New Radiation Therapy Technique Shortens Breast Cancer Treatment

Tuesday, October 05, 2004

About 200,000 American women will be diagnosed with breast cancer this year. When a woman has breast cancer, she may undergo various treatments, including surgery, radiation therapy, and chemotherapy—or more often a combination of these treatments.

Surgical removal of the cancer lump (lumpectomy) is often the first step. After surgery, women wishing to preserve their breast usually undergo six to seven weeks of daily radiation treatments with external “beams” of radiation directed at the entire breast. Radiation uses high-energy x-rays to destroy cancer cells that remain in the breast after surgery.

This breast-conserving combination of lumpectomy followed by whole breast radiation is equivalent to mastectomy (surgical removal of the breast) in terms of survival from breast cancer, and is the treatment of choice for most women.

Brachytherapy Reduces Radiation Therapy Time to One Week

Breast brachytherapy (pronounced “bray' key” therapy) is an alternative to whole breast external beam radiation for treating breast cancer. With brachytherapy, small radioactive sources are implanted in and near the tumor to deliver radiation from within the body. Brachytherapy is used to treat certain types of breast cancer, as well as prostate cancer, gynecologic, and lung cancers.

Brachytherapy (“brachy” is Greek for “short”) for breast cancer is relatively new. Some women may prefer breast brachytherapy over external beam radiation because it is faster treatment—one week with brachytherapy versus six to seven weeks with external beam radiation.

Breast brachytherapy also treats less total volume of tissue, and some believe this may allow patients to avoid some of the side effects of external beam radiation. The particular advantage for breast brachytherapy—fewer side effects—has not yet been scientifically proven, however.

The scientific evidence to date does show that the overall cure rate with breast brachytherapy is the same as with traditional external beam radiation therapy.

Most patients with small to medium sized breast cancers who would otherwise undergo external beam radiation after lumpectomy are good candidates for breast brachytherapy. Patients should also have limited cancer in their lymph nodes.

There are two techniques of breast brachytherapy:

  • Balloon-catheter breast brachytherapy, which involves inserting a balloon catheter (a narrow plastic tube) into the breast under local anesthetic. The balloon on the catheter is positioned within the cavity that is left behind after removal of the cancer. The balloon is inflated and remains in the breast for one week. Treatments are delivered twice daily for five days through the catheter. No overnight stay in the hospital is required, and the patient is in the clinic for about 45 minutes for each treatment. Discomfort from the catheter is generally mild; patients may continue to work during this time if they choose. Following therapy, the balloon is deflated and the catheter is removed.

  • Multiple-catheter breast brachytherapy, a procedure in which small, flexible catheters are inserted into the surgical cavity under local anesthetic. The catheters remain in place for a week and are removed after the last treatment. Everything about this technique is otherwise the same as for the balloon technique. The catheters are removed at the end of treatment.

The choice of treatment—balloon catheter or multiple catheter—will vary with each patient. Some patients who are not good candidates for the balloon technique, which is the simplest, can still be considered for breast brachytherapy using the multiple-catheter technique. There are some patients who should not have breast brachytherapy as part of their cancer treatment. For these patients, we continue to recommend external beam radiation.

Dr. Scott Tannehill is a radiation oncologist on staff at Columbia St. Mary’s. Dr. Tannehill, a nationally recognized expert in brachytherapy, treats cancer patients at the Constance Walker Radiation Oncology Center (414-961-3850), located on Columbia St. Mary’s Columbia Campus, and at the Heitz Radiation Oncology Center (262-243-8384, located on Columbia St. Mary’s Ozaukee Campus.


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