Lumpectomy Followed By Intraoperative Electron Radiation Therapy (IOERT)
Invasive Ductal Breast Cancer, Carcinoma Breast Stage I
About this trial
This is an interventional treatment trial for Invasive Ductal Breast Cancer focused on measuring Stage I Breast Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Patient agrees to breast conservation therapy (segmental resection, partial mastectomy, and radiation therapy) as the treatment for their breast cancer
- Patient agrees to evaluation of the axilla with sentinel lymph node biopsy
- Peri or post-menopausal women age > 50, defined as women who have experienced no menstrual period in the past 6 months or more
- BRCA1 and 2 gene mutation negative, if tested. [genetic testing is NOT required based upon personal or family history]
- Unifocal (unicentric), invasive ductal carcinoma or favorable sub-types (mucinous, tubular, colloid) < 2.0 cm in diameter, primary T-stage of Tis or T1 (AJCC criteria)
- Grade 1, 2, or 3 acceptable
- Associated LCIS is allowed
- Pure DCIS allowed if <2.5 cm, low to intermediate nuclear grade and resected margins negative at > 3 mm (per ASTRO criteria)
- Estrogen receptor (ER) status of positive
- Patient has clear margins >2 mm on gross pathologic examination
- Patient is node-negative, defined as N0 (i-) or N0 (i+)
- Patient must be deemed functionally and mentally competent to understand and sign the informed consent
- Neoadjuvant hormonal therapy is allowed if all other ASTRO suitable criteria have been met prior to onset of hormonal therapy
Exclusion Criteria:
- Prior breast malignancy or other malignancy if metastatic, or with expected survival of < 5 years
- Immunocompromised status
- Pregnancy
- Women with an active connective tissue disorder (i.e. scleroderma, lupus and others)
- Breast cancer that involves the skin or chest wall, locally advanced breast cancer
- Invasive lobular carcinoma
- Evidence of lymphovascular invasion (LVI)
- Invasive carcinoma with extensive intraductal component (EIC)
- Neoadjuvant chemotherapy
- Patients with 1 or more positive lymph node determined during surgery with sentinel node and/or axillary dissection
- Someone who is not a candidate for breast conserving management, i.e., prior whole breast radiation therapy
Sites / Locations
- Advocate Christ Medical Center
Arms of the Study
Arm 1
Experimental
IOERT arm
Intraoperative electron radiotherapy (IOERT) is delivered after completion of the lumpectomy and sentinel node procedure. IOERT is performed on a mobile self-shielded magnetron-driven X-band linear accelerator specifically developed for use in the operating room. This machine produces megavoltage electron beams of energy ranging between 4 and 12 MeV. The radiation is delivered from the device to the tumor bed through an attached applicator. A single dose of 21 Gy calculated to the 90% depth posterior to the tumor bed will be administered and will last approximately 2.5 minutes.