What is Breast Brachytherapy(brăk - ē - therapy)?
This year, more than 200,000 new cases of breast cancer will be diagnosed in the United States. Surgical removal of the cancer lump (lumpectomy) is usually the first step. After this surgery, women with early breast cancer are offered mastectomy(surgical removal of the entire breast) or radiation therapy to the breast. Most women choose radiation because the survival rate for such treatment is the same as with mastectomy, and it allows the patient to preserve her breast.
Radiation treatments are given to kill off any possible remaining cancer cells in the breast. Radiation is done to help prevent a recurrence, or return, of breast cancer and can be given with external or internal radiation. External beam radiation, also called whole-breast irradiation (WBI), treats the whole breast from the outside, by aiming highly penetrating x-rays at your tumor cavity.
External beam radiation begins four to six weeks after surgery. Patients receive one treatment a day for six to seven weeks. It is very successful in preventing recurrence of cancer in the breast, but many women find the long duration of treatment to be burdensome.
There is another option - Brachytherapy. Breast Brachytherapy means placing radiation sources (usually tiny pellets the size of pencil lead) inside and adjacent to a cancer, or inside an area that may contain residual cancer after surgical removal of the visible tumor mass.
Take a moment and watch this excellent video of Dr. Robert Kuske discussing breast brachytherapy, how it works and the different methods in providing this 5-day treatment for breast cancer. Just click on the arrow in the video and it will begin.
This is pronounced 'brak- e - therapy' with the first 'a' pronounced as the 'a' in bat. If you are from Harvard, you may prefer to pronounce it 'bray - key - therapy' and this is acceptable, but perhaps a tad snobbish. "Brachy" comes from the Greek root meaning from a short distance. For example, the brachysaurus was a dinosaur with short front limbs. In the case of breast cancer, brachytherapy is a form of partial breast irradiation in which tissue adjacent to the original cancerous breast lump is treated after the lumpectomy with radiation sources placed within this area, for a very brief period, over several (in this case usually ten) treatment sessions. This is accomplished by many different catheter (plastic tube) systems commercially available, such as the MammoSite® balloon catheter, the SAVI® (egg-whisk like) device, the Contura® multi-channel balloon catheter, or multiple thin catheters placed individually around the tumor site.
Brachytherapy has been an accepted treatment method for many cancers for no less than 100 years. Brachytherapy was used decades before the first 'beam' emitting radiation treatment machine was built. Cancers that are commonly treated with brachytherapy include cancers of the cervix and uterus, mouth and throat, prostate, and cancers of muscles called sarcomas. For cancer of the cervix in women, the use of brachytherapy is considered critical for cure. And today brachytherapy is performed thousands of times each year for men with prostate cancer and is as effective as surgical removal of the prostate for many men with this disease.
How does Breast Brachytherapy work?
Brachytherapy involves placing a radiation source within or close to the cancer. Using brachytherapy, doctors can reduce the radiation exposure to nearby normal tissues that do not need - and can be harmed by - the radiation. Brachytherapy is used to treat many cancers, including prostate cancer and gynecologic cancers.
The beauty of breast brachytherapy lies in the laws of physics: very close to the radioactive seeds, the radiation intensity is very high, but just a short distance away (millimeters) this radiation intensity falls off rapidly. This law of physics gives us a therapeutic advantage: if the seeds are precisely positioned in the tissues containing cancer cells, the normal tissues such as lung, heart, ribs, and skin that are not at risk for having cancer cells can be avoided!
It is regarded as a safe and effective alternative to standard external beam treatment for many patients with breast cancer; overall patient survival with either approach is going to be similar. The primary reason a woman would select breast brachytherapy over standard external beam radiation is time: external beam radiation requires over six weeks of daily treatment, but breast brachytherapy can be completed in one week.