Long-term results of breast cancer patients who received IOERT as boost during BCS: A single-institution retrospective analysis
Semra Günay1
, Berk Gökçek2, Özge Kandemir3, Arzu Akan1, Orhan Yalçın1
1Clinic of Breast and Endocrine Surgery, Prof. Dr. Cemil Taşcıoğlu City Hospital, Health Science University Faculty of Medicine, İstanbul, Türkiye
2Clinic of General Surgery, Prof. Dr. Cemil Taşcıoğlu City Hospital, Health Science University Faculty of Medicine, İstanbul, Türkiye
3Clinic of Radiation Oncology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Health Science University Faculty of Medicine, İstanbul, Türkiye
Abstract
Objective: Intraoperative electron radiotherapy (IOERT) applied as boost to the tumor bed during breast conserving surgery is advantageous in terms of local recurrence in breast cancer patients. In addition, it has other advantages over the adjuvant boost RT such as no risk of tumor bed change, ease of sequencing radiotherapy chemotherapy, and reduced workload of the radiotherapy clinic. This study aimed to evaluate the long-term results of our patients who were treated with this method in our institution and are still being followed up.
Material and Methods: One hundred and three patients enrolled in this study received IOERT equivalent to 10 Gy as boost during BCS and were subsequently given adjuvant WBI according to the biological subtype of the tumor systemic therapy. These patients were analyzed using their files and hospital records. Patients were evaluated for overall survival, local recurrence, distant metastasis, and cosmetic outcome (using LENT-SOMA scale).
Results: Median age was 53,5 (27-74), mean follow-up time was 75 (48-106) months. Mean pathological tumor size was 18 mm (4-30), 90 of the patients had invasive ductal carcinoma, eight of them were lobular and five of them had mixed histological structure. Ninety-three of the patients presented histological grade II, 15 grade III; 74 patients were luminal A-like, 15 luminal B-like, eight HER2 positive and six triple negative breast cancer. According to the LENT-SOMA scale, 35 had grade 0, 42 each had grade I, 23 had grade II, and two had grade III. All patients underwent whole breast irradiation after surgery, 81 received chemotherapy and 90 endocrine therapy. There was one local recurrence, distant recurrence was seen in four patients and one patient died of non-breast cancer causes. Overall survival was %99, and event free survival %96.
Conclusion: IOERT for breast cancer treatment during BCS is a safe option with low chronic toxicity and the cosmetic outcome gets better over time.
Keywords: Breast cancer, breast conserving surgery, boost radiotherapy, intraoperative electron radiotherapy, lent-s
Cite this article as: Günay S, Gökçek B, Kandemir Ö, Akan A, Yalçın O. Long-term results of breast cancer patients who received IOERT as boost during BCS: A single-institution retrospective analysis. Turk J Surg 2023; 39 (2): 115-120.
This study was approved by İstanbul Prof. Dr. Cemil Taşçıoğlu City Hospital Clinical Research Ethics Committee (Decision no: 278, Date: 17.10.2022).
Externally peer-reviewed.
Concept - SG, ÖK; Design - SG, ÖK; Supervision - SG, ÖK; Fundings - SG, BG, AA; Materials - SG, BG; Data Collection and/ or Processing - SG, BG; Analysis and/or Interpretation - SG, BG, ÖK, AA, OY; Literature Search - SG, BG, ÖK-; Writing Manuscript - SG; Critical Reviews - OY.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.