New procedure reduces radiation sessions for breast cancer patients

A new procedure allows a breast cancer patient to undergo a lumpectomy and then receive all of the necessary radiation in one dose while still sedated from the surgery. (Courtesy of MedStar Georgetown University Hospital)

WASHINGTON – It is being hailed as a game changer in breast cancer treatment. For select patients, there is now an alternative to the traditional six weeks of radiation therapy and its accompanying side effects.

The new procedure, using INTRABEAM intraoperative radiotherapy, allows a breast cancer patient to undergo a lumpectomy and then receive all of the necessary radiation in one dose while still sedated from the surgery.

Traditionally, radiation is administered in several doses over a set amount of time.

A study published in The Lancet found the procedure should be seriously considered for some breast cancer patients. That is exactly what’s happening at two local area hospitals, MedStar Georgetown University Hospital and MedStar Washington Hospital Center.

“This is definitely a big advance for us,” says Dr. Eleni Tousimis, chief of breast surgery at MedStar Georgetown University Hospital.

In the new procedure, probes are used to help deliver the radiation directly into the patient’s incision site. Instead of treating the entire breast, the radiation is targeted solely at the area where the tumor was located prior to being removed.

Tousimis notes that cosmetically, the results are excellent, leaving little to no burning or scaring. Logistically, this “one and done” treatment is a huge improvement over the inconvenience of repeated trips to the hospital for standard radiation therapy.

“This is one treatment during the surgery while the patient is asleep. When they wake up from the surgery, their treatment is all done,” Tousimis says.

But intraoperative radiotherapy is not for everybody. Right now, it is only an option for women older than 50 with certain kinds of tumors.

Tousimis says the cancerous growths have to be less than two centimeters and they must be hormone receptor positive. However, she notes that more studies are going on, and over time, the minimum age will drop.

Age was not an issue for Rhoda Gensler. At 83, the self-described “pioneer” from Potomac, Md., became the first patient at Georgetown to undergo surgery incorporating the new radiation technique.

“I was so happy,” Gensler says. “I know what my friends have gone through with burned bodies and tremendous pain.”

Gensler says her experience was totally different, and almost completely pain-free.

“On the day of my surgery, I left the hospital at 8:30, and at 9:30, I was eating at The Tavern at Great Falls and eating a big dinner,” she says.

Gensler says she has no worries about a recurrence of the cancer. If it does happen again, she will simply undergo the same procedure once more.

And that is another big difference between standard radiation therapy and intraoperative radiotherapy.

When a woman who has had a lumpectomy and weeks of full breast radiation develops a new tumor, her only option is a mastectomy.

However, if the radiation was targeted at the direct site of the tumor, as it is with intraoperative radiotherapy, and the new tumor is in another portion of the breast, another lumpectomy is an option.

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