Intraoperative electron beam therapy reduces risk of breast cancer recurrence

Intraoperative radiation therapy with electron beams appears to be a good substitute for a prolonged course of postoperative external radiation treatments, Italian physicians report. Not only does intraoperative therapy reduce the risk of tumor recurrence, it costs less, improves compliance, and avoids the treatment delays associated with conventional whole-breast radiation therapy.

Dr. Umberto Veronesi and associates at the European Institute of Oncology in Milan note in the Archives of Surgery for November that 85% of local relapses in the absence of radiation therapy occur in the operated area of the breast. Thus, they propose that the radiation’s role should be to destroy residual cancer cells in the operating field.They treated 237 patients with breast cancer whose tumors were < 2 cm in diameter. Surgery included wide excision with axillary node biopsy or dissection. A mobile linear accelerator was used to deliver 17 to 21 Gy, which required about 20 minutes of intraoperative time. Adverse effects included transient fibrosis in four patients and moderate skin retractions in two. Three patients developed ipsilateral breast carcinoma within 9 to 17 months after initial treatment, but the secondary cancers were all outside the radiation field.Dr. Veronesi's group points out with intraoperative treatment, radiation is not delayed for a course of adjuvant anthracycline drugs. The procedure also "markedly reduces radiation exposure to the skin, lung and subcutaneous tissues, contributing to a low incidence of radiation-induced sequelae."(Source: Arch Surg 2003;1138:1253-1256: Reuters Health: November 20, 2003: Oncolink)