Our Summary

This study investigates the complications of a relatively new method for treating early-stage breast cancer called intraoperative radiation therapy (IORT). This method involves removing the cancerous lump and immediately treating the surrounding tissue with targeted radiation during the same surgery. This can often remove the need for further external beam radiation therapy (EBRT) in many cases.

The study examined the medical records of 445 patients who had undergone one of three treatments: lumpectomy with IORT, lumpectomy with EBRT, or lumpectomy alone. They found that patients who had undergone IORT had higher rates of postoperative complications, such as fluid build-up at the surgery site (seroma), surgical site infection, skin redness (erythema), and minor complications like scars, breast deformity, swelling, vein inflammation, and chronic tenderness.

However, the researchers note that these complications are mostly minor and temporary. They suggest that the higher rate of reported complications could be due to the fact that IORT is a new technology, and thus the associated complications are more likely to be reported. The researchers recommend educating physicians and patients about potential complications to help manage expectations and improve their handling after surgery.

FAQs

  1. What is intraoperative radiation therapy (IORT) and how is it used in treating early-stage breast cancer?
  2. What kind of postoperative complications might occur after undergoing IORT?
  3. Why might there be a higher rate of reported complications with IORT compared to other forms of treatment?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lumpectomy is to closely follow post-operative care instructions to minimize the risk of complications. This may include keeping the surgical site clean and dry, avoiding heavy lifting or strenuous activities, and taking prescribed medications as directed. It’s also important to attend follow-up appointments with your healthcare provider to monitor your recovery progress and address any concerns promptly. By following these guidelines, you can help ensure a successful and smooth recovery after lumpectomy surgery.

Suitable For

Patients who are typically recommended lumpectomy are those with early-stage breast cancer who have small tumors that have not spread to the lymph nodes. Lumpectomy is often recommended for patients who wish to preserve their breast tissue and avoid a full mastectomy. Lumpectomy may also be recommended for patients who are not good candidates for mastectomy due to other health conditions or preferences.

In some cases, lumpectomy may not be recommended for patients who have large tumors, tumors that are close to the chest wall or skin, or tumors that are in multiple areas of the breast. In these cases, a mastectomy may be a more appropriate treatment option. Additionally, patients with a history of certain medical conditions or prior radiation therapy to the breast may not be good candidates for lumpectomy.

It is important for patients to discuss their individual situation with their healthcare provider to determine the best treatment option for their specific case.

Timeline

Before lumpectomy:

  1. Patient undergoes diagnostic tests such as mammogram, ultrasound, and biopsy to confirm the presence of breast cancer.
  2. Patient consults with their healthcare team to discuss treatment options, including lumpectomy.
  3. Patient may undergo pre-operative tests and evaluations to ensure they are healthy enough for surgery.
  4. Patient receives instructions on how to prepare for surgery, including fasting before the procedure.
  5. Patient signs consent forms and discusses potential risks and benefits of the surgery with their healthcare team.

After lumpectomy:

  1. Patient may experience pain, swelling, and bruising at the surgical site immediately after the procedure.
  2. Patient is monitored for any signs of complications, such as infection or excessive bleeding.
  3. Patient may be discharged from the hospital the same day or within a few days, depending on the extent of the surgery.
  4. Patient may need to take pain medication and follow-up with their healthcare team for post-operative care.
  5. Patient may undergo radiation therapy, either through IORT or EBRT, depending on the treatment plan.
  6. Patient may experience side effects of radiation therapy, such as fatigue, skin irritation, and changes in breast appearance.
  7. Patient undergoes follow-up appointments with their healthcare team to monitor their recovery and check for any signs of recurrence.
  8. Patient may be referred to additional support services, such as physical therapy or counseling, to help with recovery and emotional well-being.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with lumpectomy with intraoperative radiation therapy (IORT) compared to traditional lumpectomy with external beam radiation therapy (EBRT) or lumpectomy alone?
  2. How likely am I to experience postoperative complications such as seroma, surgical site infection, skin redness, scarring, breast deformity, swelling, vein inflammation, or chronic tenderness with IORT?
  3. Will I need additional treatments or follow-up care after undergoing lumpectomy with IORT?
  4. How does the success rate of lumpectomy with IORT compare to other treatment options for early-stage breast cancer?
  5. Are there any specific factors or conditions that may increase my risk of complications with IORT?
  6. How experienced is the medical team in performing lumpectomy with IORT, and what are their success rates?
  7. What can I do to reduce my risk of complications and promote a successful recovery after undergoing lumpectomy with IORT?
  8. How long can I expect the recovery process to take, and what kind of support or resources are available to help me during this time?
  9. Are there any long-term side effects or complications associated with IORT that I should be aware of?
  10. Are there any alternative treatment options or approaches that I should consider before making a decision about lumpectomy with IORT?

Reference

Authors: Sfarad HK, Allweis TM. Journal: Clin Breast Cancer. 2024 Apr;24(3):237-242. doi: 10.1016/j.clbc.2023.12.005. Epub 2023 Dec 24. PMID: 38233254