Breast cancer patients could shorten radiation therapy with concentrated dose

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Shrinking the length of time breast cancer patients receive radiation therapy. A one-time dose delivered in the operating room during surgery helps some patients avoid weeks of fatigue and discomfort.
Dr Eric Donnelly, Northwestern Medicine radiation oncologist: “This lesion here is just 9.4 millimeters, just under a centimeter.”
Right after this small tumor in the breast was removed, Northwestern Medicine radiation oncologist Dr Eric Donnelly zapped the cavity left behind with a dose of radiation.
Dr Donnelly: “The majority of the dose is delivered to a couple centimeters within the breast.”
It’s called intraoperative radiation therapy – or IORT -- a one-time, concentrated dose delivered on the operating room table. It takes the place of multiple sessions of external beam or conventional radiation therapy, which is typically carried out over the course of six weeks.
Dr Donnelly: “In the actual lumpectomy cavity, while it’s still open, the applicator is placed inside that lumpectomy cavity, the surgeon closes the cavity around the applicator, we deliver the radiation, remove the applicator and then the breast is sewn back up.”
The goal of IORT is the same as conventional radiation -- to kill any microscopic cells left behind … cells that could travel and spread to other areas. But the localized dose helps minimize damage to surrounding healthy breast tissue and the nearby heart.
Dr Donnelly: “When we do the procedure at the same time as the surgery, it has shown to be as effective as radiation therapy.”
There are risks -- if the grade of the cancer turns out to be more aggressive than originally thought or a lymph node is involved – patients may end up needing even more radiation.
Dr Donnelly: “There is about 15 to 20 percent risk that after the surgery something surprises us on the pathology that you’re still going to have to have that external beam radiation afterwards. So the potential for some more side effects and scar tissue than you would traditionally encounter with external beam.”
Judith Shaw Beardsley, breast cancer patient: “Everyone agreed that I was a perfect subject for it, and I should save myself the rigors of radiation.”
Judith Shaw Beardsley made a leap of faith – she was one of the very first patients to receive IORT at Northwestern.
Judith Shaw Beardsley: “I was nervous about doing it because it was very new, it was nontraditional, and I thought, is it really going to work?”
So far it has. Judith has been cancer free for nearly four years. But IORT doesn’t work for every breast cancer patient. At Northwestern doctors offer the procedure only to those with invasive ductal carcinoma tumors.
Dr Donnelly: “Our ideal candidate is someone in their 60s and beyond, who has a small, early stage cancer. Traditionally, those individuals have less aggressive cancers, and their risk of recurrence is already low.”
Judith Shaw Beardsley: “I just never was aware that I had any procedure. I’m very glad, and I would recommend it to anyone who is told they are a good subject.”
Doctors at Northwestern say IORT is similar to conventional radiation in terms of risk of recurrence and survival. The data so far is based on four-year follow up, and they need to follow patients long term to see if those results hold true.
Interested patients can call 312.926.3021 or visit: http://cancer.northwestern.edu/public/why_northwestern/specialty_programs/programs/lynnsage.cfm

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