S348
Clinical - Breast
ESTRO 2026
concurrently with local recurrences (LR). A single LR was observed in 8 cases (8.5%). The median time to LR and DM were 13.4 years (range, 2.6 – 20.8) and 8.9 years (range, 1.4 – 18.6), respectively. During the follow-up period, at least one second malignant tumor was detected in 20 pts (21.2%).The 5-, 10-, 15-, and 20- year local recurrence free survival rates were 96.8%, 94.6, 90.8 and 86.6%, respectively. The 20-years overall survival and 20-years cancer specific survival were; 76.6% and 86.6%. Conclusion: Our results suggest that BCS with concurrent IORT is a promising strategy for patients with early breast cancer. A meaningful assessment of treatment outcomes in this group of patients requires at least 10 years of follow-up due to late breast cancer recurrence and the frequent occurrence of second cancers. References: Wydma ń ski, J. et al. A new method of targeted intraoperative radiotherapy using the orthovoltage photon radiosurgery system. Nowotw. J. Oncol.55, 320. https://doi.org/10.5603/njo.53008 (2005). Keywords: IORT, BCT Digital Poster 5136 Long-Term Outcomes and Safety of Internal Mammary Node Irradiation in Early-Stage Breast Cancer: A Real-World Retrospective Analysis Suela Vukcaj 1 , Silvio Sporeni 2 , Rita De Sanctis 2 , Laura Maffioletti 1 , Elisabetta Vitali 1 , Fabio Piccoli 1 , Giulia Rinaldi 1 , Micaela Motta 1 , Roberta Muni 1 , Francesco Filippone 1 , Vittoria Fotia 2 , Alberto Zambelli 2 , Maurizio Portaluri 1 1 Radiotherapy, ASST PAPA GIOVANNI XXIII, Bergamo, Italy. 2 Oncology, ASST PAPA GIOVANNI XXIII, Bergamo, Italy Purpose/Objective: The clinical benefit of internal mammary node irradiation (IMNI) in early-stage breast cancer (BC) remains controversial, particularly regarding its impact on long-term outcomes and potential cardiopulmonary toxicity. This study aimed to evaluate disease-free survival (DFS) and the safety profile of IMNI in a real-world clinical setting. Material/Methods: We retrospectively reviewed all consecutive BC patients treated with IMNI at our center over a four- year period. According to standard clinical practice, mastectomy or breast-conserving surgery (BCS) was followed by 3D conformal radiotherapy (RT) to the chest wall or whole breast (50 Gy), with a 10 Gy boost to the surgical bed. Exclusion criteria included previous malignancies, bilateral BC, recurrence before RT, and non-standard RT protocols. The primary
at diagnosis. Twenty-six (76.5%) patients received surgery for their primary breast tumours, almost half (N=12, 46.2%) being treated with mastectomy, and most of them having axillary lymph node dissection (N=21, 80.8%). 15 (44.1%) patients received adjuvant chemotherapy, 20 (58.8%) received adjuvant hormonal therapy, and 13 (38.2%) received postoperative radiation therapy. There were 38 FES-PET investigations doubled by FDG-PET in 34 patients. The median interval between diagnosis and FES-PET was 5.5 years (0-29), and the main indications were initial staging (N=6; 15.8%), restaging (N=14; 36.8%), and ER detection (N=19; 50%). Thirty-five (92.1%) of the 38 FES-PET had differences in tracer uptake intensity and/or distribution, compared to the FDG-PET. In 26 cases (68.4%), the FES-PET result influenced the redefinition of disease extension and/or the treatment decision. Conclusion: FES-PET evaluation can provide a significantly different result in selected breast cancer patients. The investigation had an impact on patients’ clinical management in the majority of the cases. Keywords: PET-CT, estrogen receptors, case management Digital Poster 5116 Intraoperative Radiotherapy (IORT) in early breast cancer: single institution experiences with a minimum 20-year follow-up. Jerzy Wydma ń ski, Ż aneta Kaniszewska-Dorsz, Grzegorz Wo ź niak, Wojciech Majewski Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland Purpose/Objective: The aim of this study was to assess the long-term results of intraoperative radiotherapy used as a boost in breast cancer conserving treatment. Material/Methods: In 2003-2004, a total of 94 patients with early breast cancer (T1-2, N0-1) and a median age of 51 years (range, 27-77 years) were investigated.Treatment consisted of breast-conserving surgery (BCS) with IORT, followed by postoperative external beam radiotherapy (EBRT) and chemotherapy/hormone therapy.A boost dose of 5 to 7.5 Gy (prescribed to 0.5 cm from the applicator surface) was delivered directly to the tumour bed. The patients received EBRT to the whole breast with a total dose of 50 Gy in 25 fractions. Results: Among 94 patients, 23 patients (24.5%) had recurrences of the diseases. Distant metastases (DM) were observed in 15 cases (16%), in 4 cases (4.3%)
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