title: Acute and Chronic Complications in Breast Cancer Patients Treated with Intraoperative Radiation Therapy.
abstract: Intraoperative radiation therapy (IORT) permits the delivery of radiation therapy directly to the tumor bed at the time of surgery. Minimal data are available about the complications associated with this modality of treatment using the Xoft(®) Axxent Electronic Brachytherapy (Axxent) System.
  
  
  
  A total of 702 patients who received IORT using the Xoft(®) Axxent System at Hoag Memorial Hospital Presbyterian between June 2010-February 2016 were accrued in an IORT data registry study. The prospective and retrospective protocols were approved by the institutional review board and met the guidelines of their responsible governmental agency. Data were collected at 1 week, 1 month, 3 months, 6 months, 1 year, and thereafter yearly. Acute complications were defined as those occurring within the first month. Chronic complications were those that persisted beyond 6 months.
  
  
  
  Acute complications were observed in 21 % of patients and included hematomas that required drainage, seromas requiring drainage more than 3 times, infections treated with antibiotics or surgery, necrosis requiring surgery, and erythema. Chronic complications were observed in 13 % of patients and included seromas, fibrosis, and hyperpigmentation. The majority of acute and chronic problems from IORT were mild. If grade I erythema, fibrosis, and hyperpigmentation were removed, only 32 of 702 (4.6 %) had significant complications. Our complication rates were comparable to those of the TARGIT trial.
  
  
  
  IORT is a modality that safely delivers radiation therapy to patients diagnosed with breast cancer. This technique allows women who cannot (or decline to) undergo whole breast radiation to consider breast-conserving therapy rather than mastectomy.
authors.affiliation: Hoag Institute for Research and Education, Hoag Memorial Hospital Presbyterian, Newport Beach, USA. melindaepstein@gmail.com.
authors.forename: Melinda
authors.initials: M
authors.lastname: Epstein
authors.affiliation: Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, USA.|Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, USA.
authors.forename: Melvin
authors.initials: M
authors.lastname: Silverstein
authors.affiliation: Department of Radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Lin
authors.affiliation: Department of Radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Kim
authors.affiliation: Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, USA.|Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, USA.
authors.forename: Sadia
authors.initials: S
authors.lastname: Khan
authors.affiliation: Hoag Institute for Research and Education, Hoag Memorial Hospital Presbyterian, Newport Beach, USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: De Leon
authors.affiliation: BreastLink, Orange, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Guerra
authors.affiliation: Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, USA.
authors.forename: Lincoln
authors.initials: L
authors.lastname: Snyder
authors.affiliation: Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, USA.
authors.forename: Colleen
authors.initials: C
authors.lastname: Coleman
authors.affiliation: Department of Radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, USA.
authors.forename: January
authors.initials: J
authors.lastname: Lopez
authors.affiliation: Department of Radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, USA.
authors.forename: Ralph
authors.initials: R
authors.lastname: Mackintosh
authors.affiliation: Department of Radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D002908:Chronic Disease; D004890:Erythema / Q000209:etiology; D005260:Female; D005355:Fibrosis; D006406:Hematoma / Q000209:etiology; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology; D007430:Intraoperative Care / Q000009:adverse effects*; D015412:Mastectomy, Segmental / Q000009:adverse effects; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D012189:Retrospective Studies; D049291:Seroma / Q000209:etiology; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology