Assessment of IORT application in early stage breast cancer surgery: a cross-sectional study

Abstract

Breast conserving therapy has been proved to be equivalent to mastectomy- based treatment and nowadays is the standard of care approach for patients

with early-stage breast cancer. Adjuvant radiotherapy has demonstrated to improve local control after breast conserving surgery is performed. Since most local recurrences appear at or near the localization of the primary tumour, accelerated partial-breast irradiation (APBI) techniques have been developed. This form of radiation allows to target smaller breast tissue. Intraoperative radiotherapy (IORT) is a form of APBI that enables to deliver a single dose of irradiation to the tumour bed during the surgical frame time, which shortens the treatment time and improves the quality of life of the patients. This procedure was supported by two randomized trials and today IORT is an established alternative to traditional whole breast radiotherapy (WBRT) for selected patients. Based on the evidence regarding IORT, in 2019 a clinical protocol for the application of this modality of radiotherapy was introduced in Hospital Universitari Josep Trueta (HUJT) in Girona. The patients who meet its eligibility criteria undergo breast conserving surgery plus IORT. However, some patients still require additional external beam radiotherapy (EBRT) due to adverse outcomes in the final pathological assessment.

Objective: The aim of this study is to perform an assessment of the current Protocol for IORT application of HUJT. Our objective is to identify possible eligibility criteria that may be adjusted with the intend to reduce the number of patients who require additional EBRT after the initial IORT treatment. Participants: Women diagnosed with early-stage breast cancer who underwent breast

conserving surgery plus IORT in HUJT.

Methods: A cross-sectional design carried out in the Breast Pathology Unit of HUJT, a tertiary referral hospital in Girona. The study will be carried out from 2020 to 2022. Data on tumour features, pathological outcomes and patient characteristics will be collected and ascertained