18.03.2019 Breast cancer conference in Vienna:
long-term study confirms success of intraoperative radio therapy 

Austria Center Vienna, IBCC 2019 Bild vergrößern

Breast cancer is still the most common form of cancer among women in the western world. Statistically, one in eight women in Austria will be diagnosed with breast cancer at some point in their life. A range of studies will be presented at the International Breast Cancer Conference at the Austria Center Vienna, including one that looked at 10-year data showing that cancer returns in only one percent of cases when a special type of radio therapy is administered.   

In 2016, 5,646 people received a breast cancer diagnosis in Austria. “Thanks to mammograms and sonography we have access to outstanding screening technologies for breast cancer, compared with other types of cancer. And tumours identified at an early stage have long since lost their fear factor,” explained Prof. Felix Sedlmayer, Head of University Hospital Salzburg’s Radio Therapy and Radio Oncology Department. 

Significantly less invasive: intraoperative radio therapy (IORT)
A particularly successful treatment method known as intraoperative radio therapy, or IORT for short, is being given to patients at University Hospital Salzburg: the tumour bed is irradiated for 10 minutes during the operation with electrons aimed deep into the tissue. This therapy has proven to be significantly less invasive as it completely spares the skin and unaffected tissue, and the duration of subsequent full-breast irradiation is reduced in many cases, or removes the need for it entirely in patients with a very low risk of the tumour returning. 

Long-term data confirm: tumours return in only one percent of patients
Since 1998 a total of 3,600 patients have been treated with IORT, primarily in a procedure known as a tumour bed boost which is carried out ahead of whole breast irradiation. The risk of recurrence – i.e. the chance of a tumour subsequently developing in the same breast – for patients given the treatment was below three percent, even after 10 years. As a result, patients across all risk groups were given a reduced three week course of whole breast irradiation following IORT as part of a long-term study (HIOB) initiated in Salzburg in 2011. Initial long-term data on tumour control and cosmetic outcomes will be presented at this year’s congress, with recurrence rates reported at under one percent to date. “Study data relating to the use of IORT over such a long timespan are very rare, and until now there has been no data at all available on its use in combination with a shortened course of whole breast irradiation. So it is all the more gratifying that we are able to provide proof of the effectiveness of this methodological approach.” In a second talk, the long-term data from another Austrian study will be presented. ABCSG 8A monitored the effectiveness of additional radio therapy in patients with a low risk profile. “The risk of new tumours developing is three times higher without radio therapy,” Prof. Sedlmayer reported. “Radio therapy remains a key element after breast conserving surgery, but is tailored to individual patients on an ongoing basis depending on the risk of recurrence.”

Radio therapy an effective way to prevent tumours returning
Depending on the type of tumour, modern personalised treatment paths can also make use of additional pharmaceutical measures. As the majority of mammary carcinoma are hormone-receptor positive, anti-hormonal therapies are a highly effective way to treat them. Tumours known as HER2 positive carcinomas form proteins that serve as growth signals for the cancer cells. With this type of tumour, medication has been successfully used to suppress these proteins. A third group, triple negative tumours, cannot be influenced by anti-hormonal or HER2-targeted therapies. For these tumours, besides conventional chemotherapy, investigations are also being conducted into immunotherapies such as checkpoint inhibitors, which prevent the cancer from disguising itself from the immune system’s guardian cells and continuing to grow unchecked. Despite the wider trend towards personalised treatments, it is striking that all forms of treatment tend to be supplemented with irradiation. “Breast conserving surgery has established itself as the norm and radio therapy continues where the surgeon has left off. It remains the most effective way to prevent recurrence,” explained Sedlmayer. “But nowadays we are able to turn many forms of cancer into clinically manageable chronic illnesses, even in patients who we are unable to cure, not only increasing life expectancy but also improving quality of life.”

About the International Breast Cancer Conference 
From 20-23 March 3,000 specialists will meet at the Austria Center Vienna for the International Breast Cancer Conference (IBCC) to focus on primary treatment of early-stage breast cancer.


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