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What is breast brachytherapy?
It is a technique used to deliver radiation treatment to the involved portion of the breast in patients with early stage breast cancer who are suitable candidates. It involves implanting catheters into the breast under ultrasound or mammographic guidance as an outpatient procedure with local anesthesia and mild sedation.
Which patients are candidates for breast brachytherapy?
Women that have had a lumpectomy and sentinel node evaluation of the lymph nodes for invasive or in situ breast cancer are potential candidates. In addition, the lymph nodes should be negative, the surgical margins must be negative and the tumor should be less than 3 centimeters in size. There are other technical factors that need to be evaluated using an ultrasound before a patient can definitely be deemed a candidate for this technique.
What is involved with the treatments?
The patient is treated twice a day for four or five weekdays (8-10 total treatments). The treatments are given as an outpatient and are painless. The catheters are hooked up to tubing that connects to a device that contains a radioactive source on the end of a wire. The device is computer controlled using a predetermined treatment plan developed by the physician and radiation staff to treat just the lumpectomy region and the immediately surrounding breast tissue.
What are the side effects?
There can be a small area of temporary skin redness in some patients. There is a small risk for infection, but preventive antibiotics are given to minimize this risk. The catheter entrance and exit sites heal slowly, and occasionally some permanent small scars may remain. Fat necrosis (means “dead fat”) can develop in 20% of patients, which may create a tender lump that usually resolves, and rarely may need to be surgically removed. There is no risk of rib fracture, lung inflammation, heart sac inflammation, severe breast swelling or severe skin burning over the entire breast as can sometimes be seen with standard external beam radiation.
How effective is it?
Studies that have evaluated properly selected patients treated with breast brachytherapy show equivalent tumor control rates to those seen with standard external beam radiotherapy.
