title: Single dose IOERT versus whole breast irradiation : Cosmetic results in breast-conserving therapy.
abstract: BACKGROUND
  Scarce data are available about the cosmetic result of single dose intraoperative electron radiotherapy (IOERT) in breast-conserving radiotherapy.
  
  
  METHODS
  We included 71 breast cancer patients. Breast-conserving surgery and sentinel node procedure had started almost 3 years earlier. Subsequently, 26 patients were treated with IOERT and 45 patients received postoperative whole breast irradiation (WBI). For both groups we determined seven dimensionless asymmetry features. We compared the subjectively and the objectively derived cosmetic scores with each other.
  
  
  RESULTS
  For four asymmetry features we noted significantly smaller differences for patients treated with IOERT when compared to those treated with WBI: relative breast contour difference, relative breast area difference and relative breast overlap difference. After correcting for excision volume a significant difference was noticed also for relative lower breast contour. For the IOERT group the cosmetic scores "excellent or good" as determined by each patient and one physician were 88 and 96 %, respectively. When the overall cosmetic scores for patients treated with IOERT and WBI were compared to those of the objectively derived scores, there was a fair level of agreement.
  
  
  CONCLUSIONS
  For patients treated with IOERT we noted less asymmetry and high rates of "good or excellent" subjectively derived cosmetic scores. The level of agreement between the subjectively and the objectively derived cosmetic scores was limited. Due to the small sample size and the design of the study no definitive conclusions can be drawn.
authors.affiliation: Radiotherapy Centre West, Medical Centre Haaglanden, Lijnbaan 32, 2501 CK, The Hague, The Netherlands. h.struikmans@mchaaglanden.nl.|Department of Radiotherapy, Leiden University Medical Centre, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. h.struikmans@mchaaglanden.nl.
authors.forename: Henk
authors.initials: H
authors.lastname: Struikmans
authors.affiliation: Radiotherapy Centre West, Medical Centre Haaglanden, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.
authors.forename: Malou
authors.initials: M
authors.lastname: Snijders
authors.affiliation: Radiotherapy Centre West, Medical Centre Haaglanden, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.
authors.forename: Mirjam E
authors.initials: ME
authors.lastname: Mast
authors.affiliation: Radiotherapy Centre West, Medical Centre Haaglanden, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.
authors.forename: Ursula
authors.initials: U
authors.lastname: Fisscher
authors.affiliation: Department of Radiotherapy, HAGA Medical Centre, Leyweg 275, 2545 CH, The Hague, The Netherlands.
authors.forename: Jan-Huib
authors.initials: JH
authors.lastname: Franssen
authors.affiliation: Department of Radiotherapy, Reinier de Graaf Medical Centre, Reinier de Graafweg 3/11, 2625 AD, Delft, The Netherlands.|Department of Radiotherapy, Leiden University Medical Centre, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
authors.forename: Marcelle J
authors.initials: MJ
authors.lastname: Immink
authors.affiliation: Department of Surgery, Medical Centre Haaglanden, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.
authors.forename: Andreas
authors.initials: A
authors.lastname: Marinelli
authors.affiliation: Department of Surgery, HAGA Medical Centre, Leyweg 275, 2545 CH, The Hague, The Netherlands.
authors.forename: Jos
authors.initials: J
authors.lastname: Merkus
authors.affiliation: Radiotherapy Centre West, Medical Centre Haaglanden, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.
authors.forename: Anna
authors.initials: A
authors.lastname: Petoukhova
authors.affiliation: Department of Radiotherapy, HAGA Medical Centre, Leyweg 275, 2545 CH, The Hague, The Netherlands.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Speijer
authors.affiliation: Radiotherapy Centre West, Medical Centre Haaglanden, Lijnbaan 32, 2501 CK, The Hague, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Koper
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D003357:Cosmetic Techniques; D019583:Dose Fractionation, Radiation; D004583:Electrons / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008408:Mastectomy / Q000379:methods; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods; D016896:Treatment Outcome
keywords: Accelerated partial breast irradiation; Asymmetry; Intraoperative electron radiotherapy; Lumpectomy; Radiotherapy