By: Shelagh McNally for Fibroids1
Breast cancer patients were given some good news this week. A new technique for shortening radiation therapy has been proven to be just as effective as the longer, traditional method.
Typically women who opt for a lumpectomy to treat their breast cancer usually have to face a course of radiation therapy to kill any remaining cancer cells.
Daunting time commitment
The most common treatment is external radiation, sometimes called whole-breast radiation therapy (WBRT). In this technique a linear accelerator machine aims a beam of high-energy radiation at the breast area affected by the cancer. Although this form of radiation is given on an outpatient basis, it is done five days a week for six to seven weeks. For many women this kind of commitment adds additional stress to their recoveries.
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From the Breast Cancer Organization
The Five Steps of a Breast Self Exam
Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Look for changes in size, shape, and colour. Make note of any dimpling, puckering, or bulging of the skin or a nipple that has changed position.
Step 2: Now, raise your arms and look for the same changes.
Step 3: While you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).
Step 4: Do a complete check of your breasts, following a pattern of beginning at the nipple and moving in larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically.
Step 5: Finally, feel your breasts while you are standing or sitting.
Visit breastcancer.org for a more detailed description of how to do a full breast exam. |
Effective alternative
A type of internal radiation known as accelerated partial breast irradiation (APBI) using balloon brachytherapy shortens the radiation therapy down to one week. APBI has been gaining in popularity after a study presented at the Society of Surgical Oncology (SSO) Annual Cancer Symposium in March showed it is as effective as WBRT in terms of recurrence rates, cosmesis, and patient satisfaction. Another study presented this week at the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting in Boston confirmed those findings. The American Society of Breast Surgeons (ASBS) MammoSite RTS Registry Trial evaluated data from more than 1,400 women with early stage breast cancer treated with the MammoSite Radiation Therapy System. After following 400 women for nearly four years, the results found that those treated with APBI had the same chance of the cancer returning as those who had the standard radiation treatment.
“Not only does it (APBI) make radiation treatment much more convenient, it may actually increase the rate of breast conservation. Some women choose mastectomy because they live too far from a radiation center and cannot afford the time and expense of six to seven weeks of living or traveling to the center,” said Peter Beitsch, M.D., lead author of the study and a surgical oncologist at Medical City Dallas Hospital in Dallas. “Also, there are many women who for a host of reasons don’t receive the necessary postoperative radiation and the shortened course should hopefully allow more women to receive the therapy that they need.”
New methodology
APBI uses brachytherapy which is a form of radiotherapy that uses radioactive seeds most commonly delivered using multiple catheters or a MammoSite balloon-catheter device.
In multi-catheter internal radiation, tiny tubes (catheters) are sewn under the skin with the ends sticking out through holes in the skin. CT scans, ultrasound, or other imaging techniques are used to guide the catheters into place. Stitches hold the tubes in place. Radioactive seeds are then fed into the tubes long enough to deliver the prescribed dose of radiation. Low-dose radiation treatments can take a few days. In high-dose the radioactive seeds may be left in for up to 10 minutes.
The MammoSite system uses a special tube with a balloon on the end that is carefully placed in the lumpectomy cavity. The balloon is filled with fluid to hold it in place while the radioactive seeds are fed into the center of the cavity.
Shortened time
Both treatments are done over five days and once the treatment is finished, the radioactive seeds, stitches, and tubes are removed.
Some patients experience minor discomfort during the insertion and removal of the catheters or MammoSite system. However, unlike traditional radiation, most patients are able to return to their daily routines after APBI.
Suitable candidates
More research needs to be done to determine its efficacy for younger women with breast cancer. The ASBS prefers patients be older than 50 years of age with a tumor of at least 2mm in all directions. Researchers are looking at the possibility of APBI for younger women and believe it will become a viable treatment.
