The evolution of targeted intra operative radiotherapy in early breast cancer.

Targeted intraoperative radiotherapy (IORT) delivers a single dose of radiation to a fresh tumour bed immediately after lumpectomy, commonly used to treat early breast cancer (EBC). It is delivered during the same sitting, with improved patient compliance and better sparing of adjacent healthy tissue, compared to conventional adjuvant radiotherapy to the whole breast. The recently published 12-year results (median follow up of 8.6 years) of the TARGIT-A trial offers reliable conclusions, of comparable oncological outcomes with a reduced toxicity profile supporting IORT as a replacement for whole breast external beam radiotherapy (EBRT) for suitable patients with EBC. Reduced need of multiple hospital visits is an added logistic advantage which makes IORT a cost-effective, less painful and cosmetically favourable alternative to standard EBRT, now included in several international guidelines with growing popularity among clinicians worldwide.