Perioperative interstitial therapy followed by external radiation therapy in the preservative management of early breast cancer.

Treatment of early breast cancer by lumpectomy and irradiation is well accepted. The five- and ten-year results of preservative treatment are comparable to more radical procedures. The technique of perioperative interstitial radiation has several advantages: (1) more accurate placement of the tubes in the tumor bed at the time of surgery; (2) implant volume is kept to a minimum, which improves cosmetic results; and (3) elimination of second general anesthesia for patients considered for implant boost therapy.Modified external radiation to regional lymphatics by combining electron and photon therapy at the 50 percent level can reduce side effects, such as skin reaction and esophagitis, and the dose to the heart, lungs, and opposite breast.