Intraoperative radiation therapy is promising treatment for early-stage breast cancer

In Clinical Studies News by Barbara Jacoby



Women with early-stage breast cancer are often treated with breast-conserving surgery followed by whole-breast irradiation (WBI). However, WBI is burdensome, requiring four to six weeks of daily treatments. It also exposes healthy areas of the body — namely, the heart, lungs and skin — to radiation. As a result, studies have shown that women treated with WBI have an increased occurrence of cardiac events years after the radiation treatment.

Fortunately, there’s now a promising alternative for some breast cancer patients.

Intraoperative radiation therapy (IORT) has become increasingly popular because it involves just one dose of radiation given at the time of breast-conserving surgery, allowing women to return to their daily lives more quickly. Plus, the radiation is more targeted, so it limits radiation exposure to normal tissue.

More targeted, less risk

In recent years, University of Virginia Health System has taken IORT one step further with the development of Precision Breast IORT. Precision Breast IORT is a novel form of IORT that incorporates computed tomography (CT) imaging technology and high-dose rate brachytherapy (radiation delivered inside the body).

When compared to conventional IORT, Precision Breast IORT provides radiation oncologists better visualization of the tumor bed, so they know exactly where to deliver the radiation. It also allows for a higher dose of radiation to be delivered, compared with conventional IORT. This higher dose of radiation is directed precisely to the area of the breast where the tumor was removed, which is at greatest risk for cancer recurrence, while sculpting the dose away from the heart, ribs and skin.

Recovery time after Precision IORT treatment is minimal. The surgery is performed using general anesthesia, so patients have their breast cancers removed, receive a dose of customized radiation and go home all on the same day. The most notable side effects are fatigue and mild pain from the surgery.

Promising start for new treatment

Data from an initial phase I study completed at UVa Health System showed that Precision Breast IORT is both safe and feasible. A phase 2 study, which began in 2015 at UVa and is still enrolling patients, is taking a closer look at the long-term effectiveness of this procedure, compared with other forms of radiation treatment. Patients who choose Precision Breast IORT will be enrolled in this phase 2 trial, and will be followed for a minimum of five years. The study will evaluate recurrence rates and the cosmetic results of Precision IORT compared with other treatments, as well as the patient’s quality of life during and after treatment.

Women who are eligible for Precision IORT include those who:

» Are age 45 or older

» Have been diagnosed with stage 0 or stage 1 breast cancer

» Have a tumor that is 3 centimeters or smaller in size

» Have no history of breast radiation in the breast that needs treatment

» Are node-negative, with no cancer in the lymph nodes.

Advancing cancer care via clinical trials

At UVa Cancer Center, a National Cancer Institute-designated cancer center, patients diagnosed with early-stage breast cancer have access to a variety of treatments. Medical oncologists, breast surgical oncologists and radiation oncologists take the time to explain to every patient the pros and cons of each treatment, including treatments like Precision IORT that are only available through clinical trial.

Clinical trials are critical to researchers’ efforts to develop more effective cancer treatments. And participants are key to a trial’s success. Plus, patients who enroll in clinical trials are closely monitored by physicians throughout the study and beyond.

To learn more about treatments for early-stage breast cancer at UVa, visit