Radioterapia srodoperacyjna w raku piersi

Abstract

Author(s): Tamara Kuzba-Kryszak, Marta Biedka, Szymon Zoilkowski, Adrianna Makarewicz

Initiation of mammographic screening and increase of patient’s oncology knowledge make more and more diagnosis of breast cancer in early stages. The conventional treatment for early breast cancer includes breast-conserving surgery and radiotherapy to the whole breast with boost to the tumor bed. Approximately 80% of the breast recurrences after breast irridiation occur in the area of the original tumor site; the relapses observed in a different quadrant are likely to be regarded as a new ipsilateral carcinoma instead of a true relapse of the primary tumor. According to this observation, irradiation of the whole mammary gland could be avoided in select patients and adjuvant radiotherapy could be limited to the sterilization of residual cancer in the immediate vicinity of the tumor bed. In APBI currently are applied several techniques: 1) Interstitial brachytherapy (HDR, PDR, permanent implants); 2) Brachytherapy using the balloons (Mammosite, Contura,); 3) Hybrid brachytherapy devices (SAVI applicator); 4) External beam radiotherapy (3D, IMRT); 5) IORT (intraoperative radiotherapy) with electrons or X-rays. Results of trials in intraoperative radiotherapy show that treating with a single dose, during surgery can become new standard in selected group of patients with early stage breast cancer. Proceeding like that bring us closer to a scenerio in which a patient with early breast cancer might complete all her local treatment at 2 visits in reference hospital.

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