Early mammographic and sonographic findings after intraoperative radiotherapy (IORT) as a boost in patients with breast cancer.
The aim of this study was to evaluate mammographic and sonographic changes at the surgical site within the first 2 years after IORT as a boost followed by whole-breast radiotherapy (WBRT), compared with a control group treated with WBRT alone. All patients had breast-conserving surgery for early-stage breast cancer. Group A: n = 27, IORT (20 Gy) followed by WBRT (46 Gy). Group B (control group): n = 27, WBRT alone (56-66 Gy). Mammography: fat necrosis in 14 group A versus four group B patients (P < 0.001); parenchymal scarring classified as unorganized at the last follow-up in 16 vs seven cases, respectively (P = 0.03). Ultrasound: overall number of patients with circumscribed findings 27 vs 18 (P < 0.001); particular hematomas/seromas in 26 vs 13 patients (P < 0.001). Synopsis of mammography and ultrasound: overall postoperative changes were significantly higher classified in group A (P = 0.01), but not judged to have a significantly higher impact on interpretation. Additional diagnostic procedures, due to unclear findings at the surgical site, were performed on four patients of both groups. Within the first 2 years after IORT as a boost, therapy-induced changes at the original tumor site are significantly more pronounced compared with a control group. There is no evidence that the interpretation of findings is complicated after IORT.
Wasser
K
K
Department of Radiology, University Hospital Mannheim, University of Heidelberg, Heidelberg, Germany. klaus.wasser@rad.ma.uni-heidelberg.de
Schoeber
C
C
Kraus-Tiefenbacher
U
U
Bauer
L
L
Brade
J
J
Teubner
J
J
Wenz
F
F
Neff
W
W
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology / Q000528:radiation effects*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D044584:Carcinoma, Ductal / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D002921:Cicatrix / Q000175:diagnosis; D003131:Combined Modality Therapy; D005218:Fat Necrosis / Q000175:diagnosis; D005260:Female; D006801:Humans; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis; D011832:Radiation Injuries / Q000175:diagnosis*; D018714:Radiotherapy, Adjuvant; D016217:Ultrasonography, Mammary