title: Comparison of mammographic findings after intraoperative radiotherapy or external beam whole breast radiotherapy.
abstract: BACKGROUND
  The TARGIT (TARGeted Intraoperative Radiotherapy) trial was designed to compare local recurrence and complication rates in breast cancer patients, prospectively randomised to either EBRT (external beam whole breast radiotherapy) or a single dose of IORT (intraoperative radiotherapy). The aim of our study was to compare follow-up mammographic findings, ultrasound and biopsy rates in each group.
  
  
  METHODS
  Follow-up imaging and breast biopsies of women from one centre participating in the TARGIT-A trial were independently reviewed by two radiologists blinded to the radiotherapy treatment received.
  
  
  RESULTS
  The cohort consisted of 141 patients (EBRT n = 80/IORT n = 61). There was no significant difference in the patient or disease characteristics of the two groups. The number of follow-up mammograms and length of follow-up was similar (EBRT/IORT n = 2.0/2.4; 4.3yr/5.1yr; p = 0.386 χ(2) test). There were no significant differences in mammographic scar or calcification appearances of the post-operative site. Generalised increase in breast density and skin thickening were more common in the EBRT compared to the IORT group (p = 0.002; p = 0.030, χ(2) test respectively). A trend towards additional ultrasound at follow-up was observed in the IORT group (15 of 61 [24.6%] versus 11 of 80 [13.8%]), however this was not statistically significant (p = 0.100 χ(2) test). No disease recurrence was demonstrated on any of the breast biopsies taken. Only one biopsy was reported as fat necrosis in the IORT group.
  
  
  CONCLUSIONS
  Mammographic changes were more common following EBRT, although more additional follow-up ultrasounds were performed in the IORT group. IORT is not detrimental to subsequent radiological follow up.
authors: Dundee Cancer Centre, Clinical Research Centre, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. Electronic address: b.elsberger@nhs.net.
authors: B
authors: B
authors: Elsberger
authors: Dundee Cancer Centre, Clinical Research Centre, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
authors: A
authors: A
authors: Romsauerova
authors: Dundee Cancer Centre, Clinical Research Centre, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
authors: S
authors: S
authors: Vinnicombe
authors: Dundee Cancer Centre, Clinical Research Centre, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
authors: P
authors: P
authors: Whelehan
authors: Breast Unit, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
authors: D C
authors: DC
authors: Brown
authors: Dundee Cancer Centre, Clinical Research Centre, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
authors: J A
authors: JA
authors: Dewar
authors: Dundee Cancer Centre, Clinical Research Centre, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
authors: A M
authors: AM
authors: Thompson
authors: Dundee Cancer Centre, Clinical Research Centre, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
authors: A
authors: A
authors: Evans
mesh_terms: D000368:Aged; D062005:Biopsy, Large-Core Needle; D001943:Breast Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D002277:Carcinoma / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008327:Mammography; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: EBRT; Early breast cancer; IORT; TARGIT-A trial