Intraoperative radiation therapy in second conservative surgeries for early breast cancer
Alberto Lanuza Carnicer,
Spain
PO-1202
Abstract
Intraoperative radiation therapy in second conservative surgeries for early breast cancer
Authors: Alberto Lanuza Carnicer1, Cecilia Escuin Troncho1, María Cerrolaza Pascual1, Victoria Navarro Aznar1, Julia Díaz Abad1, Arantxa Campos Bonel1, María Pilar Sanagustín Piedrafita1, José Miguel Ponce Ortega1, Francisco Javier Villalobos Salguero2, Ana Palomares Cano3, Virginia Rodrigo Vinue3, Cristina García Aguilera1, María Reyes Ibáñez Carreras1
1Hospital Universitario Miguel Servet, Radiation Oncology, Zaragoza, Spain; 2Hospital Universitario Miguel Servet, Gynecology and Obstetrics, Zaragoza, Spain; 3Hospital Universitario Miguel Servet, General Surgery and Digestive System, Zaragoza, Spain
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Purpose or Objective
Mastectomy
is the current standard treatment for recurrence of breast cancer (BC) or second
tumors after previous glandular irradiation. Breast-conserving surgery (BCS)
with reirradiation by intraoperative radiation therapy (IORT) in the
ipsilateral breast is an emerging technique in the treatment of early stage
cases.
Material and Methods
711 patients
with BC treated by IORT between may 2015 and septembrer 2021 were retrospectively
analyzed. Those with a previous history of ipsilateral BC who underwent a
second BCS and IOR were selected. A total of 20 Gy was administered with Axxent Xoft device during surgery. Different
variables such as pathological and radiological features, toxicities according
to the CTCAE scale (v.5) and local control were studied.
Results
Of the
total, 9 patients (1.27%) met the established selection criteria. The initial
treatment in 8 patients was BCS and external radiotherapy (EBRT) and in 1 BCS
and IORT. In the second BCS, IORT was administered to all patients. Mean time
between both surgeries was 12 years. In 3/9 cases (33.3%) the recurrence took
place in the same quadrant. 100% were invasive ductal carcinoma (IDC): 8
Luminal A (88.8%) and 1 triple negative (TN) wich was out of protocol due to
the patient’s refusal to mastectomy. The mean size was 11,4mm. In the ultrasound control one month after the
surgery, seroma was observed in 5 patients and glandular edema in 3 patients. Regarding
to dermatological toxicity, 2 patients developed acute G1 radiodermatitis and
only 1 patient developed chronic toxicity, that was resolved 6 months later. None
of the Luminal profile tumors recurred after a median follow-up of 23.6 months.
Conclusion
For those pacients with recurrent breast
cancer in the ipsilateral breast after previous glandular radiotherapy, second
breast-conserving surgery with IORT is a feasible treatment with excellent tolerance in selected cases
with a favorable prognosis profile.