One-Day Breast Cancer Treatment

Los Angeles - When breast cancer is caught early, lumpectomy plus radiation is widely considered just as effective as a total mastectomy. Now, there's a new therapy in testing that could combine surgery and radiation into one single visit.

Watch for the video report here after FOX 11 10 O'clock News.

The procedure's called "Targeted Intraoperative Radiotherapy" or TARGIT for short.

Dennis Holmes, Breast Cancer Surgeon
I think the TARGIT trial is one of the most important studies that has been published about breast conservation since 1986.

Breast cancer surgeon Dennis Holmes told us about research recently reported at a meeting of the American Society of Clinical Oncologists.

The finding was that a single high-dose of radiation given during lumpectomy surgery for breast cancer was just as effective as a six-week course of standard radiation.

In other words, the patient is finished with her breast cancer treatment in just one day.

Dennis Holmes, Breast Cancer Surgeon
When the patient wakes up the radiotherapy is done the surgery is done and the patient goes home.

Here's how it all happens.

During surgery, the cancerous tumor is removed and x-rayed to make sure it was cleanly removed, and then to pathology.

While the tumor is being analyzed in the lab, the doctor and his team position the Intrabeam applicator and a radiation barrier is placed at the bottom of the lumpectomy cavity to prevent radiation from entering the chest and affecting the lungs and heart.

The doctors and nurses have a radiation barrier applied to them as well for skin protection.

While the patient continues to sleep, the Intrabeam gets to work.

It takes 18 minutes to deliver the dose of radiation patients normally get over a six-week standard course.

Dennis Holmes, Breast Cancer Surgeon
With the standard approach, the reason that we have to give it over many days is that we can only give so much radiation on a given day. Otherwise, the skin will be over exposed.

By moving skin out of the way, that danger is eliminated.

The procedure is not for everyone.

Dennis Holmes, Breast Cancer Surgeon
Not every woman is a candidate for TARGIT treatment, but not everyone is a candidate for breast conservation to begin with. Some women require mastectomy.

For now, Intrabeam trials are limited to women who had tumors about the size of a quarter or smaller, women who had tumors that did not involve the lymph nodes, and women who are 45 and over.

Dennis Holmes, Breast Cancer Surgeon
That's pretty much the population that was studied, and in that population the recurrence rate was very low. It was low in those that received standard breast radiotherapy and it was equally low in those that received targit radiotherapy.

But Dr. Holmes says he wouldn't be surprised if, over the next several years, the TARGIT approach turns out to be safer.

Dennis Holmes, Breast Cancer Surgeon
It targets radiation to the portion of the breast from which the cancer is removed. That's different from standard breast radiotherapy which irradiates the entire breast.

Story Summary & More Information:

The TARGIT Breast Cancer Trial has looked at outcomes in 2200 women with early stage breast cancer or Ductal Carcimoma In Situ (DCIS). Women in the trial had tumors smaller than a quarter, no lymph node involvement and were over 45 years old.

Approximately half got lumpectomy plus a standard 5-7 week course of external radiation. The other half got a single high dose of radiation with Intrabeam during their surgery.

Over the course of 2-4 years recurrence rates were roughly 1% in both groups of women.

USC Breast Cancer Surgeon Dr. Dennis Holmes reported that there was no difference in surgery recovery between his patients who got radiation during surgery and those who did not.

To read more about Dr. Holmes, see:
doctorsofusc.com/doctor/bio/view/72102

To read more about the Targit Clinical Trial at USC Norris Cancer Center, see:
www.targittrial.com/whatisiort.htm

The American Cancer Society is urging caution. Read what one critic is saying here:
cancer.org/AboutUs/DrLensBlog/post/2010/06/29/Is-TARGIT-Radiation-Therapy-For-Breast-Cancer-Really-On-Target.aspx

BreastCancer.org has a detailed analysis of the trial here:
breastcancer.org/treatment/radiation/new_research/20100605b.jsp