Purpose Standard local treatment for early breast cancer is breast conserving surgery (BCS) with adjuvant external breast radiotherapy (EBRT)1. Intra-operative radiotherapy (IORT), a single-dose technique has several advantages; targeted irradiation reducing geographic miss, decreased skin/cardiopulmonary toxicity, and increased quality of life1. We aim to assess the efficacy of IORT; evaluating recurrence, survival, and complications. Methodology From 2017-2021, selected patients underwent BCS and IORT at Moorabbin Hospital. Patient selection criteria, tumour clinicopathology, complications, and oncologic outcomes were retrospectively analysed. Results 101 patients were identified; mean age 66 +/-8.46 years, with a mean tumour size of 15.11+/- 7.70mm. 93.40% were hormone receptor positive, 58.49% with Ki67 ≤ 14%, and 98.9% of invasive tumours Grade 1-2. 5.94% had lymph node metastasis, whilst 9.9% received further EBRT. At median follow-up of 48 months, 4.95% had locoregional/distant recurrence; with no breast cancer-related mortality. Acute and chronic complications occurred in 12.9% and 15.8% respectively, with chronic seroma the most common at 11.88%. Conclusion Our analysis resulted in comparable oncologic outcomes to the literature. Complications were low, with minor clinical significance. Our short-term 4-year recurrence rates and 100% breast cancer specific survival are promising; albeit long-term analysis required. Orecchia R, Veronesi U, Maisonneuve P, et al. Intraoperative irradiation for early breast cancer (ELIOT): long-term recurrence and survival outcomes from a single-centre, randomised, phase 3 equivalence trial. Lancet Oncol. 2021 May;22(5):597-608.