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New radiation therapy shortens breast cancer procedure to 5 days from 6 weeks


May 27, 2008 08:56AM


After breast cancer surgery, patients typically face an agonizing six weeks of radiation therapy.

A new procedure is giving some the choice of a five-day treatment.


"Normally, we treat the whole breast with radiation," said Dr. Gilbert Padula, a radiation oncologist at The Lacks Cancer Center at St. Mary's Health Care. "But, with this type of procedure, we only treat the cavity left inside the breast by the lumpectomy."

More precise than conventional radiation therapy, accelerated partial breast irradiation or, APBI, using the MammoSite Radiation Therapy System delivers a more concentrated dose of radiation to the site of the tumor while reducing the risk of damage to surrounding healthy breast tissue. The total dose of radiation is equivalent to what patients receive during a full regimen of conventional radiation treatments.

A new choice
The new option -- also known as Accelerated Partial Breast Irradiation (APBI) -- cuts radiation therapy from six weeks to five days.

The procedure

1. After the tumor is removed, a small soft balloon attached to a thin catheter is inserted through a small incision and placed inside the cavity left by the lumpectomy. The balloon, along with a small portion of the catheter, is secured to the patient for the duration of the therapy.

2. The balloon is filled with saline solution so that it snugly fills the cavity.

3. Treatment is planned by the radiation oncologist who will take images of the balloon and determine the amount of radiation needed.

4. During treatment, the catheter is connected to a computer-controlled machine that inserts a radiation "seed" into the balloon to deliver the therapy.

5. Once therapy is complete, the seed is removed and the catheter is disconnected from the machine. No radiation remains inside the breast between treatments.

6. After five days of treatment, the balloon catheter is removed through the original incision.

Who can have the procedure?
Women with small, early breast cancers are typically eligible for the APBI procedure. There still is uncertainty about who it is best for and, when there is doubt, the doctor may recommend standard radiation therapy. Generally, the tumor must be small with clear surgical margins after the lumpectomy, and preferably no lymph nodes containing cancer.

More online
Breast cancer patients interested in participating in the accelerated partial breast irradiation clinical trial may contact Dr. Gilbert Padula's office at 752-6218. For more information, go to

"The benefit is that patients can resume their normal lives much sooner," Padula said.

Clinical trials

Approved by the U.S. Food and Drug Administration, the new therapy is in ongoing clinical trials at The Lacks Cancer Center and other sites throughout the U.S. Although early results indicate both treatments are equally effective, the new approach is considered experimental until the trials provide definite proof. Typically, women diagnosed with small, early breast cancers may be eligible for the new therapy.

Those who choose to be part of the clinical trials are randomly assigned either the new or the traditional radiation treatment. To ensure receiving the new therapy, women also can choose to have it without being part of the clinical trials, and most health insurance companies will cover the cost.

Breast cancer options

Late last fall, Liz (who asked that her last name not be used), 47, of Lowell, underwent a breast-saving lumpectomy to remove a tumor and a small amount of surrounding tissue. When she consulted with her medical team through Breast Services at The Lacks Cancer Center, she was offered the option of being treated with the new procedure. Liz was sure APBI was right for her.

"The thought of coming in once a day for such a long period of time just wasn't something I wanted to do," she says. "I wanted to be done with my treatments as soon as I could to help get my life back to normal as soon as possible."

The therapy involves a small incision in the breast. A deflated balloon attached to a thin catheter is inserted in the breast into the space left by the lumpectomy.

Inflated with a saline solution, the balloon is secured inside the breast, while a portion of the catheter remains outside. The balloon can be placed during surgery or during a separate procedure up to several weeks later, and remains inserted for the duration of the therapy.

Using a CAT scan of the balloon, Liz's radiologist determined the dose of radiation to administer.

During the treatment, a catheter was connected to a computer-controlled machine and a tiny, radioactive seed was sent from the machine into the inflated balloon inside the breast.

Each treatment was between 5 and 10 minutes while the seed remained inside the balloon, delivering a concentrated dose of radiation.

At the end of the procedure, the seed was drawn back into the machine, and the catheter disconnected. The treatment was repeated twice daily during a 5-day period, and no radiation remained in the breast between treatments.

"It's not a painful procedure at all," Padula said.

Once all radiation sessions are completed, the balloon is deflated and removed with the catheter tube.

Few side effects

Although side effects can include redness, bruising and possibly some breast pain, Liz experienced none of these.

"I never had one bit of a problem," she said. "I would recommend this procedure to anyone."

"The current trend in treating breast cancer is breast conserving therapy," said breast surgeon, Dr. Jamie Caughran. "We want to save as much of the breast as we possibly can, yet still remove the tumor and margin area, while leaving the breast pretty much the same as it was."

"We're moving into a whole new world of treatments for breast cancer with more targeted therapy," Padula said. "In the future, every woman will have more options for personalized care."





Posts: 143
Reply with quote  #2 
That is so interesting!  Since my tumor was 1.2cm I wonder if I would have been a canidate for that.  I thought radiation was going to be a breeze after the horrible nausea and sickness I had with chemo.....WRONG!  I am still tired from the radiation and it has been 2 months.
Thank you for this information.
I think it sounds great!

DX 8-14-07
Invasive Medullary Carcinoma
Triple Negative
Stage 1c
Grade 3- Poorly Differentiated
Lymph Node-Negative

Posts: 1
Reply with quote  #3 
I had Mammosite Radiation in January '07.  It was really nice to be done with rad tx in five days.  I would recommend it to anyone that is considering it.  There are certain criteria that must be met as far as placement of the catheter and whether there is enough room between the catheter and the skin and the catheter and the chest wall.  However, if one qualifies, the option of 5 days targeted radiation as opposed to 6 weeks of whole breast radiation is a great choice.

There wasn't alot of patient information when I had my tx so that is why I volunteer with to share my story with others trying to make a choice between traditional radiation and Mammosite. If you want to read my story or contact me you can do so through the above site, click on stories, then the state of Alabama then me, Jackie.  I do not receive anything from the maker of Mammosite.  I just want to help others during this difficult time by sharing
support and my experinces.

Hope this helps someone.

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Posts: 7,476
Reply with quote  #4 
Hey Cheryl, how are you girl?

Jackie, thank so much for all this info- it is GREAT!




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Goddess Forever
Posts: 2,525
Reply with quote  #5 
This was only in trial in 2004 0r 2005, right?
I had the full round after mast and this wasn't even considered then...or do I misunderstand? It was still a trial?

~ There are lies, damned lies and statistics ~

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Goddess Forever
Posts: 243
Reply with quote  #6 
I wish I would have known about this before my surgery. But, I can still do it (if I qualify) I only had my surgery two and a half weeks ago. I am definitely going to ask about this. Sounds like it's for me

Thanks for the article Gina, I was looking for more info online and the article you posted was what I was looking for..

You go girl!

A mind that is stretched by a new experience can never go back to its old dimensions. - Oliver Wendell Holmes
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