“Deborah agreed to take part in a trial as she was keen to help other cancer patients in the future. "If taking part in a trial means others might be helped then I’m very happy with that."
A trial looking at radiotherapy during surgery for early stage breast cancer (TARGIT-A)
This trial compared external radiotherapy with radiotherapy given during surgery (intra operative radiotherapy) for breast cancer.
With external radiotherapy, you go to the radiotherapy department for daily treatment once you have recovered from surgery. This is a little like having an X-ray and takes a few minutes each time. The usual treatment is radiotherapy 5 days a week, for up to 6 weeks. This is called a course of radiotherapy.
In this trial, some people had a single dose of radiotherapy during surgery instead of a course of radiotherapy afterwards. This is called intra operative radiotherapy, or IORT. The surgeon puts an applicator into the breast during surgery. The applicator delivers radiotherapy directly to the breast tissue.
The main aim of this trial was to see if intra operative radiotherapy is as good as external radiotherapy at stopping breast cancer coming back after surgery.
Summary of results
The research team found that radiotherapy during surgery is a useful treatment option for early stage breast cancer.
This trial recruited 3,451 women from 33 hospitals in several different countries. Everyone who took part was due to have surgery and radiotherapy for early stage breast cancer.
The women taking part were put into 1 of 2 treatment groups at random, and
- Half had a single dose of radiotherapy during surgery (intra operative radiotherapy)
- Half had a 3 to 6 week course of radiotherapy after surgery (external radiotherapy).
The research team looked at how often the cancer came back in the breast area (local recurrence), and how many women in each group died. They found these were low and similar in both groups.
There are 2 different ways of giving intra operative radiotherapy. One is during surgery to remove the lump. The other is as a separate operation afterwards. When the research team looked at this, they found that the results were a bit better for women who’d had radiotherapy during surgery to remove the lump.
They found that while the number of women who died from breast cancer was the same in the two groups, there were fewer deaths from causes other than breast cancer in the group who had intraoperative radiotherapy during surgery than in the group who had external radiotherapy.
They also looked at the number of women who had serious problems with their wound healing after surgery, or skin problems after radiotherapy. They found that wound healing was not affected, but skin problems were a little more common in women who had external radiotherapy.
The trial team concluded that doctors should consider intra operative radiotherapy at the same time as surgery as an option for treating women with early stage breast cancer.
We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Professor J S Vaidya
Professor J S Tobias
Professor Michael Baum
NIHR Health Technology Assessment (HTA) programme
NIHR Clinical Research Network: Cancer
NIHR University College London Hospitals Biomedical Research Centre
Ninewells Cancer Campaign
National Health and Medical Research Council, Australia
German Federal Ministry of Education and Research