First intraoperative radiation therapy for breast cancer

Primeiro tratamento de radioterapia intraoperatória em cancro da mama

The Hospital da Luz held its first intraoperative radiation therapy for breast cancer last December.

The main advantage of partial breast radiation therapy, which is recommended for selected cases, is that it is a single treatment performed during surgery under general anaesthetic. It has the added convenience of not requiring repeat hospital visits, recovery and return to work is faster and it is the least costly form of treatment overall.

Gynaecologist Isabel Riscado and general surgeon João Leal de Faria were responsible for the general surgery and the intraoperative radiation therapy was performed by Francisco Mascarenhas, medical coordinator in the Department of Radiotherapy. The procedure was carried out entirely in the Hospital da Luz operating theatre. The operation proceeded as planned without any complications. The intraoperative radiation therapy added about 30 minutes to the operating time, but did not prolong the hospital stay.   

Conventional radiological treatment of breast cancer involves applying radiation to the whole of the affected breast, generally for about six weeks, or for three weeks with hypofractionation, this last an increasingly common approach. The disadvantages of conventional whole breast irradiation are the occurrence of radiation-induced tumours, and ischaemic heart disease in patients subjected to irradiation of the left breast.

As an alternative therapy, partial breast radiotherapy is the irradiation of the area at greater risk of relapse, that is the tumour area and a limited volume of normal tissue. This type of treatment can be performed in two ways:

  • Intraoperatively in a single session, directing all radiation onto the tumour immediately after tumour resection during surgery
  • After surgery, in several sessions over a period of one to two weeks