Leading breast cancer specialists to share best
practices on leveraging the latest in cancer therapies to enhance patient care
and minimize virus exposure


iCAD hosted a free virtual roundtable event for
clinicians, titled “The Impact of COVID-19 on Breast Cancer Surgery and
Targeted Radiation Therapy,” on June 4, 2020 at 7 pm ET/4 pm PT. To view the
webinar on-demand, please visit this link: https://www.icadmed.com/educational-webinars.html.


The roundtable featured leading specialists in breast
cancer treatment, including the following experts*:

  • Charles Wesley Hodge, MD, Radiation Oncologist,
    Florida Hospital Celebration Health/AdventHealth
  • Michael Howard, PhD, DABMP, RSO, Director of
    Oncology Services, Chief of Medical Physics, Sarah Cannon Cancer Institute,
    Parkridge Medical Center, HCA Healthcare
  • Sadia Khan, DO, FACS, Assistant Clinical
    Professor of Surgery at Keck School of Medicine, USC, Director of Integrative
    Breast Oncology at Hoag Breast Program
  • Barry Rosen, MD, FACS, Breast Surgeon, Advocate
    Healthcare, Managing Partner, TME Breast Care Network
  • Rakesh Patel, MD (Moderator), Managing Partner,
    Precision Cancer Specialists, Inc., Managing Partner, Targeted Medical
    Education (TME) Breast Care Network, Past President, American Brachytherapy

“The COVID-19 pandemic has introduced unprecedented
challenges to our health care system and specifically impacted cancer
screenings and treatment in our country and worldwide. During these
extraordinary times, it is imperative for clinicians to share best practices
and adapt approaches to patient care. iCAD is honored to host virtual events
such as this, which provide an educational forum for clinicians to enhance
patient care during this global healthcare crisis and beyond,” according to
Stacey Stevens, President of iCAD. “In the face of this pandemic, iCAD’s
technology is now more relevant than ever. Intraoperative radiation therapy
(IORT) with the Xoft® Axxent® Electronic Brachytherapy (eBx®) System® offers a
viable solution that could potentially alleviate the burden to our health
system, while enabling clinicians to administer high-quality care to patients
who are candidates, while minimizing their potential exposure to the novel


Xoft breast IORT is a single-fraction therapy option that
allows select early-stage breast cancer patients to replace weeks of daily
radiation with one treatment, delivered at the time of surgery. This targeted
treatment option offers a full course of radiation in just one day, which could
contribute to a reduction in the healthcare system resources needed for breast
cancer patients during the COVID-19 pandemic and reduce those patients’ risk of
exposure to the novel coronavirus by minimizing the number of visits required
to a hospital or medical facility.


“In the recent months during the COVID-19 pandemic,
hospital resources have become limited in many areas, and guidelines issued by
a number of medical societies advise clinicians to determine how best to triage
the care of cancer patients safely.1 Some breast cancer patients are
choosing to delay parts of their treatment for safety concerns,” according to
Sadia Khan, DO, FACS, Assistant Clinical Professor of Surgery at Keck School of
Medicine, USC, Director of Integrative Breast Oncology at Hoag Breast Program.
“In areas where there is still a high incidence of COVID-19, some patients with
breast cancer may opt to choose IORT, which offers a one-dose radiation option
for patients who meet the criteria. For those who are candidates, IORT gives
patients an additional option to complete their radiation in a one-time dose,
which decreases their exposure to the hospital.”


Positive results from a long-term study involving Xoft
breast IORT conducted at Hoag Memorial Hospital Presbyterian were published in
the Annals of Surgical Oncology in 2019.2 Led by Melvin J.
Silverstein, MD, Medical Director of the Hoag Breast Center, the prospective
study, titled Intraoperative Radiation Therapy (IORT): A Series of 1000 Tumors,
found breast cancer recurrence rates of patients who were treated with Xoft
breast IORT were comparable to those seen in the cornerstone, randomized
TARGIT-A and ELIOT trials, which evaluated IORT using different technology.


“A number of breast cancer patients at our facility have
had their treatment delayed due to the COVID-19 pandemic. This is concerning to
physicians and patients alike, as some cases could potentially progress and it
could result in a considerable backlog of patients who require urgent treatment
with more advanced disease,” according to Michael Howard, PhD, DABMP, RSO,
Director of Oncology Services, Chief of Medical Physics, Sarah Cannon Cancer
Institute, Parkridge Medical Center, HCA Healthcare. “The concern for a second
wave of COVID is very real, but IORT offers a way to help reduce this potential


“The reality is, IORT may be able to play a bigger role
right now in the treatment of patients. In some cases, it may be ultimately
more beneficial to offer IORT to avoid the backlog in treatment as a means of
not overrunning hospitals and radiation centers once we are back up and
running,” added Barry Rosen, MD, FACS, Chief of Breast Surgery, Advocate
Healthcare and Managing Partner, TME. “IORT is one of those exceptional
interventions that I believe satisfies the triple aim in treatment: it offers benefits
to patients, providers and payers alike. For patients, it offers added
convenience, with better cosmetic outcomes and fewer side effects; from a
physician standpoint there is an inherent efficiency, as it enables them to
condense one month of daily treatments to a single dose of targeted radiation.
Lastly, for payers, the overall cost of treatment is reduced as the course of
treatment may be reduced from weeks of daily fractions to one concentrated dose
of radiation, administered at the time of surgery.”


“As clinicians, we are going to have to adapt to the
COVID-19 situation as it evolves. At a certain point, delaying treatment for
even early-stage breast cancer is going to come with risk. In many cases, the
decision really should be made to go forward with cancer treatment; IORT offers
a treatment option that may allow more women to get the treatment they need
during this time,” according to Charles Wesley Hodge, MD, Radiation Oncologist,
Florida Hospital Celebration Health/AdventHealth. “We are facing an
unprecedented challenge in healthcare, and as clinicians we need to come
together and adjust to these new realities. For those of us who practice in the
oncology space, it is particularly challenging because we are dealing with a
potentially life-threatening illness that requires appropriate management. Now
is the time for clinicians to work together, to adjust to our new reality, and
to come up with an approach that will do the greatest good for our patients.”


This virtual roundtable event is a part of larger series
of webinars hosted by iCAD in recent weeks, featuring leading experts in breast
cancer detection and treatment. This series has examined various aspects of
breast cancer care in the era of COVID-19, including risk adaptive tools and pragmatic
solutions for both screening and treatment. To view the schedule, register for
an upcoming free event, or view a prior event on-demand, visit


*Panelists were compensated with an honoraria/speaking
fee, but are encouraged to provide their own expert opinions and viewpoints.
Dr. Patel is a member of iCAD’s Board of Directors.

  1. The American Society of Breast Surgeons (ASBrS),
    the National Accreditation Program for Breast Centers (NAPBC), the National
    Comprehensive Cancer Network (NCCN), the Commission on Cancer (CoC) of the
    American College of Surgeons, and the American College of Radiology® (ACR®)
    joint recommendations. “Recommendations for Prioritization, Treatment and
    Triage of Breast Cancer Patients During the COVID-19 Pandemic.”
  2. Silverstein,
    M.J., Epstein, M., Kim, B. et al.
    Intraoperative Radiation Therapy
    (IORT): A Series of 1000 Tumors. Ann Surg Oncol 25, 2987–2993 (2018).
    https://doi.org/10.1245/s10434-018-6614-3. Accessed viahttps://link.springer.com/article/10.1245/s10434-018-6614-3.