Most breast cancer patients who have lumpectomies—breast conserving surgery to remove a cancerous tumor and surrounding margin of normal breast tissue—are also treated with radiation therapy to help destroy any lingering cancer cells after surgery. Yet many women find the six or more weeks of post-operative radiation therapy to be inconvenient, especially if they live far from their treatment center. For these and other women with early-stage breast cancers, researchers are finding that a new form of breast cancer radiation therapy called brachytherapy, or internal beam radiation, may work as well as traditional radiation therapy but in significantly less time (one week versus six or more). Though brachytherapy is still not a standard treatment for breast cancer, clinical results suggest that the new radiation method could become a viable alternative to standard radiation for women who have lumpectomies.
In a study recently published in the Journal of Clinical Oncology, researchers compared external beam radiation therapy to brachytherapy in women who underwent lumpectomies for early-stage breast cancers. External beam radiation is the standard radiation treatment for breast cancer patients and involves delivering radiation from a source outside the body. Brachytherapy, on the other hand, involves placing 10 to 20 plastic tubes (catheters) in the breast tissue next to the area where the tumor was removed. Small pellets of radioactive substances are inserted into these catheters. Then, nine or more times over the course of four to five days, the catheters are briefly connected to a high-dose-rate brachytherapy machine for internal radiation treatment.
In the study, Frank A. Vicini, MD, Program Director of Radiation Oncology at William Beaumont Hospital in Royal Oak, Michigan, and his colleagues found that women who received brachytherapy after lumpectomy were no more likely to experience a recurrence (return) of breast cancer than patients treated with standard external beam radiation. The researchers also found no significant differences in the likelihood that the patient’s cancer had metastasized (spread) to distant body parts (such as the bone, lung, or liver) regardless of which type of radiation therapy was given. The patients were followed for an average of three years.
Though experts are not disputing the effectiveness of standard external beam radiation therapy, studies such as this one suggest that brachytherapy holds promise as another treatment option. In addition to a substantial reduction in the amount of time needed to administer brachytherapy, the treatment has also been associated with fewer side effects than external beam radiation. This is likely because the radiation is confined to a smaller area of the body and has less potential to irritate breast skin or damage healthy tissue. Yet brachytherapy is not without potential side effects of its own, including risk of infection and breast swelling.
Brachytherapy is already a standard treatment option for many prostate cancer patients. It can spare many men from having to undergo a radical prostatectomy, the surgical removal of the prostate. Brachytherapy is also performed on women with cervical cancer and patients with cancer of the mouth. However, further research including long-term follow-up of patients, is still needed before brachytherapy can be offered to a large number of breast cancer patients as an alternative to traditional external beam radiation. Currently, brachytherapy for breast cancer is available at a handful of centers across the United States while researchers continue to study its effectiveness. Breast cancer patients must meet eligibility requirements to have brachytherapy at these centers. For example, women must have small breast tumors, and the cancer can only involve three or fewer axillary (armpit) lymph nodes.
- The study, "Accelerated Treatment of Breast Cancer," is published in the April 1, 2001 issue of the Journal of Clinical Oncology (Vol. 19, Issue 7). An abstract of the report is available at http://www.jco.org/
- To learn more about radiation therapy for breast cancer, including both external beam and internal beam (brachytherapy) radiation, please visit http://www.imaginis.com/breasthealth/radio_bctreatment.asp
