Breast HealthRadiation Oncologist Alicia Gittleman, MD, and Breast Surgical Oncologist Kathleen Minnick, MD, break down the most important things to know about intra-operative radiation therapy, or IORT — an innovative treatment option for breast cancer.

1. IORT is a form of breast radiation, delivered precisely.
Intraoperative radiation therapy (IORT) is a form of breast radiation that is delivered precisely during surgery to remove a tumor, allowing for a single dose of radiation to directly target a specific area where cancer is most likely to return.

2. Certain factors mean you’re a candidate.

  • Are 50 years of age or older and not known to have a genetic mutation placing them at increased risk of additional breast cancers in the future
  • Have solitary tumors less than three centimeters in size
  • Have no evidence of lymph node involvement

The surgeon and radiation oncologist may also consider additional features of the tumor, such as grade and status.

3. It’s usually a one-time procedure.
Compared to traditional courses of radiation therapy, which are delivered over a period of one to six weeks, IORT is generally a one-time procedure. During surgery, once the tumor has been removed, an applicator is placed in the tumor cavity in the breast and low-energy X-rays are delivered. No additional outpatient procedure is required. Although unusual, an additional three weeks of radiation may be offered if your doctors believe more treatment is required.

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4. It’s a team effort.
The procedure is a collaborative effort between physicians, physicists, pathologists and ancillary staff. A breast surgical oncologist removes the tumor and a radiation oncologist, with the aid of a physicist, delivers the radiation. At the time of surgery, a pathologist performs an examination of the tissue to make sure the whole tumor was removed. Images also assist in making this assessment.

5. Patients may experience fewer side effects with a smaller treatment area.
Patients who have a lumpectomy followed by whole breast radiation can experience breast tenderness, skin irritation, and fatigue. When a smaller area is treated (as with IORT), patients may experience a lower degree of side effects or the effects may be limited to a smaller area of the breast.

6. Evidence supports use of IORT.
A 2020 study published in the British Medical Journal (BMJ)* looked at thousands of patients who received either whole breast radiation therapy or IORT and found that select patients did equally well with either option. Patients can rest assured that this one-time treatment is as effective as the more traditional therapies.

7. It’s not widely available.
The procedure is performed by only a handful of medical teams in Southeast Florida.

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