Radiation Therapy

Breast-conserving therapy (BCT) is recommended by the National Comprehensive Cancer Network in their guidelines as an excellent treatment option for early-stage breast cancer. The “gold standard” of BCT involves surgical removal of the tumor with clear margins, usually followed by 3–5 weeks of external-beam radiation therapy after the breast has healed. Even though BCT is an excellent choice, many women in the United States who are eligible for BCT opt for mastectomy or only undergo breast-conserving surgery. Women who live far from radiation treatment centers often find it difficult to travel long distances for their daily treatments. Women who work, even if they live close to radiation centers, may find that daily external-beam radiation therapy treatments interfere with their work schedules. Elderly patients, especially those older than 70 years, also show a very poor compliance rate with BCT. Finally, some women choose mastectomy because they have concerns about radiation toxicity. The inconvenience of protracted BCT radiation schedules has led to the development of newer types of BCT radiation that can deliver the required radiation treatment over shorter periods of time. One technique that can shorten the necessary radiation to as little as one treatment, in the appropriate low-risk patient, is intraoperative radiation therapy (IORT). This chapter discusses the role of IORT in the treatment of breast cancer patients who are eligible for BCT and shows how an IORT program can positively impact the community hospitals’ oncology program.