Intraoperative Radiation

Radiation can be given during lumpectomy surgery, after the cancer has been removed. This is called intraoperative radiation therapy (sometimes abbreviated as IORT). While the underlying breast tissue is still exposed, a single, high dose of radiation is given directly to the area where the cancer was.

One method of intraoperative radiation uses the linear accelerator (used in external radiation) to deliver an electron beam to the area where the cancer was. Radiation with electrons only goes a short distance and can be concentrated on the area at risk. Special techniques are used to protect the underlying tissue. The procedure takes about 2 minutes and then the surgery is completed as usual.

Another technique is known as high-dose-rate remote afterloading intraoperative radiation. This procedure uses a small tube, which is placed in the area where the cancer was. The tube is connected to a computerized radiation machine, which delivers a high dose of radiation through the tube. The procedure takes about 5 to 10 minutes.

For safety reasons, all the doctors and nurses must leave the room while intraoperative radiation is delivered. But a special patient monitoring station is located outside the operating room so your doctors watch and check on you the whole time.

Only a few treatment centers offer radiation during surgery. There are several reasons why:

• Using intraoperative radiation for internal radiation is very new. Only small studies with short follow-ups have been done so far.
• Intraoperative internal radiation hasn't been compared to the standard of care: whole-breast radiation after lumpectomy.
• It's very expensive to have a radiation machine and proper shielding in an operating room. Most radiation therapy departments are far away from the operating rooms, so the equipment can't be shared or moved.