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- Single-dose IORT is delivered directly after surgery, unlike whole or partial breast radiation requiring multiple treatment sessions.
- Best IORT candidates are postmenopausal, early-stage patients with very small tumors and no lymph node involvement.
- Financial incentives limit access; radiation oncologists earn about $525 for IORT versus $1,300 for five sessions and $1,730 for 15, per Medicare.
- American Society for Radiation Oncology (ASTRO) recommends use mainly in clinical trials, citing slightly higher recurrence despite similar long-term survival.
- Critics blame revenue motives; Dr. Phillip Ley of Merit Health Surgical Oncology told NBC News it is about money and greed.
October 22, 2026
The Food and Drug Administration (FDA) approved IORT in 1999.
Intraoperative radiation therapy (IORT) costs cancer patients less time and money in treatment and is less invasive compared to traditional radiation treatments for breast cancer. Access, however, is limited in the United States.
The Food and Drug Administration (FDA) approved IORT in 1999. It’s a treatment that involves just a single dose of radiation to a patient’s breast tissue after surgery, compared to whole or partial breast radiation treatments that often require multiple sessions and more money.
IORT is not recommended for every breast cancer patient. It’s an excellent option for candidates who are postmenopausal with an early-stage diagnosis, very small tumors, and no evidence of lymph node involvement.
Breast surgeons, however, tell NBC News that it’s harder to find IORT treatment options in the United Staets because it cuts into the revenue of doctors and hospitals who make a ton of money from traditional radiation treatments.
Breast Cancer Treatment: IORT Vs. Radiation
Radiation oncologists who perform IORT reportedly receive $525 per treatment, far less than the $1,300 they receive when performing whole breast radiation with five sessions and the $1,730 generated by 15 sessions, according to Medicare estimates from 2022. The benefits for hospitals and doctors don’t end there—patients also have to pay facility fees with each visit.
It’s important to note that breast cancer surgeons receive the same amount regardless of IORT treatments, whole breast irradiation, or partial irradiation.
While IORT has similar long-term survival outcomes and eliminates the potential for burns on the skin and life-threatening damage to the heart and lungs, the American Society for Radiation Oncology (ASTRO) does not recommend it for patients outside of clinical trials. One issue, according to ASTRO, is the recurrence rate. Research indicates slightly higher cancer recurrence rates when compared to those who undergo whole breast irradiation.
But countries such as Europe, South America, and Asia have been using IORT for more than two decades.
“This is about money and greed,” Dr. Phillip Ley, the director of oncology services at Merit Health Surgical Oncology, told NBC News.
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