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Emory hospital offers new treatment for early-stage breast cancer

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Janet Christenbury
A team of community and faculty doctors at Emory University Hospital Midtown is now treating patients with Intraoperative Radiation Therapy (IORT) during breast-conserving surgeries.

An innovative new tool in the fight against breast cancer allows patients to undergo a one-time radiation treatment, directly in the cavity where the tumor has been removed, during surgery for early-stage breast cancer. A team of community and faculty doctors at Emory University Hospital Midtown is now treating patients with Intraoperative Radiation Therapy (IORT) during breast-conserving surgeries.

Emory University Hospital Midtown is one of three centers in Georgia to provide the high-tech treatment.

Targeted IORT is an individualized radiation treatment that delivers low-energy X-rays directly into the tumor bed at the time of surgery (immediately following a lumpectomy or partial mastectomy). During the procedure, the Zeiss INTRABEAM machine delivers the radiation dose through a spherical-shaped applicator, which is placed in the cavity to ensure direct contact with the targeted tissue. Radiation is delivered precisely to the area with the highest risk of tumor recurrence, while minimizing radiation to healthy tissue.

"IORT is a good option for patients undergoing breast-conservation surgeries because they can receive a single, targeted dose of radiation to the tumor bed during their surgical procedure, without radiating the entire breast," says Karen Godette, MD, associate professor of radiation oncology, Emory University School of Medicine and medical director of the radiation oncology department at Emory University Hospital Midtown. "Clinical studies show that if patients are selected properly, IORT is just as good as standard radiation therapy after surgery, in terms of tumor recurrence."

The one-time radiation treatment takes 20-45 minutes to deliver, depending on the size of the cavity. Most patients do not need supplemental radiation following IORT. The radiation treatment in the operating room also means no delay in receiving radiation. Standard radiation treatment usually begins four to six weeks after surgery to allow the surgical wound to heal.

"Proper selection of patients for this procedure is key," says Rogsbert F. Phillips, MD, a community-based breast surgeon and Emory Healthcare Network physician at Emory University Hospital Midtown, who was instrumental in bringing this new therapy to the hospital. "The best candidates are usually women aged 50 and above who have early-stage breast cancer, or small tumors that have not spread to other areas of the body. This procedure is not appropriate for patients with aggressive breast cancers, such as triple-negative breast cancer or metastatic breast cancers."

Emory Healthcare Network physician Yara Robertson, MD, who practices with Phillips, is also trained in the IORT treatment for breast cancer. Robertson emphasizes how important IORT is for patients who sometimes travel far distances to Emory University Hospital Midtown for breast cancer treatment.

IORT's one-time treatment also costs less than traditional radiation treatments, which can last up to six weeks.

"Besides offering targeted radiation therapy to the tumor site with minimal side effects, the convenience factors should also be considered beneficial," says Monica Rizzo, MD, associate professor of surgery at Emory, whose focus is on surgical oncology. "We are pleased to offer this treatment option to patients at Emory University Hospital Midtown, as we continue to promote the importance of finding and treating breast cancers early."

Rizzo and Godette are members of Winship Cancer Institute of Emory University.

"IORT is a new modality for treating breast cancer, and it has proven to be as effective for the treatment of early breast cancer as compared to total breast radiation," says Phillips. "More and more women are finding out about IORT and requesting it. The team of physicians at Emory University Hospital Midtown is proud to be a part of this cutting edge technology. We are grateful for our hospital leaders who supported this endeavor."

INTRABEAM received FDA-approval in 1999, and is covered by most insurance companies.

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