Comparison of seroma production in breast conserving surgery with or without intraoperative radiotherapy as tumour bed boost

Ebner, Florian; Schramm, A; Bottke, Dirk; Friedl, Thomas W. P.; Wiegel, Thomas; Fink, Visnja; Lato, Kristian; Bekes, Inga; Janni, Wolfgang; Gregorio, Nikolaus de

doi:10.1007/s00404-016-4124-8

Cited by 11 publications

(8 citation statements)

References 20 publications

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“…There are several types of surgical complications. The variability of complication rates in published studies stems from the criteria used to consider an adverse event to be a complication, and range from 5% to 40% of cases [6,10,15,22]. Our rate was similar to those reported in the most current literature.…”

Section: Discussionsupporting

confidence: 76%

“…IORT increased the occurrence of postsurgical seroma [15,25]. Early closing of the surgical cavity by breast remodeling, which we systematically carry out, could account for the lower amount of seromas observed in our series, as compared with other published series.…”

Section: Discussionsupporting

confidence: 46%

“…Since they are small, easy-to-locate lesions, small resections can be performed; thus reducing postoperative complications [2,13]. The need for axillary emptying or for application of complementary ERT may increase such complications [15,16]. Both of these factors were not statistically significant.…”

Section: Discussionmentioning

confidence: 90%

“…With more experience, it became clear that it was not necessary to modify the tumorectomy technique because of the use of IORT. This type of seroma usually appears late, and less than 5% of cases require more than 2 aspirations for resolution [6,15,25].…”

Section: Discussionmentioning

confidence: 99%

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Complications and local relapse after intraoperative low-voltage X-ray radiotherapy in breast cancer

et al. 2020

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To study those factors that influence the occurrence of surgical complications and local relapse in patients intervened for breast cancer and receiving intraoperative radiotherapy. Methods: Observational study on patients intervened for breast cancer with conservative surgery and intraoperative radiotherapy with low-voltage X-ray energy source (INTRABEAM), from 2015 to 2017 with 24 months minimum followup. Variables possibly associated to the occurrence of postoperative complications were analyzed with the Student t-test and the Fisher exact test; P < 0.05 considered significant. Subsequently, the construction of multiple multivariate analysis models began, thus building a logistic regression analysis using the IBM SPSS Statistics ver. 23 software. Local relapse was described. Results: The study included 102 patients, mean age of 61.2 years; mean global size of tumor, 12.2 mm. Complications occurred in 29.4%. Fibrosis was the most frequently observed complication, followed by postoperative seroma. Using a 45 mm or larger applicator were significantly associated with the occurrence of complications. Tumor size 2 cm or larger and reintervention showed borderline significant association. Only one case of local relapse was observed. Conclusion: Certain factors may increase the risk of complication after the use of intraoperative radiotherapy. Using external complementary radiotherapy does not seem to increase the rate of complications. Select patients and the involvement of a multidisciplinary team are essential for achieving good results.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Complications and local relapse after intraoperative low-voltage X-ray radiotherapy in breast cancer

et al. 2020

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“…However, 96.8% of our patients showed no wound infection or delayed wound healing and are therefore comparable with their control group. Other authors do not even see a difference in the frequency and amount of seromas after IORT boost (23, 24). In conclusion, IOERT as a boost is a safe and well-tolerated therapy without higher incidence of perioperative complications.…”

Section: Discussionmentioning

confidence: 89%

Acute Toxicity and Early Oncological Outcomes After Intraoperative Electron Radiotherapy (IOERT) as Boost Followed by Whole Breast Irradiation in 157 Early Stage Breast Cancer Patients—First Clinical Results From a Single Center

et al. 2019

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Introduction: Breast conserving surgery (BCS) followed by postoperative whole breast irradiation (WBI) is the current standard of care for early stage breast cancer patients. Boost to the tumor bed is recommended for patients with a higher risk of local recurrence and may be applied with different techniques. Intraoperative electron radiotherapy (IOERT) offers several advantages compared to other techniques, like direct visualization of the tumor bed, better skin sparing, less inter- and intrafractional motion, but also radiobiological effects may be beneficial. Objective of this retrospective analysis of IOERT as boost in breast cancer patients was to assess acute toxicity and early oncological outcomes. Material and Methods: All patients, who have been irradiated between 11/2014 and 01/2018 with IOERT during BCS were analyzed. IOERT was applied using the mobile linear accelerator Mobetron with a total dose of 10 Gy, prescribed to the 90% isodose. After ensured woundhealing, WBI followed with normofractionated or hypofractionated regimens. Patient reports, including diagnostic examinations and toxicity were analyzed after surgery and 6–8 weeks after WBI. Overall survival, distant progression-free survival, in-breast and contralateral breast local progression-free survival were calculated using the Kaplan-Meier method. Furthermore, recurrence patterns were assessed. Results: In total, 157 patients with a median age of 57 years were evaluated. Postoperative adverse events were mild with seroma and hematoma grade 1–2 in 26% and grade 3 in 0.6% of the patients. Wound infections grade 2–3 occurred in 2.2% and wound dehiscence grade 1–2 in 1.9% of the patients. Six to eight weeks after WBI radiotherapy-dependent acute dermatitis grade 1–2 was most common in 90.9% of the patients. Only 4.6% of the patients suffered from dermatitis grade 3. No grade 4 toxicities were documented after surgery or WBI. 2- and 3-year overall survival and distant progression-free survival, were 97.5 and 93.6, and 0.7 and 2.8%, respectively. In-breast recurrence and contralateral breast cancer rates after 3 years were 1.9 and 2.8%, respectively. Conclusion: IOERT boost during BCS is a safe treatment option with low acute toxicity. Short-term recurrence rates are comparable to previously published data and emphasize, that IOERT as boost is an effective treatment.

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Intraoperative Radiation Therapy

Fastner

Zippel²,

Noy³

2022

Breast Cancer Radiation Therapy

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Comparison of seroma production in breast conserving surgery with or without intraoperative radiotherapy as tumour bed boost

Abstract: Patients with IORT encountered no increased seroma production and removal of the drains was not delayed compared to patients with breast conserving surgery only. Our results indicate that IORT does not increase the seroma production compared to surgery alone.

Cited by 11 publications

References 20 publications

Complications and local relapse after intraoperative low-voltage X-ray radiotherapy in breast cancer

Complications and local relapse after intraoperative low-voltage X-ray radiotherapy in breast cancer

Acute Toxicity and Early Oncological Outcomes After Intraoperative Electron Radiotherapy (IOERT) as Boost Followed by Whole Breast Irradiation in 157 Early Stage Breast Cancer Patients—First Clinical Results From a Single Center

Intraoperative Radiation Therapy

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