conserving therapy. Strahlenther Onkol. 2007;183(12):661–6.

    Article  PubMed  Google Scholar 

  3. Holland R, Veling SH, Mravunac M, et al. Histologic multifocality of Tis, T1–2 carcinomas. Implications for clinical trials of breast-conserving surgery. Cancer. 1985;56:979–90.

    Article  PubMed  CAS  Google Scholar 

  4. Faverly DR, Hendriks JH, Holland R. Breast carcinomas of limited extent: frequency, radiologic-pathologic characteristics, and surgical margin requirements. Cancer. 2001;91(4):647–59.

    Article  PubMed  CAS  Google Scholar 

  5. Veronesi U, Marubini E, Mariani L, et al. Radiotherapy after breast-conserving surgery in small breast carcinoma: long-term results of a randomized trial. Ann Oncol. 2001;12(7):997–1003.

    Article  PubMed  CAS  Google Scholar 

  6. Romestaing P, Lehingue Y, Carrie C, Coquard R, et al. Role of a 10-Gy boost in the conservative treatment of early breast cancer: results of a randomized clinical trial in Lyon, France. J Clin Oncol. 1997;15(3):963–8.

    PubMed  CAS  Google Scholar 

  7. Bartelink H, Horiot JC, Poortmans PM, et al. Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-year results of the randomized boost versus no boost EORTC 22881-10882 trial. J Clin Oncol. 2007;25(22):3259–65.

    Article  PubMed  Google Scholar 

  8. Antonini N, Jones H, Horiot JC, Poortmans P, et al. Effect of age and radiation dose on local control after breast conserving treatment: EORTC trial 22881-10882. Radiother Oncol. 2007;82(3):265–71.

    Article  PubMed  Google Scholar 

  9. Fowler JF. The linear-quadratic formula and progress in fractionated radiotherapy. Br J Radiol. 1989;62(740):679–94.

    Article  PubMed  CAS  Google Scholar 

  10. Bentzen SM, Agrawal RK, Aird EG, et al. The UK standardisation of breast radiotherapy (START) trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet. 2008;371(9618):1098–107.

    Article  PubMed  CAS  Google Scholar 

  11. Whelan TJ, Kim DH, Sussman J. Clinical experience using hypofractionated radiation schedules in breast cancer. Semin Radiat Oncol. 2008;18:257–64.

    Article  PubMed  Google Scholar 

  12. Bartelink H. Commentary on the paper “a preliminary report of intraoperative radiotherapy (IORT) in limited-stage breast cancers that are conservatively treated”. A critical review of an innovative approach. Eur J Cancer. 2001;37:2143–6.

    Article  PubMed  CAS  Google Scholar 

  13. Nairz O, Deutschmann H, Kopp M, et al. A dosimetric comparison of IORT techniques in limited-stage breast cancer. Strahlenther Onkol. 2006;182(6):342–8.

    Article  PubMed  Google Scholar 

  14. Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227–32.

    Article  PubMed  Google Scholar 

  15. Dubois JB, Hay M, Gely S, et al. IORT in breast carcinomas. Front Radiat Ther Oncol. 1997;31:131–7.

    Article  PubMed  CAS  Google Scholar 

  16. Merrick HW, Battle JA, Padgett BJ, Dobelbower RR. IORT for early breast cancer: a report on long term results. Front Radiat Ther Oncol. 1997;31:126–30.

    Article  PubMed  Google Scholar 

  17. Battle JA, DuBois JB, Merrick HW, Dobelbower RR. IORT for breast cancer. In: Gunderson LL, Willett CG, Harrison LB, Calvo FA, editors. Current clinical oncology: intraoperative irradiation techniques and results. Totwa, NJ: Humana; 1999. p. 521–6.

    Google Scholar 

  18. Veronesi U, Orecchia R, Luini A, et al. A preliminary report of intraoperative radiotherapy (IORT) in limited-stage breast cancers that are conservatively treated. Eur J Cancer. 2001;37:2178–83.

    Article  PubMed  CAS  Google Scholar 

  19. Sedlmayer F, Reitsamer R, Menzel C, et al. IORT with electrons in limited-stage breast cancer – a novel boost strategy during breast conserving therapy. In: Kogelnik HD, Lukas P, Sedlmayer F, editors. Progress in radio-oncology VII. Bologna: Monduzzi Editore; 2002. p. 323–32.

    Google Scholar 

  20. Mansfield CM, Komarnicky LT, Schwartz GF, et al. Perioperative Implantation of Ir-192 as the boost technique for stage I and II breast cancer: Results of a 10-year study of 655 patients. Radiology. 1994;192:33–6.

    PubMed  CAS  Google Scholar 

  21. Orecchia R, Ciocca M, Lazzari R, et al. Intraoperative radiation therapy with electrons (ELIOT) in early-stage breast cancer. Breast. 2003;12:483–90.

    Article  PubMed  CAS  Google Scholar 

  22. Edmundson GK, Vicini FA, Chen PY, et al. Dosimetric characterisation of the MammoSite RTS, a new breast brachytherapy applicator. Int J Radiat Oncol Biol Phys. 2002;52:1132–9.

    Article  PubMed  Google Scholar 

  23. Gittleman M, Vigneri P, Carlson D, et al. Clinical evaluation of the mammosite breast brachytherapy catheter: an analysis of technical reproducibility, acute toxicity, and patient demographics. Int J Radiat Oncol Biol Phys. 2003;57:365–6.

    Article  Google Scholar 

  24. Kraus-Tiefenbacher U, Steil V, Bauer L, et al. A novel mobile device for intraoperative radiotherapy (IORT). Onkologie. 2003;26:596–8.

    Article  PubMed  CAS  Google Scholar 

  25. Vaidya JS, Baum M, Tobias JS, et al. Targeted intra-operative radiotherapy (Targit): an innovative method of treatment for early breast cancer. Ann Oncol. 2001;12:1075–80.

    Article  PubMed  CAS  Google Scholar 

  26. Ciabattoni A, Fortuna G, Ciccone V. IORT in breast cancer as boost: preliminary results of a pilot randomized study on use of IORT for stage I and II breast cancer. Radiother Oncol. 2004;73.

    Google Scholar 

  27. Kraus-Tiefenbacher U, Bauer L, Scheda A, et al. Long-term toxicity of an intraoperative radiotherapy boost using low energy X-rays during breast-conserving surgery. Int J Radiat Oncol Biol Phys. 2006;66(2):377–81.

    Article  PubMed  Google Scholar 

  28. Reitsamer R, Sedlmayer F, Kopp M, et al. The Salzburg concept of intraoperative radiotherapy for breast cancer: results and considerations. Int J Cancer. 2006;118(11):2882–7.

    Article  PubMed  CAS  Google Scholar 

  29. Reitsamer R, Peintinger F, Sedlmayer F, et al. Intraoperative radiotherapy given as a boost after breast conserving surgery in breast cancer patients. Eur J Cancer. 2002;38(12):1607–10.

    Article  PubMed  CAS  Google Scholar 

  30. Lemanski C, Azria D, Thezenas S, Gutowski M, Saint-Aubert B, Rouanet P, et al. Intraoperative radiotherapy given as a boost for early breast cancer: long-term clinical and cosmetic results. Int J Radiat Oncol Biol Phys. 2006;64(5):1410–5.

    Article  PubMed  Google Scholar 

  31. Ivaldi GB, Leonardi MC, Orecchia R, et al. Preliminary results of electron intraoperative therapy boost and hypofractionated external beam radiotherapy after breast- conserving surgery in premenopausal women. Int J Radiat Oncol Biol Phys. 2008;72:485–93.

    Article  PubMed  Google Scholar 

  32. Joseph DJ, Bydder S, Jackson LR, Corica T, et al. Prospective trial of intraoperative radiation treatment for breast cancer. ANZ J Surg. 2004;74(12):1043–8.

    Article  PubMed  Google Scholar 

  33. Vaidya JS, Baum M, Tobias JS, Massarut S, Wenz F, Murphy O, et al. Targeted intraoperative radiotherapy (TARGIT) yields very low recurrence rates when given as a boost. Int J Radiat Oncol Biol Phys. 2006;66(5):1335–8.

    Article  PubMed  Google Scholar 

  34. Sedlmayer F, Fastner G, Merz F, et al. Radiother Oncol 2009;97:83 (Suppl 1), S1.

    Google Scholar 

  35. Reitsamer R, Peintinger F, Kopp M, et al. Local recurrence rates in breast cancer patients treated with intraoperative electron-boost radiotherapy versus postoperative external-beam electron-boost irradiation. A sequential intervention study. Strahlenther Onkol. 2004;180(1):38–44.

    Article  PubMed  Google Scholar 

  36. Sedlmayer F, Fastner G, Merz F, et al. IORT with electrons as boost strategy during breast conserving therapy in limited stage breast cancer: results of an ISIORT pooled analysis. Strahlenther Onkol. 2007;183 Spec No 2:32–4

    Google Scholar 

  37. Frasson AL, Zerwes FP, Braga AP, Barbosa FS, Koch HA, Frasson AL, et al. Intraoperative radiotherapy in the conventional linear accelerator room for early breast cancer treatment: an alternative choice in developing countries. J Exp Clin Cancer Res. 2007;26(3):379–84.

    PubMed  CAS  Google Scholar 

  38. Mussari S, Sabino Della Sala W, Busana L, et al. Full-dose intraoperative radiotherapy with electrons in breast cancer. First report on late toxicity and cosmetic results from a singleinstitution experience. Strahlenther Onkol. 2006;182(10):589–95.

    Article  PubMed  Google Scholar 

  39. Ollila DW, Klauber-DeMore N, Tesche LJ, et al. Feasibility of breast preserving therapy with single fraction in situ radiotherapy delivered intraoperatively. Ann Surg Oncol. 2007;14(2):660–9.

    Article  PubMed  Google Scholar 

  40. Proulx GM, Hurd T, Lee RJ, Stomper PC, et al. Intraoperative radiation therapy (IORT) to the tumor bed only for breast cancer: technique and outcome. Radiat Oncol. 2001;35:35–41.

    Google Scholar 

  41. Veronesi U, Orecchia R, Luini A, et al. Full-dose intraoperative radiotherapy with electrons during breastconserving surgery: experience with 590 cases. Ann Surg. 2005;242(1):101–6.

    Article  PubMed  Google Scholar 

  42. Intra M, Leonardi C, Luini A, et al. Full-dose intraoperative radiotherapy with electrons in breast surgery: broadening the indications. Arch Surg. 2005;140(10):936–9.

    Article  PubMed  Google Scholar 

  43. Baum M, Vaidya JS. Targeted intra-operative radiotherapy-TARGIT for early breast cancer. Ann NY Acad Sci. 2008;1138:132–5.

    Article  PubMed  Google Scholar 

  44. Kraus-Tiefenbacher U, Bauer L, Kehrer T, et al. Intraoperative radiotherapy (IORT) as a boost in patients with early-stage breast cancer – acute toxicity. Onkologie. 2006;3:77–82.

    Article  Google Scholar 

  45. Lemanski C, Azria D, Gourgon-Bourgade S, et al. Intraoperative radiotherapy in early-stage breast cancer: results of the Montpellier Phase II Trial. Int J Radiat Oncol Biol Phys. 2009;17(6):617–22.

    Google Scholar 

  46. Wenz F, Welzel G, Keller A, et al. Early initiation of external beam radiotherapy (EBRT) may increase the risk of long-term toxicity in patients undergoing intraoperative radiotherapy (IORT) as a boost for breast cancer. Breast. 2008;17(6):617–22.

    Article  PubMed  Google Scholar 

  47. Petit JY, Veronesi U, Orecchia R, et al. Nipple sparing mastectomy with nipple areola intraoperative radiotherapy: one thousand and one cases of a five years experience at the European institute of oncology of Milan (EIO). Breast Cancer Res Treat. 2009;117(2):333–8.

    Article  PubMed  CAS  Google Scholar 

  48. Vaidya JS, Joseph DJ, Tobias JS, et al. Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomized, non-inferiority phase 3 trial. Lancet. 2010:376:91–102.

    Google Scholar 

  49. Veronesi U, Orecchia R, Luini A, et al. Intraoperative radiotherapy during breast conserving surgery: a study on 1,822 cases treated with electrons. Breast Cancer Res Treat. DOI 10.1007/s10549-010-1115-5.

    Google Scholar 

  50. Sautter-Bihl ML, Sedlmayer F, Budach W, et al. Intraoperative radiotherapy as accelerated partial breast irradiation for early breast cancer: beware of one-stop shops? Strahlenther Onkol. 2010;186(12):651–7.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiotherapy and Radio-Oncology, Paracelsus Medical University Clinics, Salzburg, Austria

    Felix Sedlmayer & Gerd Fastner

  2. Department of Radiotherapy, Centre Regional de Lutte Contre Le Cancer (CRLC), Montpellier, France

    Jean-Bernard DuBois

  3. Department of Special Gynecology / Breast Unit, General Hospital, Paracelsus Medical University Clinics, Salzburg, Austria

    Roland Reitsamer

  4. Department of Surgery, Division of Surgical Oncology and Endocrine Surgery, University of North Carolina, Chapel Hill, USA

    David Olilla

  5. Department of Radiotherapy, European Institute of Oncology (EIO), Milano, Italy

    Roberto Orecchia

Authors
  1. Felix Sedlmayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jean-Bernard DuBois
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roland Reitsamer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gerd Fastner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Olilla
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Roberto Orecchia
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Felix Sedlmayer .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, Mayo Clinic, East Shea Blvd 13400, Scottsdale, 85259, Arizona, USA

    Leonard L. Gunderson

  2. Dept. Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA

    Christopher G. Willett

  3. Gregorio Marañón, Depto. Radiación de Oncología, Hospital General Universitario, C/ Dr. Esquerdo 46, Madrid, 28007, Spain

    Felipe A. Calvo

  4. Albert Einstein College of Medicine, Radiation Oncology, Beth Israel Medical Center, Union Square East 10, New York, 10003, New York, USA

    Louis B. Harrison

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Sedlmayer, F., DuBois, JB., Reitsamer, R., Fastner, G., Olilla, D., Orecchia, R. (2011). Breast Cancer. In: Gunderson, L., Willett, C., Calvo, F., Harrison, L. (eds) Intraoperative Irradiation. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-61779-015-7_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-61779-015-7_10

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-61779-014-0

  • Online ISBN: 978-1-61779-015-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation