Breast Brachytherapy
Posted 5/3/2012
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Breast Brachytherapy means radiation that is directed only at the tumor bed and immediate area, not at the whole breast. Over the past decade, there have been increasing numbers (although still small) of women for whom this reduced radiation therapy has been suggested. There are always strict criteria about women for whom it makes sense, and, at least at our institution, the standard 5-6 week whole breast radiation remains the standard.
This article from MedScape discusses a recent study that suggested brachytherapy is not as effective as the standard treatment. In the study, there were more recurrences and, therefore, the need for more mastectomies in subsequent years. There is a pretty strong counter-argument, and you may find this interesting.
Here is the beginning and then a link:
Breast Brachytherapy Takes a Hit (or Not)
Among older women treated with lumpectomy, breast brachytherapy is associated with more complications than whole-breast irradiation, according to a new retrospective observational study.
Brachytherapy is also associated with a decreased likelihood of long-term breast preservation, but there is no difference in overall survival, according to the study findings, which used Medicare claims data and are published in the May 2 issue of JAMA.
The findings "prompt caution over widespread application of breast brachytherapy" outside of studies, say senior author Benjamin Smith, MD, from the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues.
However, a critic of the study has suggested that these findings are largely irrelevant to current practice. "It's a study of older technology that has been subsequently improved upon," said Robert Kuske, MD, who is medical director of Arizona Breast Cancer Specialists in Scottsdale. He explained that during the study period, 2003 to 2007, there was only 1 form of breast brachytherapy in use - the single-catheter MammoSite "balloon," which was approved by the US Food and Drug Administration in 2002.
"There has been a mass movement away from this single-channel brachytherapy device," he told Medscape Medical
News in an interview.
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