Winter 2007
Ask The Expert : Shorter Radiation Treatment for Breast Cancer
Shorter Radiation Treatment for Breast Cancer
Andrew Kenler, MD
Andrew Kenler, MD

I’ve been hearing about a new kind of post-surgery radiation treatment for breast cancer that only takes five days to complete. Please tell me more!
Surgeon Andrew Kenler, MD, responds:

After surgery, radiation therapy is used to target any stray cancer cells that may remain. Standard therapy sends an external beam of radiation to the outside of the breast in the area of the cancer, and generally takes about six or seven weeks of outpatient treatments. The new, shortened form of radiation treatment, used after breast-conserving lumpectomy (removal of the cancerous lump only), is called brachytherapy (brake-ee-therapy). It uses a strong source of radiation, which is delivered right inside the affected area of the breast. This technique is safe for patients because the radiation is delivered to a small area for just minutes at a time. Most women find the one-week course of therapy much preferable to six or seven weeks!

There are two techniques. The first, called the multiple catheter technique, involves placing 10 to 12 thin tubes, or catheters, into the breast, surrounding the area where the tumor was removed.

The second, balloon brachytherapy, involves just one balloon-tipped catheter. It is placed into the cavity where the tumor was removed and is then inflated to fill the cavity. Both of these catheterization procedures are done under local anesthetic. Once the catheter(s) are in place, they remain for five days.

Radiation treatments are then given on an outpatient basis twice a day for five days. During each treatment, a tiny pellet of radioactive material is threaded through the catheter(s) for several minutes. The pellets are then removed, and the patient may go about her normal routine. At the end of the five days of treatment, the catheters(s) are removed.

Not all women are candidates for brachytherapy. It is most effective when the removed tumor was small, no cancer cells were found at the outer edges of the tumor, and few lymph nodes were involved.

Side effects for breast brachytherapy are rare, and include inflammation, infection, and bruising, all of which can be treated or last only a short time.

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