术中放射治疗应用于乳房保留手术——病例分析(2015~2018)

Regular mammography screening project for Taiwanese women aged 45~69 years has been administered for about 15 years which has achieved a good result in detection of early breast cancer and reduction in breast cancer mortality. According to NCCN (National Comprehensive Cancer Network) guideline, breast conserving surgery (BCS) is recommended for low grade breast cancer, because it provides better cosmetic effect and life quality compared to radical mastectomy. BCS combined with post-operative whole breast irradiation is a standard therapy for low grade breast cancer in previous practice because it provided same overall survival as traditional mastectomy. Inevitably, whole breast irradiation may yield some skin complications such as skin fibrosis, sclerosis, telangiectasia and even cause hyperpigmentation of nipple-areolar complex with lack of elasticity. Moreover, it may result in deformity of ipsilateral breast and alter psychological effect. FDA has approved the administration of intraoperative radiation therapy (IORT) in patients with breast cancer undergoing breast conserving surgery since 2012. It provided same level of safety as traditional post-operative whole breast irradiation and avoided aforementioned side effects [1]. Our institute started to perform IORT in low grade breast cancer since 2015. 60 patients received IORT and there were no apparent immediate or delay complication since then. Besides, no local recurrence or distant metastasis was detected during cancer surveillance. IORT is considered as a safe and feasible option in treatment of low grade breast cancer.