A novel application of IORT in early stage breast cancer with INTRABEAM system

Objective To explore a novel application of INTRABEAM system in nipple sparing mastectomy combined with intraoperative radiotherapy for early stage breast cancer and investigate the efficacy and safety of this approach. Methods A total of 20 female patients with early stage breast cancer(from December 2012 to December 31, 2016) were retrospectively studied. NSM with or without axillary dissection was performed first. After confirming negative margin for NAC frozen section results and no poor local bleeding in the NAC, INTRABEAM IORT was carried out with a single dose of 16 Gy, followed by breast reconstruction. The complications and short-term outcomes were assessed. Results All 20 patients carried out I stage breast reconstruction. No acute radiation injury with symptoms (heart, lung, or hematologic system) or NAC necrosis was observed. No local recurrence or metastasis was observed except only one patient with mediastinum lymph node metastasis. Although every patient had reduction in NAC sensitivity, the contours of the breasts (including the NAC) were satisfactory. Conclusion INTRABEAM IORT may be a feasible and effective approach for NSM with stage I breast reconstruction in patients with early stage breast cancer. Key words: Breast cancer; Early stage; Nipple sparing mastectomy; Intraoperative radiotherapy