Intraoperative Radiation Therapy for Breast Cancer

New York-Presbyterian/Columbia University Medical Center is one of the first institutions in the New York metropolitan area to offer intraoperative radiation therapy (IORT), which entails a single dose of radiation therapy that is administered immediately after lumpectomy. This innovative breast cancer therapy became available at the BreastCenter during the summer of 2013.

For most women diagnosed with early-stage breast cancer, a lumpectomy may be an appropriate treatment option. Unlike a mastectomy, a lumpectomy only removes a portion of the affected breast. After this procedure, additional radiation therapy is usually required to destroy any microscopic cancer remnants that are undetectable by breast imaging.

Compared to traditional radiation therapy, IORT offers important benefits to women undergoing surgery for breast cancer. Conventional radiation is delivered to the entire breast, and patients must come to the hospital five days per week for about six weeks. This time burden, especially in cases when women must travel a distance to the hospital, leads some to shorten or even stop their radiation therapy despite the risk of recurrence. In contrast, IORT delivers a single higher dose of radiation directly to the area where the tumor was removed.

Both conventional radiation and IORT have comparable rates in reducing the risk of cancer recurrence, according to the randomized multicenter trial of IORT called TARGIT A, but IORT clearly saves patients a tremendous amount of time by avoiding daily trips to the hospital for six weeks. It is also far less expensive than conventional radiation. TARGIT A also found that IORT causes less skin toxicity than conventional radiation.

IORT is currently available to the majority of women who undergo lumpectomy to remove breast tumors less than two centimeters in size.