Intra-Operative Electron Radiation Therapy (IOERT) Anticipated Boost in Breast Cancer Treatment: An Italian Multicenter Experience.

In breast cancer, the use of a boost to the tumor bed can improve local control. The aim of this research is to evaluate the safety and efficacy of the boost with intra-operative electron radiotherapy (IOERT) in patients with early-stage breast cancer undergoing conservative surgery and postoperative whole breast irradiation (WBI). The present retrospective multicenter large data were collected between January 2011 and March 2018 in 8 Italian Radiation Oncology Departments. Acute and late toxicity, objective (obj) and subjective (subj) cosmetic outcomes, in-field local control (LC), out-field LC, disease-free survival (DFS) and overall survival (OS) were evaluated. Overall, 797 patients were enrolled. IOERT-boost was performed in all patients during surgery, followed by WBI. Acute toxicity (≥G2) occurred in 179 patients (22.46%); one patient developed surgical wound infection (G3). No patients reported late toxicity ≥ G2. Obj-cosmetic result was excellent in 45%, good in 35%, fair in 20% and poor in 0% of cases. Subj-cosmetic result was excellent in 10%, good in 20%, fair in 69% and poor in 0.3% of cases. Median follow-up was 57 months (range 12-109 months). At 5 years, in-field LC was 99.2% (95% CI: 98-99.7); out-field LC 98.9% (95% CI: 97.4-99.6); DFS 96.2% (95% CI: 94.2-97.6); OS 98.6% (95% CI: 97.2-99.3). In conclusion, IOERT-boost appears to be safe, providing excellent local control for early-stage breast cancer. The safety and long-term efficacy should encourage use of this treatment, with the potential to reduce local recurrence.

Metaplastic breast cancer. A case series.

Special type breast cancers display a wide range of different histological types in which clear recommendations on clinical and therapeutic management still lack and most of the information available derive from case report and case studies. In particular metaplastic breast cancer (MBC) is a rare and aggressive type of breast cancer accounting for around 1% of breast malignancies. We reported our experience in the management of five patients with MBC diagnosed and treated in our institution during the last few years (2016-2020). KEY WORDS: Metaplastic breast cancer, Special type breast cancers.

IORT in breast cancer. Our experience of the first patients treated.

AIM: The aim of this study was to assess the therapeutic effect of intraoperative radiotherapy, describe the method and examine the results of our experience. BACKGROUND: Breast conserving therapy has recently become a standard treatment modality in patients with early invasive cancer. Radiotherapy, along with surgery, is an integral part of such treatment. The important thing of radiotherapy is to deliver a high dose to the tumour bed. One of the methods is the intraoperative radiotherapy. MATERIALS AND METHODS: The analysis comprised 41 breast cancer patients treated with breast conserving surgery. Patient's range age was 35-80 years. Cancer type distribution inlcuded: 95% ductal carcinoma, 5% other carcinoma. Applicator size: 4 cm. (12%), 5 cm. (64%), 6 cm. (17%), 7 cm. (7%). Electron energies: 6 MeV (22%), 8 MeV (56%), 10 MeV (22%). Intraoperative radiation therapy was delivered in the operating theatre during surgery. After that, all patients were treated with whole breast irradiation. RESULTS: 41 patients treated with IORT procedures completed. In general there were no severe postoperative complications and we did not detect tumor recurrence in any patient even if the time elapsed from the treatment is still short. CONCLUSIONS: Due to its exceptional physical and radiobiological properties, intraoperative radiation therapy can be a good alternative to other methods of boosting dose to the postoperative site in management. KEY WORDS: Breast cancer, IORT, intraoperative radiotherapy, Surgery.