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Factors predictive of failure to complete planned intraoperative breast radiation using the intrabeam® system
Author(s) -
Dossett Lesly A.,
Abbott Andrea M.,
Sun Weihong,
Loftus Loretta,
Lee Marie Catherine,
Diaz Roberto,
Laronga Christine
Publication year - 2016
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24473
Subject(s) - medicine , intraoperative radiation therapy , discontinuation , mastectomy , lumpectomy , surgery , breast conserving surgery , breast cancer , radiation therapy , cancer
Purpose Intraoperative radiation therapy (IORT) is a form of breast irradiation that is delivered in a single session at the time of partial mastectomy. In up to 10% of patients, planned IORT is not completed; this leads to wasted resources and decreased patient satisfaction. Our objective was to evaluate factors associated with failure to complete planned IORT. Methods and Materials An IRB‐approved review of planned IORT cases from 2011 to 2015 was conducted. Eligibility criteria included: age ≥60, invasive ductal or mammary carcinoma, tumor <3.0 cm, ER positive, and clinically node negative. Discontinuation of planned IORT was at the discretion of the breast surgical and radiation oncologists. Results Twenty‐one (15%) of one hundred and forty‐five planned IORT cases were not completed. Reasons for failure to complete IORT included inadequate applicator to skin distance (n = 15, 71%), altered wire localization findings the day of surgery (n = 4, 19%), equipment failure (n = 1, 5%), and hemodynamic instability (n = 1, 5%). Significant surgeon variability was associated with failure to complete planned IORT ( P < 0.001). Conclusions Insufficient skin‐to‐applicator spacing is the most common reason for failure to complete IORT. In this series, higher volume surgeons completed a greater proportion of IORT cases, suggesting a learning curve to patient selection or intraoperative technique. J. Surg. Oncol. 2016;114:930–932 . © 2016 Wiley Periodicals, Inc.