Intra Operative Radiation Therapy (IORT)
Has anyone had this form (IORT) of radiation? Radiation is implanted in the surgical site during the time of the lumpectomy. I have been told that I am a candidate for this and am trying to make a decision. In November, 2011, I had DCIS in the left breast with 3 weeks of radiation and no boost. Worked well and was cancer free until last week when they found an invasive ductile malignancy (Grade 2, Stage 1, 7 mm) in the R. breast but no nodule involvement. The other option is a 5 day / 2 times per day radiation program. Has anyone had that program? Thanks so much for your input. In the past when I was active in this board, it really helped sort things out for me. So once again I have breast cancer and am returning for your help to make a decision. I will go to another board and ask about chemo and this time around I am going to need it too.
Comments
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I, too, have been told I can have IORT for my treatment. Looking forward to hearing from others.
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I had a lumpectomy and IORT on Thursday. The IORT was offered through I clinical trial, which I'm now a part of. I had stage 0 DCIS with a 5mm area of microcalcifications. On Thursday morning they took me in for a guide wire insertion (assisted by mammogram), which was relatively painless (a quick pinch or two for the lidocane but that was it). They prepped me for surgery and wheeled me into the operating room. I saw the IORT machine, got onto the operating table, they put something in my IV and off to sleep I went.
Next thing I knew I woke up in the recovery room with a little nausea but no pain. They gave me something for the nausea, it got better, I got up and went home.
It's been 3 days since the surgery and IORT and I've not had any pain whatsoever. The only way I even know they did the surgery and the IORT is that I'm a tiny bit tired and there is a glued incision on my breast (about 3 1/2 inches long, curved around one side of the areola. That's it - they say that the effectiveness of the IORT is equal to regular radiation. It is certainly an easy process. Given my results so far, I'd highly recommend it.
Let me know if you have any specific questions - I'd be happy to answer them. When I was trying to decide about the IORT, there weren't that many people around who had had it ... so I'm glad to help out if there is anything else you'd like to know.
Debbie
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Good Morning Debbie,
I am exploring this IORT option as I have lung issues which may preclude the normal radiation protocol. However, they did say that if they could not get clean margins I would have to have the standard radiation too. Did they tell you this as well? Thank you so much for sharing your experience and such a quick reply. Patricia
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Hi Patricia - They did tell me that - however, during the surgery, they actually do prelimiary testing of the margins (in my case by x-ray), so they are pretty confident they have clear margins before they do the IROT. There is never certainty until after the final pathology report and if the margins are not clear, I'm sure they would do another surgery and perhaps traditional radiation. I should get my final path report tomorrow - fingers crossed!
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I just got confirmation today that I can get the IORT. I fought so hard to get this option on the table, because of my age 36. My OS has to go back for a reexisions and we will do the IORT at that time. I just finished my chemo. I'm doing a happy dance. I am having my ovaries removed after all the cancer treatment is done. My Felix (tumor) is located right above my heart, so two radiologist didn't want to give me a boost and one didn't want to give me rads. I'm trying to find SE for the IORT. Doing some research tonight on it.
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Hi FairyDogMother - I have to tell you that I have had absolutely NO side effects from the IORT. In fact, I had to confirm with the RO's office that they'd even done the procedure because I couldn't tell at all.
Were your nodes clear when they did the SNB?
If your docs say it will work for you, I highly recommend the IORT! It's a God-send!
Debbie
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nodes were clear. I had a close margin and my OS will go in and clear it while the RO will do the IORT. I had chemo already and we are waiting from the all clear with the blood work. Chemo killed my liver enzymes which are high. I'm so looking forward to trying something new. Thank you for sharing your experience. Thank you to all gals sharing.
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pcollins
I had a lumpectomy, Sentinel lymph nodes and IORT today. The lymph nodes were checked during surgery and found to be clear. Normally, if they are not clear, they will not do IORT. However, the radiologist told me that if they weren't clear, they'd do 3weeks of radiation. He said there is a clinical trial going on now to see if you can do both (about 5 yrs to know the results)
IORT is amazing. Goes under the skin straight to the spot. I feel great and haven't had any pain meds.
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Monday I went in for my reexision
and I am out with having my Xoft. I am
the first patient under 40 to get this type of radiation. My boob is hurting, feels like it is on fire,
a little heavy, but other than that I feel like I’m getting back to “normal.” I’m trying to figure out how to wear a bra
for my classes this evening since clothing hurts. RO didn’t think I would have the 1 cm
clearance for the Xoft, but I ended up with 2 cm clearance. Love my OS for
fighting for me. My DH told me, “I’m
glad you are a scientist and read all those peer review journals and fought for
treatment.” I figured there has to be
better ways to treat cancer.IORT is awesome! I'm tender today.
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I'm a little annoyed my breast surgeon did not suggest or mention IORT, just found out about it now from my family doctor where i went for my bloodwork and presurgery EKG... i am having a lumpectomy and lymph node biop on March 11... tumor is <0.5 cm very very small... stage 1 grade1b her2+ er-pr- k167very high somewhere around 90%...we did discuss high dose whole breast radiation (3 weeks) after surgery.. she said i am 'borderline' for chemo because of the size of the tumor but I am doing it even if i have to find a new doctor... have not talked to an oncologist yet...
just seems to me that the IORT would be a great way to zap the hell out of the cancer first off, i want it along with the high dose whole breast 3 week rads AND herceptin chemo cocktail ....with my pathology and high K167 score i want to hit this with everything they have ... -
Patti - Remember that IORT is still in the clinical trial stage. It may be that there is nowhere in your area that offers it. You can go to the National Cancer Institute Clinical Trials page here: http://www.cancer.gov/clinicaltrials
Do a search for IORT in your area and see what comes up. I hope things turn out well for you. The IORT was a Godsend for me.
Debbie
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IOERT has been successfully use overseas for the last ten years. It does not generate a big profit for the hospitals, one two-minute dose of radiation vs. 25 whole breast radiation treatments. The good news is Dr. Robert A. Gardner, medical director and surgeon of the Palm Beach Breast Institute in West Palm Beach is bringing the LIAC IOERT to JFK in south Florida. Breast cancer operations to begin in May. Maybe other hospitals around the country will take the lead in there States and will forgo profit over women’s quality of life.
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I had surgery I September, 2013 - DCIS lumpectomy (stage 1, .5mm, HER2-, ER+, BRCA-) with reconstruction/reduction. I had the IORT and really cannot say that I had any specific effects from it. I was tired from the anesthesia and pain meds for a few days but the only side effect I have noticed from the IORT is there was a huge bruise in the area of the tumor and where the balloon/catheter would have been inserted. I now have a perfect circle of "dots" on my skin in the area where the bruise was; about 1.5" radius. Like a circle of tiny, tattoo-like bruises that are still there after 8 months. The treated breast was a little more tender and sore than the other side during recovery. It now feels a little thick/hardened in the area but, overall, my breasts feel very normal and everything healed really well. I feel the IORT makes so much sense and am very grateful to have been offered this in lieu of external, full-breast radiation (which made me nervous). I had a fantastic team - anyone in OC - I would highly recommend!! Feel free to contact me if you need a referral. Feeling like a lucky girl. Best to all, P. -
Hi I'm very new here and was just diagnosed two weeks ago with Stage 1, Grade 1 and was told I would be a candidate for this IORT procedure which is being offered in my area of this last year. I'm now in the process of getting my lab works done and go tomorrow for a Breast MRI to make sure they are just seeing the one tumor from my most recent MRI and Sonogram. My BS told me they are doing this procedure at our hospital and met last week with the Radiologist MD and she said right now everything looks good and I would be in a group study to be followed if I elect this. I'm waiting on my surgery date which will be in July and opted to go this route instead of the weeks of radiation. The only thing that would change is if they find any cells in my lymph nodes at the time of surgery which they will also check after the lumpectomy while I'm still in the operating room. If everything looks good they will do this procedure. I'm keeping my fingers crossed. Just the nerves right now of getting the surgery done.
Grade 1, ER+, PR+ Her2
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Darlene - Try not to worry - the surgery is a piece of cake! I had more pain and discomfort from the biopsy than I did from the surgery. Never had to take a pain pill and was up and running within a day or two after the surgery. The IORT was so amazing I didn't even know I had it. You'll sail through this with flying colors!
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Thanks so much Pokemom1959. I'm still waiting for surgery date. My Radiologist Dr. decided since I will be in study group for this procedure to get a breast MRI done. I did this and they found a very tiny spot on other breast .06 centimeter. I'm hearing this may not be anything and this did no show even on my 3D mammogram which was done earlier when they found the tumor on my other breast that was .07 centimeter. So I have to go next week for another core needle breast biopsy to make sure. This is just all so new to me and my head has been spinning. I will be so glad the day surgery is here. :-) From what you said this surgery is wonderful. I'm so glad our local hospital has started IORT within the last year here in Virginia. I'll keep you posted. Thanks again.
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I sure wish they had the IORT at my facility. It would have been Great. I had lump. and 5 days later a bilateral reduction. My BS also at the same time went back in to increase one of the margins. Which was "clean". It would have been the perfect time for the IORT. One shot and Done. Would have been a had the 5 day internal rads if I hadn't done the reduction. And because of the surgery, I ended up with 6 week instead of the 4 week so the dose was smaller each treatment. Don't fret the surgery it's not bad. I was home the same day.
Good luck with your biopsy. Fingers crossed.
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Two South Florida West Palm Beach patients had a single dose IOERT treatment during surgery 7/xx/2014. They were the first patients to receive Breast Cancer Treatment in a Day Therapy at JFK Hospital. Jupiter Hospital has also ordered a LIAC IOERT unit. Patients that aren't suitable for the single dose treatment may be suitable for the Boost treatment.A “boost” for traditional radiation patients. Patients
who must receive additional radiation therapy following surgery can receive a
boost of radiation during IOERT. After they have recovered from the surgical
procedure, they can continue with their radiation treatments, but the total
course of treatment is shortened by 1-2 weeks.
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Well my surgery date is August 6 so I'm ready as I ever will be. Little nervous but hopefully everything will go as planned. Since I last left a post they found some benign tissue on my other breast from a breast MRI so now will be getting my lumpectomy on the left with a few lymph nodes removed and the benign tissue removed from the right breast on same day. Right now I'm still getting the IORT at that time and hope this will be it. I'm keeping fingers crossed.
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You will do great, Darlene. I had IORT in Feb 2013 and am really glad I was able to do that.
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Thank you so much! Makes me feel good to hear this. I'm fortunate that our hospital just started this a year ago here and I qualified in the study here for this procedure. My tumor is only .7 invasive which is very small and hopefully this will be taken care of. He will take a few lymph nodes and if that is all clear it should be okay. I think possibly then be put on some kind of pill for the next five years. I'm keeping my fingers crossed and thanks so much for your encouragement. You didn't have much pain afterwards? I think what I hear the only discomfort will be is the incision under the arm. Can't wait to get to the surgery and get this taken care of. :-)
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BBC Today announce :A pioneering breast cancer treatment that replaces weeks of
radiotherapy with a single, targeted shot is set to be offered on the NHS.A typical radiotherapy department will spend around 30% of
its time dealing with breast cancer.Previous estimates have suggested a shift to intra-operative
radiation could free up resources and save the NHS £15m a year.Prof Jeffrey Tobias, who has pioneered the technique at
University College London Hospitals, told the BBC:"We're lagging behind,
we're out of step, it's a great pity."In Germany there are 60 centres capable of doing this,
in the UK there are six. -
Darlene, I had very little pain from the SNB and minor pain for a couple of days from the lumpectomy. They dose the radiation based on the cavity left by the tissue that was removed. My cancer was 4 mm but was deep, so they took a 4.5 x 5 x 1 cm piece of tissue. That qualified me for the maximum dose - 43 min of radiation. 10 days post op I started feeling pain from the radiation, but no one else I know that had the same procedure had radiation pain. So I assume mine was caused by the dosage. Also, I have very sensitive skin and think I would have had had skin issues from traditional external radiation.
Still, knowing what I know now, I would do it the same way and have IORT.
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So good to know! It's this waiting that is killing me. I guess that is the case with everyone. Mine is deep also but not sure yet how much radiation they will do. I'm just so anxious to get this done with. I'm excited though about being in this study group. I know they will keep close watch on us. I was so excited when the surgeon told me about this procedure and from what he saw and the biopsy he felt I was a good candidate and then met with the radiology doctor. She seemed very upbeat about this. From the size of my tumor only being .7 he told me about the size of golf ball they would remove. Did you have much problem with lymph node removal. I think that incision will be more aggravating then the lumpectomy area because of where it is located. Did it take you long to be back to normal routine again? I hate to ask you so many questions. But trying to prepare myself. :-)
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Darlene, I am happy to answer questions. Some people have problems with the node biopsy but I did not. I had less pain from that area. Maybe it is the location - mine was closer to the breast than under the arm. I had surgery on Fri and was working half day by the following Tues. I work from home in between trips for work. At that time I was flying across the country regularly for work and I picked up my regular travel schedule 3 weeks after surgery. No pain - I just tired quickly as anyone would after surgery.
I had a lot of pain with my biopsy and was afraid the wire guidance procedure before the node removal would be painful. I told the radiologist who did the wire guidance that I was more afraid of what she was going to do than anything else and told her my biopsy experience. She was very kind and I had no pain at all for that procedure.
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Hi Again!!!!
Well I'm posting my good news on here today. I'm almost two weeks out from my surgery with a lumpectomy and also the IORT procedure that was done. I received my pathology report back this week from my surgeon and the news was good. He was able to remove the .7 centimeter invasive tumor and was able to get good clear margins and also the same in my lymph nodes. So I shall meet with the Oncologist this week to see what further treatment shall be. I'm keeping fingers crossed since the cancer is gone that it will be just hormonal treatment for the next five to ten years. I'm so thankful and still trying to take these past few months all in.
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Good for you Darlene, Iort and Ioert are the greatest. -
Darlene dance it out! Excellent news!
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