Intraoperative Radiotherapy Specialist

Dennis R. Holmes, M.D., F.A.C.S. -  - Breast Cancer Surgeon

Dennis R. Holmes, M.D., F.A.C.S.

Breast Cancer Surgeon located in Los Angeles, CA and Glendale, CA

As National Co-Chair of the TARGIT U.S. Registry clinical trial and President of the TARGIT Collaborative Group, breast surgeon Dennis R. Holmes, M.D., F.A.C.S., is a world-recognized expert in targeted intraoperative radiotherapy (TARGIT) with offices in Santa Monica, Glendale, and Los Angeles, California.

Intraoperative Radiotherapy Q & A

What is targeted intraoperative radiotherapy?

TARGeted Intraoperative radioTherapy (TARGIT) or IORT is a form of breast radiation that is administered as a single treatment at the time of lumpectomy to reduce the risk of cancer recurrence. As a type of partial breast irradiation, TARGIT limits the radiation treatment to the tumor site where the risk of recurrence is highest. This spares the rest of the breast and surrounding tissues (e.g., heart and lung) the side effects of radiation. TARGIT takes only 30 minutes to deliver. By comparison, traditional whole breast radiotherapy administers radiation to the whole breast, chest wall, and to some degree the nearby organs, and takes several weeks to complete.




What are the advantages of TARGIT versus traditional radiotherapy?

For most patients, TARGIT completely eliminates the needs for the 3-week or 6-week course of traditional whole breast radiation normally required after lumpectomy surgery.

Also, TARGIT reduces the overall side effects of radiation by confining the radiation dose to the part of the breast from which the cancer was removed, sparing the rest of the breast and surrounding tissues (e.g., heart and lung) the side effects of radiation.  However, there are cases of advanced or high-risk breast cancer that benefit from treatment with both TARGIT and whole breast radiation.

Is TARGIT an effective treatment for breast cancer?

The effectiveness of TARGIT was investigated in an international study called the TARGIT-A Trial, a clinical trial that compared partial breast single dose targeted intraoperative radiotherapy (IORT) to 3-6 week post-operative whole breast radiotherapy among women undergoing lumpectomy for early stage breast cancer. The clinical trial publication, which Dr. Holmes co-authored, demonstrated equal breast cancer recurrence rates and equal cancer survival rates among recipients of targeted IORT during lumpectomy compared to those receiving multiple weeks of whole breast radiation after lumpectomy. The paper was published today in the British Medical Journal.

With long term follow-up (median 8.6 years, maximum 18.9 years), the TARGIT-A Trial demonstrated no significant difference in the 5- year local recurrence rates and 8.6 year local-recurrence free survival rate, breast cancer survival rate, and overall survival rate. Women receiving targeted IORT had a significantly lower risk of dying from other causes (e.g., heart disease or cancers). The findings of the TARGIT-A trial are summarized in the following table:


Am I a candidate for TARGIT?

If you’ve been diagnosed with breast cancer and are considering a lumpectomy, you may be eligible for TARGIT if you meet the following criteria:

  • Age 40 or older have breast cancer in only one part of the breast
  • Have breast cancer treatable with lumpectomy
  • Have a tumor that is 3 cm (1.5 inches) or smaller
  • Don’t have any signs of cancer in the lymph nodes
  • Have stage 0, 1 or early stage II breast

Is TARGIT safe and effective?

TARGIT was shown to be as safe as traditional whole breast radiotherapy in a large, international study called the TARGIT-A Trial. More importantly, breast cancer survival was equal between the two treatments and deaths related to heart disease and other cancers were significantly lower among women receiving TARGIT.

For more information about intraoperative radiotherapy, visit Dr. Holmes’s YouTube Channel here