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From June 1979 to December 1986, 166 patients with early-stage breast cancer underwent lumpectomy and intraoperative radiation therapy (IORT). The surgical procedure was performed as a sole treatment for 117 patients, and 69 patients underwent lumpectomy followed by IORT and mastectomy (a second course of IORT). The median dose of IORT was 3,000 rad. Local recurrence occurred in 13 patients, 3 of them with a second course of IORT (2.9%). Distant metastases were observed in 7 patients (4.2%): 5 of them (3.6%) with a second course of IORT. The mortality rate was low, 2 cases (1.2%) because of cardiac infarction and pulmonary embolus, 1 case (0.6%) because of pulmonary infarction and 1 patient (0.6%) from bleeding related to the radiation therapy. Although there were differences in the incidence of local recurrence and distant metastases between the two groups, the differences were not statistically significant. Patients with clinical stage I and II disease did not have a significantly different disease-free survival as compared with patients with clinical stage III disease. The complication rate, including local recurrence, distant metastases, surgical complications, and radiation therapy complications, was low. The main complication was wound dehiscence, caused by inadequate hemostasis. Postoperative drainage was used in 30 patients (18.1%) and removed when the drainage was less than 15 cc/day for 2 consecutive days, except for 3 cases (1.9%), which were readmitted due to infection. Twenty-nine patients (17.7%) had complications related to the radiation therapy. The rate of complications was higher in a second course of IORT (33.3%) than in the first course (8.2%). No complications (0.6%) required hospital admission. No increase in the incidence of late complications was observed.Ealing and West London are on the up — but out west, the headlines go to Acton, Hayes and Loughton.
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