Does current data support use of intraoperative breast radiotherapy?

I use the intrabeam IORT system and have treated about 90 patients. 22% have been given adjuvant whole breast or breast/axilla/scf xrt. The toxicity of IORT is significantly lower than other forms of APBI and external beam. The results of the Targit A trial support our experience in regards to toxic...

There are 3 major concerns with this approach:

1. Patients are selected for a treatment strategy without full pathological review of data
2. Dose to the target volume is not consistent with known radiobiology
3. The treatment does not allow for image-guided dose delivery (ie look up table dosimetry).

It is...