2.  10-16 Gy  Decreased fibrosis  Enhanced local control  Deep seeded tumors https://www.google.com/search?site=&tbm= isch&source=hp&biw=1366&bih=624&q=radia tion+breast+fibrosis&oq=radiation+breast+fibr osis&gs_l=img.3...1186.5828.0.6127.25.14.0.6.0. 0.429.2251.0j1j4j1j2.8.0....0...1ac.1.48.img..18.7. 2004.i3YbI13P1kI&gws_rd=ssl#facrc=_&imgdii= _&imgrc=YY5D- BJHUZlgqM%253A%3BEMF3Lh5Z_GOE1M%3Bht tp%253A%252F%252Fwww.aboutcancer.com %252Fbreast_image_tobias4.jpg%3Bhttp%253 A%252F%252Fwww.aboutcancer.com%252Fb re4b.htm%3B258%3B208

3.  Larger field size  Small breast size  Shallow tumor

4.  2 different volumes to 2 different doses each day  Adenocarcinomas  Enhanced local control  Decreased treatment time

5.  Few patients fit the criteria  Increased acute side effects https://www.google.com/search?site=&tbm=isch&source=hp&biw=490&bih=639&q=linac&oq=linac&gs_l=img.3..0l10.2035.2961.0.3194.5.5.0.0.0.0.201.718.0j3j1.4.0....0...1ac.1.48.img..1. 4.716.77l56vWY34M&gws_rd=ssl#q=radiation%20breast%20fibrosis&tbm=isch&facrc=_&imgdii=_&imgrc=shfnKM-PWp3BLM%253A%3BqCPg_UX-C- gHyM%3Bhttp%253A%252F%252F4.bp.blogspot.com%252F-d- QCEFty82I%252FTZvmDtBKvCI%252FAAAAAAAAHsY%252FmsuzW8oOF8M%252Fs1600%252FRadiation%252Bburn.jpg%3Bhttp%253A%252F%252Fdbrueckman.blogspot.com%252F2011%25 2F04%252Fmy-breast-cancer-journey.html%3B1600%3B1200

6.  Noninvasive Breast Brachytherapy Applicators (NIBB)  Decrease toxicity  Improve cosmetic outcomes  Decreased fibrosis https://www.google.com/search?q=interstitial+breast+brachytherapy&espv=2 &source=lnms&tbm=isch&sa=X&ei=oCPFU5b5E8i- 8QGN2oDwAw&ved=0CAYQ_AUoAQ&biw=780&bih=596#q=mammosite+radi ation+therapy+system&tbm=isch&facrc=_&imgdii=_&imgrc=1zAL3oPzuyXlOM% 253A%3B1hd5qK5wPT498M%3Bhttp%253A%252F%252Fwww.mammosite.com%2 52Fphysicians%252Fimages%252FRadiationProcedure.jpg%3Bhttp%253A%252F% 252Fwww.mammosite.com%252Fphysicians%252Fradiation- therapy%252Fabout-mammosite.cfm%3B300%3B156

7.  Very invasive  Not many cancer centers do this procedure

8.  18-20Gy using Targeted Intraoperatve Radiotherapy(Targit)  Superb tissue localization  Sterilization  Decreased side effects  Mayo Clinic of Arizona Study

9.  Machine cost  Expertise needed in OR

10.  Availability  Cost Benefit