Intraoperative Radiotherapy with INTRABEAM® in Early-Stage breast Cancer patients: a 10-Year Monocentric experience
This 10-year retrospective study of 247 early-stage breast cancer patients demonstrates that intraoperative radiotherapy with INTRABEAM® offers favorable long-term oncological outcomes and acceptable toxicity, serving as a convenient and well-tolerated alternative to whole-breast irradiation, particularly for elderly or frail populations.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
For many women diagnosed with early-stage breast cancer, the standard path to recovery involves a surgery to remove the tumor, followed by a course of radiation therapy. This radiation is typically delivered to the entire breast over several weeks, with daily visits to a clinic. While this approach is highly effective at preventing the cancer from returning, the process can be physically demanding and logistically difficult, especially for older patients or those with other health conditions. The goal of modern medicine is to find ways to maintain the same level of protection against cancer while reducing the burden on the patient. This is where a technique called intraoperative radiotherapy comes in. Instead of waiting for surgery to finish and then scheduling weeks of separate treatments, this method delivers a single, precise dose of radiation directly to the area where the tumor was removed, right while the patient is still on the operating table. It is a way to treat the specific spot at highest risk while sparing the rest of the breast and surrounding organs from unnecessary exposure.
A team of researchers at the Bergonié Institut in France recently looked back at a decade of experience using this specific approach with a device known as INTRABEAM. Between 2012 and 2021, they treated 247 women with early-stage breast cancer using this single-session radiation during their breast-conserving surgery. The patients were carefully selected, mostly being older women with small tumors that were not aggressive and had not spread to the lymph nodes. The researchers wanted to see if this streamlined method could provide the same long-term safety as the traditional, longer course of radiation, and if it was safe enough to use as a standard option for the right candidates.
The procedure itself is quite direct. Once the surgeon removes the tumor, a spherical device is placed directly into the empty space left behind. This device emits a low-energy beam of radiation that targets the tissue immediately surrounding the cavity. Because the radiation drops off very quickly, it treats the area most likely to harbor hidden cancer cells without affecting the skin or the heart. The entire radiation step takes about twenty-five minutes on average. After the treatment is complete, the device is removed, and the surgeon closes the incision. In this study, the vast majority of patients received no further radiation therapy. However, the medical team remained vigilant; after the surgery, they examined the removed tissue under a microscope. If they found high-risk features, such as cancer cells near the edges of the removed tissue or larger tumor sizes than expected, they recommended that the patient return for the standard, weeks-long radiation treatment. About one in five patients fell into this category and received the additional treatment, ensuring that no one with higher-risk disease was left under-treated.
The results of this ten-year review were encouraging. Over a median follow-up period of just over four years, the rate of the cancer returning in the same breast was extremely low, affecting only about one in a hundred patients. For the group of women who received the single-session treatment alone, the five-year survival rate was high, and the rate of the disease remaining under control was also strong. The side effects were generally mild and manageable. The most common issue was a collection of fluid under the skin, known as a seroma, which occurred in roughly one in six patients and usually required a simple needle aspiration to drain. Infections were rare, and serious long-term complications were uncommon. The researchers noted that the safety profile matched what has been seen in other major studies, with most patients experiencing only minor, temporary issues.
This work suggests that for a specific group of patients—typically older women with small, slow-growing tumors—a single dose of radiation given during surgery is a viable and effective alternative to the traditional weeks-long regimen. It offers a way to complete the cancer treatment in one go, removing the need for daily clinic visits and reducing the physical strain of prolonged therapy. While the study was conducted at a single center and relied on careful patient selection, the findings support the idea that this method can provide excellent long-term control with a high quality of life. It represents a practical step forward in tailoring cancer care to the individual needs of the patient, offering a less burdensome path for those who are most likely to benefit from it.
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