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Breast Cancer Radiotherapy: Whole Breast vs. Intraoperative

Posted Jun 17 2010 6:41am
Accelerated partial breast irradiation, which requires only 5-7 days in most cases, appears to be well on its way to becoming the standard of care for breast cancer patients due to its safety and effectiveness .  One form of accelerated partial breast irradiation that is also looking promising is targeted intraoperative radiotherapy (called TARGIT).  TARGIT is a form of breast cancer radiation therapy that is given on a single day during the breast conservation surgery immediately after removal of the breast cancer tumor.  While pilot studies have reported that TARGIT appears to be safe and effective, larger studies to confirm these early results have been needed.

The TARGIT-A clinical trial is a large, multicenter trial conducted in nine countries designed to compare the safety and effectiveness of TARGIT to conventional whole breast radiation therapy.  For this large breast cancer study , investigators assigned breast cancer patients to receive either whole breast radiation therapy (1,119 women) or TARGIT (1113 women).  Women assigned to the TARGIT therapy group were also eligible to receive further treatment with whole breast irradiation if post-surgical recovery required it.  Differences in local breast cancer recurrence, major toxicity, and radiation toxicity between the two groups were examined.  After 4 years of follow-up, the results showed that
  • Breast cancer recurrence was seen in 6 TARGIT patients compared to 5 whole breast irradiation cancer patients.
  • The rates of breast cancer recurrence was similar in both groups - 0.95% in the whole breast irradiation group and 1.2% in the TARGIT group.
  • Major toxicity occurred in 3.9% of whole breast irradiation patients compared to 3.3% of patients receiving intraoperative radiation therapy.
  • Radiation toxicity was substantially lower in patients receiving intraoperative radiation therapy (0.5%) compared to patients receiving whole breast irradiation (2.1%)
This large breast cancer clinical trial shows that intraoperative radiotherapy is as effective as whole breast radiation therapy in terms of local breast cancer recurrence in women over 45 years of age diagnosed with invasive ductal breast cancer.  Additionally, intraoperative radiation therapy was as safe and perhaps safer based on the fewer cases of radiation toxicity observed.  The amazing part of this study is that not only was intraoperative radiation therapy as safe and effective as whole breast radiation therapy, it only had to be given one time during surgery.  For breast cancer patients eligible for this form of breast cancer radiation therapy, TARGIT allows for the possibility of fewer side effects, fewer treatments, fewer hospital visits, and less expense.  Many women diagnosed with breast cancer have to wait a substantial length of time before they can receive their radiation therapy and previous research has reported that a delay in radiation therapy might increase the risk for breast cancer recurrence .  Therefore, targeted intraoperative radiation therapy appears to be an attractive alternative for many breast cancer patients.

Advances in breast cancer radiation therapy and other forms of breast cancer treatment are clearly needed and, fortunately, are being discovered.  However, reducing your risk of getting breast cancer remains a priority.  Read my book Fight Now: Eat & Live Proactively Against Breast Cancer to learn what changes you can make in your daily lifestyle to reduce your personal risk of breast cancer.
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