The Society of Surgical Oncology, inc.
The American Society of Breast Surgeons.
Annals of Surgical Oncology

Log in | Register

In Vivo Intraoperative Radiotherapy: A Novel Approach to Radiotherapy for Early Stage Breast Cancer

Karyn B. Stitzenberg, Nancy Klauber-Demore, Xiao Sha Chang, Benjamin F. Calvo, David W. Ollila, Lav K. Goyal, Michael O. Meyers, Hong Jin Kim, Joel E. Tepper, Carolyn I. Sartor
Multimedia Article
Volume 14, Issue 4 / April , 2007



Intraoperative radiotherapy (IORT) has the potential to eliminate the access problems associated with standard 6-week post-operative external beam radiotherapy for patients with breast cancer. However, accurate delivery of the IORT dose for breast cancer has been problematic due to difficulty estimating the tumor bed after tumor removal and tissue reapproximation. We are investigating the feasibility of partial breast irradiation using a single fraction of IORT delivered to the tumor in vivo prior to surgical resection.


In a trial, approved by the University of North Carolina School of Medicine Institutional Review Board, patients ≥55 years old with infiltrating ductal carcinoma without an extensive intraductal component with an overall tumor size ≤3.0 cm receive a single dose of IORT in place of standard post-operative radiotherapy.


All patients undergo preoperative ultrasonography to define the target volume. In a standard operating room, the tumor is exposed through a standard partial mastectomy incision. IORT is then delivered using a mobile, self-shielded, magnetron-driven X-band linear accelerator (Intraop Corp, Santa Clara, CA, USA). 15 Gy is delivered to the 90% isodose line covering the tumor with a 1 cm margin anterior–posterior and 2 cm margins laterally. After IORT, partial mastectomy is performed in the usual manner.


IORT for breast cancer, delivered to the exposed tumor in vivo, is feasible and allows accurate estimation of the tumor bed. Further follow-up is ongoing to determine the efficacy of this approach.

Add a comment

0 comment(s)



Join the conversation!

Follow the journal on Twitter and Facebook

Help to expand the reach of the journal to support the research and practice needs of surgical oncologists and their patients.