BREAST CONSERVATION THERAPY

A) EXTERNAL BEAM RADIATION THERAPY

Breast cancer is the most common type of cancer in women with over 180.000 new estimated cases for 2007 in the United States. Breast cancers are usually discovered at an early, localized stage. When treated appropriately there is a 97% rate of five-year survival. The current standard of treatment for early-stage breast cancer is lumpectomy followed by whole breast radiation.
Breast conservation therapy (BCT) consisting of lumpectomy and whole-breast external-beam radiation therapy (WB-EBRT) is delivered in a period of 5-7 weeks. It is an accepted and appropriate local treatment option for selected patients with early stage breast cancer instead of surgical removal of the breast (mastectomy).
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Linear accelerator unit used to deliver
external beam radiation therapy to the whole breast (WB-EBRT) and usual treatment fields.
2) BRACHYTHERAPY:
Brachytherapy, using high dose remote control radiation, is another appropriate method to treat breast cancer patients. It has been estimated that about 20% of eligible women treated in the United States do not receive RT as part of breast conservation therapy. The most common reasons for these omissions include advanced age and /or difficulty with travel for daily treatment for 6 weeks. This has sparked interest in evaluation of other treatment options such as accelerated partial breast irradiation (APBI) which uses brachytherapy allowing the delivery of more focused RT over a shorter period of time. APBI differs from whole-breast external beam radiation therapy in two ways. First, it is partial because the radiation targets only the segment surrounding the tumor rather than the whole breast. Second, it is accelerated because the radiation is delivered in fewer fractions at larger doses and the duration of treatment is 5 to 7 days rather than 5 to 7 weeks. Thus, APBI offers the advantages of decreased radiation dose to healthy surrounding tissues and reduced overall time of treatment.
MammoSite Device:
The MammoSite applicator consists of a small soft balloon attached to a thin catheter (tube) .The balloon is inflated once the catheter is inserted within the lumpectomy cavity ( the space left after the tumor is removed).A tiny radioactive source (seed) is placed within the balloon by a computer controlled machine for each treatment. No source of radiation remains in the patient’s body between treatments or after the final treatment is over. Neither the Mammosite catheter nor the liquid inside is radioactive.

 

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