title: Intraoperative radiotherapy for breast cancer: the lasting effects of a fleeting treatment.
abstract: In well-selected patients who choose to pursue breast conservation therapy (BCT) for early-stage breast cancer, partial breast irradiation (PBI) delivered externally or intraoperatively, may be a viable alternative to conventional whole breast irradiation. Two large, contemporary randomized trials have demonstrated breast intraoperative radiotherapy (IORT) to be noninferior to whole breast external beam radiotherapy (EBRT) when assessing for ipsilateral breast tumor recurrence in select patients. Additionally, IORT and other PBI techniques are likely to be more widely adopted in the future because they improve patient convenience by offering an accelerated course of treatment. Coupled with these novel techniques for breast radiotherapy (RT) are distinct toxicity profiles and unique cosmetic alterations that differ from conventional breast EBRT and have the potential to impact disease surveillance and patient satisfaction. This paper will review the level-one evidence for treatment efficacy as well as important secondary endpoints like RT toxicity, breast cosmesis, quality of life, patient satisfaction, and surveillance mammography following BCT with IORT.
authors.affiliation: Department of Radiation Oncology, Thomas Jefferson University Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA 19107, USA.
authors.forename: Harriet B
authors.identifier: 0000-0003-3582-968X
authors.initials: HB
authors.lastname: Eldredge-Hindy
authors.affiliation: Department of Surgery, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Rosenberg
authors.affiliation: Department of Radiation Oncology, Thomas Jefferson University Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA 19107, USA.
authors.forename: Nicole L
authors.identifier: 0000-0002-7662-7470
authors.initials: NL
authors.lastname: Simone