Annals of Surgical Oncology

, Volume 18, Issue 2, pp 453–458 | Cite as

Twelve-Month Follow-Up Results of a Trial Utilizing Axxent Electronic Brachytherapy to Deliver Intraoperative Radiation Therapy for Early-Stage Breast Cancer

  • Olga IvanovEmail author
  • Adam Dickler
  • Bennett Y. F. Lum
  • James V. Pellicane
  • Darius S. Francescatti
Breast Oncology



Accelerated partial breast irradiation (APBI) is emerging as a valid alternative to whole-breast radiation therapy (WBRT) in breast-conserving therapy (BCT) for early-stage breast cancer. Axxent electronic brachytherapy (EBX) is a form of portable, balloon-based APBI that utilizes an electronic source of kilovoltage irradiation delivery with minimal shielding requirements. As such, EBX becomes a logical and convenient modality for delivery of intraoperative radiation therapy (IORT). We report 1-year results and clinical outcomes of a trial that utilizes EBX to deliver IORT for patients with early-stage breast cancer.


Eleven patients were enrolled on an institutional review board (IRB)-approved protocol. Inclusion criteria were patient age >45 years, unifocal tumors with infiltrating ductal or ductal carcinoma in situ (DCIS) histology, tumors ≤3 cm, and uninvolved lymph nodes. Preloaded radiation plans were used to deliver radiation prescription dose of 20 Gy to the balloon surface.


The mean time for radiation delivery was 22 min; the total mean procedure time was 1 h 39 min. All margins of excision were negative on final pathology. At mean follow-up of 12 months, overall cosmesis was excellent in 10 of 11 patients. No infection, fat necrosis, desquamation, rib fracture or cancer recurrence has been observed. There was no evidence of fibrosis at last follow-up.


IORT utilizing EBX is emerging as a feasible, well-tolerated alternative to postsurgical APBI. Further research and longer follow-up data on EBX and other IORT methods are needed to establish the clinical efficacy and safety of this treatment.


Sentinel Lymph Node Biopsy Accelerate Partial Breast Irradiation Mammographic Finding Retention Suture Lumpectomy Cavity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors wish to thank the patients and their families for participating in this study. The authors would like to acknowledge Leslie Todd for assistance with medical writing.


Olga Ivanov, MD, Bennet Lum, MD, and James Pellicane, MD have nothing to disclose. Adam Dickler, MD is on the Scientific Advisory Board for Xoft, Inc. Darius Francescatti, MD is a Consulting Surgical Medical Director for Xoft, Inc.


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Copyright information

© Society of Surgical Oncology 2010

Authors and Affiliations

  • Olga Ivanov
    • 1
    Email author
  • Adam Dickler
    • 2
  • Bennett Y. F. Lum
    • 3
  • James V. Pellicane
    • 4
  • Darius S. Francescatti
    • 5
  1. 1.Department of SurgeryLittle Company of Mary HospitalEvergreen ParkUSA
  2. 2.Department of Radiation OncologyLittle Company of Mary HospitalEvergreen ParkUSA
  3. 3.Department of RadiologyLittle Company of Mary HospitalEvergreen ParkUSA
  4. 4.Department of SurgeryVirginia Breast CenterMidlothianUSA
  5. 5.Department of SurgeryRush University Medical CenterChicagoUSA

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