Thursday, December 18, 2014

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Innovative Breast Cancer Treatment Combines Surgery and Radiation Therapy in a Single Day

The University of Virginia Cancer Center is among the first centers in the U.S. to offer a new breast cancer treatment that aims to reduce treatment time to a single day instead of several weeks. U.Va. physicians expect the new treatment will better preserve healthy tissue and provide more precise treatment to the tumor site.

U.Va. physicians are combining high-dose intraoperative radiation therapy, or IORT, during surgery with computed tomography on rails-directed brachytherapy, which allows U.Va.’s specialists in breast surgery and radiation oncology to more accurately plan treatment. This combined method may be a treatment option for patients diagnosed as having early-stage breast cancer.

Traditional IORT delivers a concentrated dose of radiation during a lumpectomy breast surgery in the area surrounding where the tumor was removed without the benefit of imaging to guide the treatment.

U.Va. radiation oncologist Dr. Timothy Showalter said the use of IORT combined with CT on rails-guided brachytherapy will improve treatment coverage of the highest-risk areas around the breast tumor while limiting the amount of healthy tissue exposed to radiation.

“Our method is image-guided,” he said. “This permits the radiation oncologist and the breast surgeon to use computerized treatment planning to better sculpt the radiation dose so that it encompasses the area closest to the tumor while minimizing dose to the skin, chest wall and heart.

“Essentially, we are taking the most advanced radiation therapy tools that we use for breast brachytherapy, and using CT-on-rails technology to streamline the treatment for delivery at the time of surgery.” 

Although early in development, this combined approach is expected to both reduce risk of breast cancer recurrence and improve cosmetic outcomes.

“One of the major benefits of breast-preserving surgery is that the nipple and areola area of the breast remain untouched, allowing women to feel as normal as possible after surgery and treatment. Now, with IORT, we have the potential to provide the surgery and radiation therapy in a single day, rather than over a course of six weeks,” said U.Va. breast surgeon Dr. David Brenin.

“Traditional radiation therapy can be anywhere from six to seven weeks. However with IORT, patients can finish radiation therapy at the same time as their surgery, allowing patients to get back to their life sooner,” Showalter said.

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