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Intraoperative high dose rate brachytherapy during breast-conserving surgery: A Prospective Pilot Study
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Surgery, Örebro University Hospital, Örebro, Sweden .
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
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2021 (English)In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 110, no 3, p. 312-321Article in journal (Refereed) Published
Abstract [en]

Purpose: To evaluate feasibility, quality of life, toxicity, and cosmetic outcome for intraoperative breast cancer brachytherapy after breast-conserving surgery using high dose rate brachytherapy.

Methods and materials: Fifty-two consecutive women, > 50 years old, diagnosed with a unifocal non-lobular breast cancer <= 3 cm, N0, underwent breast-conserving surgery and sentinel node biopsy. Twenty-five women received intraoperative brachytherapy pre-pathology at primary surgery and the others post-pathology, during a second procedure. An applicator, connected to a high dose rate afterloader, was used. Two of the women were excluded due to metastases found per-operatively at a frozen section from the sentinel node. Quality of life was evaluated using two validated health questionnaires. Treatment toxicity was documented according to the LENT-SOMA scale by two oncologists. The cosmetic result was evaluated using the validated freely available software BCCT.core 2.0.

Results: The clinical procedure worked out well logistically. Seven women received supplementary external radiotherapy due to insufficient margins and, in one case, poor adaptation of the breast parenchyma to the applicator. No serious adverse effects from irradiation were registered. The results from the health questionnaires showed no major differences compared with reference groups from the Swedish population. Only two women were registered as having a "poor" cosmetic result while a majority of the women had a "good" outcome.

Conclusion: This pilot study shows that intraoperative brachytherapy is a feasible procedure and encourages further trials evaluating its role in treatment of early breast cancer.

Place, publisher, year, edition, pages
Sage Publications, 2021. Vol. 110, no 3, p. 312-321
Keywords [en]
Intraoperative brachytherapy, endocrine therapy, breast-conserving surgery, local recurrence, partial-breast radiation
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-81217DOI: 10.1177/1457496920903975ISI: 000523553000001PubMedID: 32228155Scopus ID: 2-s2.0-85082970131OAI: oai:DiVA.org:oru-81217DiVA, id: diva2:1424949
Note

Funding Agencies:

Local Research Committee  

Key Foundation of Örebro University Hospital, Sweden  

Available from: 2020-04-20 Created: 2020-04-20 Last updated: 2021-11-30Bibliographically approved

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