Della Sala Sabino Walter, Pellegrini Marco, Bernardi Daniela, Franzoso Francesca, Valentini Marvi, Di Michele Stefano, Centonze Maurizio, Mussari Salvatore
U.O. di Radiodiagnostica, Ospedale Santa Chiara, Dipartimento di Radiodiagnostica, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.
Eur J Radiol. 2006 Aug;59(2):222-30. doi: 10.1016/j.ejrad.2006.03.003. Epub 2006 Apr 17.
Assess mammographic and echographic modifications in mild cases of breast cancer (suitable for conservative surgery) after intraoperatory radio treatment (IORT) as opposed to conventional post-operative radiotherapy (RT).
We report data from 45 patients in each group (IORT and RT). All patients were examined using the same mammographic and ecographic equipment at 6, 12 and 24 months after treatment. We focused on structural alterations, edema and others, and quantified them using pre-established (unbiased) protocols. Both patient examination and subsequent assessment of the results were performed by radiologists with exepertise in breast cancer evaluation.
At 6 months, IORT patients showed slightly more pronounced structural distortions and oedema than RT patients; these differences became more apparent at 12 months, with the addition of fat necrosis and/or calcifications. These alterations were evident and consistent under both mammographic and ecographic examination, and became even more pronounced at 24 months. At this stage, RT patients showed minimal alterations of the tissue (apart from normal post-surgical scarring), whereas IORT patients showed virtually no improvement over the preceding 12-month period.
We show radiological alterations in post-operative breast cancer are significantly more pronounced in patients treated with IORT as opposed to RT.
评估术中放疗（IORT）与传统术后放疗（RT）相比，在轻度乳腺癌（适合保乳手术）患者中的乳房X线摄影和超声检查变化。
我们报告了每组45例患者（IORT组和RT组）的数据。所有患者在治疗后6个月、12个月和24个月使用相同的乳房X线摄影和超声设备进行检查。我们关注结构改变、水肿等情况，并使用预先制定（无偏倚）的方案对其进行量化。患者检查及结果的后续评估均由擅长乳腺癌评估的放射科医生进行。
6个月时，IORT组患者的结构扭曲和水肿比RT组患者略为明显；12个月时，随着脂肪坏死和/或钙化的出现，这些差异变得更加明显。这些改变在乳房X线摄影和超声检查中均明显且一致，24个月时更为显著。在此阶段，RT组患者的组织改变极小（除正常手术瘢痕外），而IORT组患者在之前12个月期间几乎没有改善。
我们发现，与RT相比，接受IORT治疗的术后乳腺癌患者的放射学改变明显更显著。
