Jacobs DHM, et al. - In elderly breast cancer patients, researchers compared intraoperative radiotherapy (IORT) vs external beam APBI (EB-APBI) with respect to health-related quality of life (HRQL). In a prospective multi-center cohort study involving women (≥60 years) receiving breast conserving therapy for early stage breast cancer, electron IORT (1 × 23.3 Gy) or photon EB-APBI (10 × 3.85 Gy daily) were used as treatment strategies. Of 204 IORT and 158 EB-APBI patients, data was available on HRQoL. Findings revealed good tolerability of EB-APBI and IORT. All HRQL scales showed a transient deterioration post-treatment but were recovered within 3 months, leading to no clinically important differences until 1 year between groups nor compared to baseline levels. Comorbidity and systemic therapy were found to be risk factors for a worse global health score at one year, as seen in multivariable analysis.