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International Journal of Breast Cancer
Volume 2014, Article ID 637898, 6 pages
http://dx.doi.org/10.1155/2014/637898
Review Article

Intraoperative Boost Radiotherapy during Targeted Oncoplastic Breast Surgery: Overview and Single Center Experiences

1Breast Center, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany
2Department of Obstetrics and Gynaecology, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany
3Department of Pathology, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany
4Department of Radiotherapy, University Hospital of Cologne, Kerpenerstrasse 34, 50931 Cologne, Germany

Received 13 April 2014; Revised 12 November 2014; Accepted 27 November 2014; Published 17 December 2014

Academic Editor: Vladimir F. Semiglazov

Copyright © 2014 Wolfram Malter et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Breast-conserving surgery followed by whole-breast irradiation is the standard local therapy for early breast cancer. The international discussion of reduced importance of wider tumor-free resection margins than “tumor not touching ink” leads to the development of five principles in targeted oncoplastic breast surgery. IORT improves local recurrence risk and diminishes toxicity since there is less irradiation of healthy tissue. Intraoperative radiotherapy (IORT) can be delivered in two settings: an IORT boost followed by a conventional regimen of external beam radiotherapy or a single IORT dose. The data from TARGIT-A and ELIOT reinforce the conviction that intraoperative radiotherapy during breast-conserving surgery is a reliable alternative to conventional postoperative fractionated irradiation, but only in a carefully selected population at low risk of local recurrence. We describe our experiences with IORT boost (50 kV energy X-rays; 20 Gy) in combination with targeted oncoplastic breast surgery in a routine clinical setting. Our experiences demonstrate the applicability and reliability of combining IORT boost with targeted oncoplastic breast surgery in breast-conserving therapy of early breast cancer.