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CASE REPORT article

Front. Oncol.
Sec. Breast Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1429326

Case Report: IORT as an Alternative Treatment Option for Breast Cancer Patients With Difficulty Staying Still

Provisionally accepted
Fardeen Bhimani Fardeen Bhimani 1Maureen McEvoy Maureen McEvoy 1Yu Chen Yu Chen 1Anjuli Gupta Anjuli Gupta 1Jessica M. Pastoriza Jessica M. Pastoriza 1Shani Fruchter Shani Fruchter 1Zachary C. Bitan Zachary C. Bitan 1Wolfgang A. Tomé Wolfgang A. Tomé 2Keyur Mehta Keyur Mehta 2Jana Fox Jana Fox 2Sheldon Feldman Sheldon Feldman 1*
  • 1 Department of Breast Surgery, Montefiore Einstein Comprehensive Cancer Center, Bronx, United States
  • 2 Montefiore Einstein Comprehensive Cancer Center, Bronx, United States

The final, formatted version of the article will be published soon.

    Background: Administering radiation therapy to individuals with intellectual disabilities (ID) and psychiatric patients taking antipsychotics poses challenges, especially with whole breast irradiation (WBI) due to difficulty staying still (DSS). In such scenarios, intraoperative radiotherapy (TARGIT-IORT) provides an alternative. Although prior studies have shown its applicability in special cases where WBI may be contraindicated, there is a paucity of literature emphasizing its role in patients with ID and psychiatric conditions who have DSS. Therefore, our case series aims to highlight the applicability of administering TARGIT-IORT in such patients.Case Reports: Four breast cancer patients underwent lumpectomy and TARGIT-IORT. Among them, two patients had ID, with one experiencing a decreased range of motion. The other two had psychiatric disorders, including schizophrenia and bipolar disorder, both manifesting involuntary movements and DSS. Three patients had invasive ductal carcinoma (IDC), and one had invasive lobular carcinoma (ILC). All patients undergoing TARGIT-IORT tolerated the procedure well. Notably, none of the patients exhibited evidence of disease on follow-up.Our study underscores the potential use of TARGIT-IORT as a viable treatment option for breast cancer patients with intellectual and psychiatric disabilities. Unlike traditional EBRT, TARGIT-IORT offers a single radiation dose, addressing challenges associated with compliance or DSS. Our findings demonstrate positive outcomes and tolerance, especially in patients where standard oncologic procedures are difficult to achieve. TARGIT-IORT could also benefit breast cancer patients with concurrent movement disorders like Parkinson's disease and other movement disorders. Nonetheless, future studies are needed to reinforce its applicability for patients with DSS.

    Keywords: breast cancer, intraoperative radiotherapy, TARGIT, IORT, Intellectual Disability, Schizophrenia, Bipolar Disorder, psychiatric disorders

    Received: 07 May 2024; Accepted: 02 Sep 2024.

    Copyright: © 2024 Bhimani, McEvoy, Chen, Gupta, Pastoriza, Fruchter, Bitan, Tomé, Mehta, Fox and Feldman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Sheldon Feldman, Department of Breast Surgery, Montefiore Einstein Comprehensive Cancer Center, Bronx, United States

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