Washington, D.C., - Feb. 25, 2013 – For the first time, breast cancer patients in the Washington, DC area have an opportunity to skip the traditional six weeks of radiation treatments after breast cancer surgery and get just one dose in the operating room immediately after having their cancer removed. Making this possible is INTRABEAM Intraoperative Radiotherapy (IORT) a technology now being offered to patients at both MedStar Georgetown University Hospital and MedStar Washington Hospital Center.
Mary Shanholtzer, 68, of White Plains, Maryland had a one centimeter lump in her breast that was found by a screening mammogram. She had a lumpectomy in January 2013 with INTRABEAM IORT given right in the operating room while she was still asleep. Mary’s lymph nodes were negative for cancer, meaning the cancer had not spread from the original site, making her a perfect candidate for INTRABEAM IORT. “What attracted me to the IORT is that it’s a one shot deal,” said Mary. “Six or seven weeks of radiation would have been burdensome for me and working full time, as I do, all that time and travel would have been a problem. It seems like this IORT was custom made for me. There was a little swelling around my incision but other than that it was easy and amazing. I only missed four days of work and I never even took a pain pill.”
“We’re offering INTRABEAM to a select group of lumpectomy patients based on their age, the size and type of tumor,” said Shawna Willey, MD, director of the MedStar Regional Breast Health Program. “This is really good news for patients who now can wake up from breast surgery and know their radiation treatment is complete instead of facing six weeks of up to 30 radiation treatments.”
Up until now, the standard treatment for those having a lumpectomy involved waiting four weeks after the initial surgery and then starting a five to six week whole-breast radiation regimen.
“INTRABEAM changes that,” said Marc E. Boisvert, MD, FACS, breast surgeon and medical director of the Center for Breast Health at MedStar Washington Hospital Center. “Now, for a select group of women receiving a lumpectomy, the radiation they receive in the operating room is the only radiation treatment they’ll ever need."
“It’s known that most breast cancer recurrences after surgery occur in the same place as the original tumor,” said Eleni Tousimis, MD, chief of Breast Surgery at MedStar Georgetown University Hospital. “With INTRABEAM, we are targeting the radiation and only treating the original tumor bed, so we kill any residual cancer cells. We also spare healthy breast tissue that whole-breast radiation may have negatively affected.”
Getting the radiation adds another 20 to 40 minutes to the roughly 90 minute surgery, and the patient is asleep while the treatment is given.
INTRABEAM radiotherapy uses a miniaturized radiation device that generates low energy x-ray radiation. The device is inserted into the tumor bed right after the cancer is removed. The radiation is mostly absorbed over a 1-2 centimeter depth from the tumor cavity. This allows for a significant reduction in the amount of radiation delivered to the surrounding healthy tissue.
“This less invasive technique has the potential to achieve similar cancer outcomes as whole breast irradiation, while improving cosmetic outcomes and improving the quality of life,” said Dr. Tousimis.
In 2010 the results of a 28-center international study of more than 2,200 patients called the TARGIT-A trial concluded that partial breast radiation is just as effective and less toxic when compared to whole-breast radiation for selected patients with early stage breast cancer. The results were published in the Journal Lancet.
“We know that patient compliance with treatment is part of what determines a good outcome,” said Dr. Boisvert. “And we know that the farther away a patient lives from the radiation center the less likely she is to get through all six weeks of treatment. Sometimes local patients have transportation problems as well. INTRABEAM IORT then can be a tremendous boost to help these patients complete and succeed in their treatment without the hardship of added travel.”
“If Intrabeam IORT had not been an option for me I would have just had more radical surgery, a mastectomy, to avoid having the six or seven weeks of radiation,” reflected Mary Shanholtzer. “This technology allowed me to save my life, keep more of my healthy breast and avoid a bigger surgery.”
“Patients who may be candidates for INTRABEAM IORT will be evaluated by both a surgeon and a radiation oncologist at the same institution,” said Dr Willey. “This is part of our commitment to the team approach which we know works best to serve our patients’ needs. Breast cancer treatments are trending toward less invasive techniques and are more targeted and personalized. Because of our commitment to being on the leading edge of breast cancer care, this is a natural for us.”
According to the Centers for Disease Control and Prevention breast cancer is the most common cancer in women aside from non-melanoma skin cancers, regardless of race or ethnicity. It’s also the most common cause of death from cancer among Hispanic women. In 2008 (the most recent year for which data are available), the CDC reports more than 210,000 diagnoses of breast cancer and 40, 500 deaths from the disease.
The MedStar Regional Breast Health Program is part of the MedStar Georgetown Cancer Network and combines the knowledge and experience of internationally-respected experts who provide a wide range of breast care services. Patients have access to the network’s full breadth of clinical diagnoses, personalized treatments advanced surgical options and clinical trials as well as social workers, and nutritionists nurse navigators and other healthcare professionals.