International Journal of Cancer Management

Published by: Kowsar

Outcomes of Breast Cancer (Invasive Lobular and Ductal Carcinoma) Treated with Boost Intraoperative Electron Radiotherapy Versus Conventional External Beam Radiotherapy

Hassan Moayeri 1 , 2 , * , Mohammad Esmaeil- Akbari 1 , ** , Nahid Nafissi 3 , Seied Rabi Mahdavi 4 , Hamid Reza Mirzaei 1 , Azam Salati 1 , Maryam Khayamzade 1 , Zeinab Shormeij 1 , Jafar Shakeri 1 , Mojgan Nabatzadeh 1 , Minoo Shahani 1 , Marzieh Kiaee 5 and Sajad Noorian Noorian 6
Authors Information
1 Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Surgery, Kurdistan University of Medical Sciences, Sanandaj, Iran
3 Department of Breast Surgery, Iran University of Medical Sciences, Tehran, Iran
4 Medical Physics Department, Iran University of Medical Sciences, Tehran, Iran
5 Department of Optic and Photonic, Iran Telecom Research Center, Tehran, Iran
6 Department of Statistics, Faculty of Scence, University of Qom, Qom, Iran
Corresponding Authors:
Article information
  • International Journal of Cancer Management: 12 (1); e84850
  • Published Online: January 9, 2019
  • Article Type: Research Article
  • Received: October 2, 2018
  • Revised: November 20, 2018
  • Accepted: November 26, 2018
  • DOI: 10.5812/ijcm.84850

To Cite: Moayeri H, Akbari M E, Nafissi N, Mahdavi S R , Mirzaei H R , et al. Outcomes of Breast Cancer (Invasive Lobular and Ductal Carcinoma) Treated with Boost Intraoperative Electron Radiotherapy Versus Conventional External Beam Radiotherapy, Int J Cancer Manag. Online ahead of Print ; 12(1):e84850. doi: 10.5812/ijcm.84850.

Copyright © 2019, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Methods
3. Results
4. Discussion
  • 1. Veronesi U, Saccozzi R, Del Vecchio M, Banfi A, Clemente C, De Lena M, et al. Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med. 1981;305(1):6-11. doi: 10.1056/NEJM198107023050102. [PubMed: 7015141].
  • 2. Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227-32. doi: 10.1056/NEJMoa020989. [PubMed: 12393819].
  • 3. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233-41. doi: 10.1056/NEJMoa022152. [PubMed: 12393820].
  • 4. Curran D, van Dongen JP, Aaronson NK, Kiebert G, Fentiman IS, Mignolet F, et al. Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG). Eur J Cancer. 1998;34(3):307-14. [PubMed: 9640214].
  • 5. de Haes JC, Curran D, Aaronson NK, Fentiman IS. Quality of life in breast cancer patients aged over 70 years, participating in the EORTC 10850 randomised clinical trial. Eur J Cancer. 2003;39(7):945-51. [PubMed: 12706363].
  • 6. Bazan JG, Stephens J, Terando A, Skoracki R, McElroy S, Sexton J, et al. Abstract OT2-03-01: Multi-institution phase II trial of intraoperative electron beam radiotherapy boost at the time of breast conserving surgery with oncoplastic reconstruction in women with early-stage breast cancer. Cancer Res. 2018;78(4 Supplement):OT2-3-01-OT2-03-01. doi: 10.1158/1538-7445.sabcs17-ot2-03-01.
  • 7. Gage I, Recht A, Gelman R, Nixon AJ, Silver B, Bornstein BA, et al. Long-term outcome following breast-conserving surgery and radiation therapy. Int J Radiat Oncol Biol Phys. 1995;33(2):245-51. doi: 10.1016/0360-3016(95)02001-R. [PubMed: 7673011].
  • 8. Antonucci JV, Wallace M, Goldstein NS, Kestin L, Chen P, Benitez P, et al. Differences in patterns of failure in patients treated with accelerated partial breast irradiation versus whole-breast irradiation: A matched-pair analysis with 10-year follow-up. Int J Radiat Oncol Biol Phys. 2009;74(2):447-52. doi: 10.1016/j.ijrobp.2008.08.025. [PubMed: 19058921].
  • 9. Arthur DW, Winter K, Kuske RR, Bolton J, Rabinovitch R, White J, et al. A phase II trial of brachytherapy alone after lumpectomy for select breast cancer: Tumor control and survival outcomes of RTOG 95-17. Int J Radiat Oncol Biol Phys. 2008;72(2):467-73. doi: 10.1016/j.ijrobp.2007.12.056. [PubMed: 18294778]. [PubMed Central: PMC2604132].
  • 10. Benitez PR, Keisch ME, Vicini F, Stolier A, Scroggins T, Walker A, et al. Five-year results: The initial clinical trial of MammoSite balloon brachytherapy for partial breast irradiation in early-stage breast cancer. Am J Surg. 2007;194(4):456-62. doi: 10.1016/j.amjsurg.2007.06.010. [PubMed: 17826055].
  • 11. Gomez-Iturriaga A, Pina L, Cambeiro M, Martinez-Regueira F, Aramendia JM, Fernandez-Hidalgo O, et al. Early breast cancer treated with conservative surgery, adjuvant chemotherapy, and delayed accelerated partial breast irradiation with high-dose-rate brachytherapy. Brachytherapy. 2008;7(4):310-5. doi: 10.1016/j.brachy.2008.04.006. [PubMed: 18778971].
  • 12. Krishnan L, Jewell WR, Tawfik OW, Krishnan EC. Breast conservation therapy with tumor bed irradiation alone in a selected group of patients with stage I breast cancer. Breast J. 2001;7(2):91-6. [PubMed: 11328314].
  • 13. Niehoff P, Polgar C, Ostertag H, Major T, Sulyok Z, Kimmig B, et al. Clinical experience with the MammoSite radiation therapy system for brachytherapy of breast cancer: Results from an international phase II trial. Radiother Oncol. 2006;79(3):316-20. doi: 10.1016/j.radonc.2006.05.010. [PubMed: 16780977].
  • 14. Smith BD, Arthur DW, Buchholz TA, Haffty BG, Hahn CA, Hardenbergh PH, et al. Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO). Int J Radiat Oncol Biol Phys. 2009;74(4):987-1001. doi: 10.1016/j.ijrobp.2009.02.031. [PubMed: 19545784].
  • 15. Ashikari R, Huvos AG, Urban JA, Robbins GF. Infiltrating lobular carcinoma of the breast. Cancer. 1973;31(1):110-6. [PubMed: 4345605].
  • 16. van Limbergen E, van den Bogaert W, van der Schueren E, Rijnders A. Tumor excision and radiotherapy as primary treatment of breast cancer. Analysis of patient and treatment parameters and local control. Radiother Oncol. 1987;8(1):1-9. [PubMed: 3809596].
  • 17. Fodor J, Major T, Polgar C, Toth J, Nemeth G. The impact of radiotherapy on the incidence and time of occurrence of local recurrence in early-stage breast cancer after breast conserving therapy. Neoplasma. 2000;47(3):181-6. [PubMed: 11043843].
  • 18. Weiss MC, Fowble BL, Solin LJ, Yeh IT, Schultz DJ. Outcome of conservative therapy for invasive breast cancer by histologic subtype. Int J Radiat Oncol Biol Phys. 1992;23(5):941-7. [PubMed: 1322387].
  • 19. Ott OJ, Hildebrandt G, Potter R, Hammer J, Lotter M, Resch A, et al. Accelerated partial breast irradiation with multi-catheter brachytherapy: Local control, side effects and cosmetic outcome for 274 patients. Results of the German-Austrian multi-centre trial. Radiother Oncol. 2007;82(3):281-6. doi: 10.1016/j.radonc.2006.08.028. [PubMed: 17126940].
  • 20. Strnad V, Ott OJ, Hildebrandt G, Pötter R, Hammer J, Lotter M, et al. Long-term results of the German-Austrian phase II study – accelerated partial breast irradiation using multicatheter brachytherapy for early breast cancer. Brachytherapy. 2009;8(2):107. doi: 10.1016/j.brachy.2009.03.011.
  • 21. Polgar C, Van Limbergen E, Potter R, Kovacs G, Polo A, Lyczek J, et al. Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: Recommendations of the Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence (2009). Radiother Oncol. 2010;94(3):264-73. doi: 10.1016/j.radonc.2010.01.014. [PubMed: 20181402].
  • 22. Bharat A, Gao F, Margenthaler JA. Tumor characteristics and patient outcomes are similar between invasive lobular and mixed invasive ductal/lobular breast cancers but differ from pure invasive ductal breast cancers. Am J Surg. 2009;198(4):516-9. doi: 10.1016/j.amjsurg.2009.06.005. [PubMed: 19800459].
  • 23. Arpino G, Bardou VJ, Clark GM, Elledge RM. Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res. 2004;6(3):R149-56. doi: 10.1186/bcr767. [PubMed: 15084238]. [PubMed Central: PMC400666].
  • 24. Harness JK, Davies K, Via C, Brooks E, Zambelli-Weiner A, Shah C, et al. Meta-analysis of local invasive breast cancer recurrence after electron intraoperative radiotherapy. Ann Surg Oncol. 2018;25(1):137-47. doi: 10.1245/s10434-017-6130-x. [PubMed: 29110277].
  • 25. Vaidya JS, Bulsara M, Wenz F, Coombs N, Singer J, Ebbs S, et al. Reduced mortality with partial-breast irradiation for early breast cancer: A meta-analysis of randomized trials. Int J Radiat Oncol Biol Phys. 2016;96(2):259-65. doi: 10.1016/j.ijrobp.2016.05.008. [PubMed: 27478165].
  • 26. Veronesi U, Orecchia R, Maisonneuve P, Viale G, Rotmensz N, Sangalli C, et al. Intraoperative radiotherapy versus external radiotherapy for early breast cancer (ELIOT): A randomised controlled equivalence trial. Lancet Oncol. 2013;14(13):1269-77. doi: 10.1016/S1470-2045(13)70497-2. [PubMed: 24225155].
  • 27. Leonardi MC, Maisonneuve P, Mastropasqua MG, Cattani F, Fanetti G, Morra A, et al. Comparison of treatment outcome between invasive lobular and ductal carcinomas in patients receiving partial breast irradiation with intraoperative electrons. Int J Radiat Oncol Biol Phys. 2017;99(1):173-81. doi: 10.1016/j.ijrobp.2017.04.033. [PubMed: 28816144].
  • 28. Peiro G, Bornstein BA, Connolly JL, Gelman R, Hetelekidis S, Nixon AJ, et al. The influence of infiltrating lobular carcinoma on the outcome of patients treated with breast-conserving surgery and radiation therapy. Breast Cancer Res Treat. 2000;59(1):49-54. [PubMed: 10752679].
  • 29. Correa C, Harris EE, Leonardi MC, Smith BD, Taghian AG, Thompson AM, et al. Accelerated partial breast irradiation: Executive summary for the update of an ASTRO evidence-based consensus statement. Pract Radiat Oncol. 2017;7(2):73-9. doi: 10.1016/j.prro.2016.09.007. [PubMed: 27866865].
  • 30. Veronesi U, Orecchia R, Luini A, Galimberti V, Zurrida S, Intra M, et al. Intraoperative radiotherapy during breast conserving surgery: A study on 1,822 cases treated with electrons. Breast Cancer Res Treat. 2010;124(1):141-51. doi: 10.1007/s10549-010-1115-5. [PubMed: 20711810].
  • 31. Shah C, Wilkinson JB, Shaitelman S, Grills I, Wallace M, Mitchell C, et al. Clinical outcomes using accelerated partial breast irradiation in patients with invasive lobular carcinoma. Int J Radiat Oncol Biol Phys. 2011;81(4):e547-51. doi: 10.1016/j.ijrobp.2011.04.050. [PubMed: 21640491].
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