Register for Brachytherapy saves breast, decreases treatment time
Breast CancerAugust 10, 2004
2004 AUG 10 - (NewsRx.com & NewsRx.net) -- Many women are unnecessarily undergoing mastectomy when there is an effective, breast-saving treatment that can be performed in under a week, according to a breast cancer specialist.
Robert R. Kuske, MD, a radiation oncologist with Arizona Oncology Services, discussed accelerated partial breast irradiation (APBI) - also known as brachytherapy - at a July 22, 2004, Radiological Society of North America (RSNA) media briefing.
According to Kuske, approximately 80% of women diagnosed with breast cancer are candidates for breast conservation therapy, in which the lump is surgically removed and any remaining cancerous cells are destroyed by radiation therapy, leaving the breast intact. Unfortunately, despite 20 years of studies demonstrating no difference in survival rates between women receiving mastectomy or lumpectomy followed by radiation therapy, only 55% of women opt for the latter treatment.
Kuske cites two major reasons breast cancer patients avoid breast-saving radiation treatments: "I believe women choose mastectomy because of the inconvenience of 6 to 7 weeks of conventional external beam radiation therapy (EBRT) and the fear of whole-breast irradiation to uninvolved breast, skin, ribs, lung, and the heart."
He has led three trials investigating brachytherapy, a technique that eliminates those barriers. Brachytherapy involves placing a tiny radioactive seed inside the breast, up against the tissues harboring the breast cancer. Since the radiation is directed to the 1-2 centimeters of breast surrounding the lumpectomy site, the rest of the breast and surrounding organs are spared, and the entire radiation treatment takes only 4-5 days. These trials have shown low toxicity and cancer recurrence rates of only 3-4% in the breast.
Two brachytherapy methods are currently used to place radiation into the treatment area: interstitial brachytherapy, which involves multiple catheters (thin, hollow plastic tubes) around the surgical excision site; or a single balloon catheter that is inserted and then inflated in the lumpectomy cavity. Compared to EBRT, brachytherapy intensely treats the part of the breast that is at the greatest risk for a recurrence of cancer with minimal radiation exposure to the rest of the breast, heart, lungs, and skin.
Women are eligible for breast brachytherapy if their tumor size is 3 cm or smaller as long as the cells do not reach the surgical margin. Up to three lymph nodes under the arm may be involved.
"Brachytherapy makes breast conservation therapy more convenient for women located in rural areas and for those who have busy lifestyles or occupations that will not accommodate up to 7 weeks of radiation treatment," Kuske said.
Kuske is currently serving as a co-principal investigator of an upcoming Phase III clinical trial comparing APBI and EBRT, sponsored by the U.S. National Cancer Institute through the National Surgical Adjuvant Breast and Bowel Project and the Radiation Therapy Oncology Group. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2004, Cancer Weekly via NewsRx.com & NewsRx.net.
©Copyright 2004, Cancer Weekly via NewsRx.com & NewsRx.net
