Device May Reduce Mastectomy for Breast Cancer

A new way of delivering radiation, known as balloon brachytherapy, may allow some women with breast cancer to avoid mastectomy and instead undergo an operation that spares the breast, new research suggests.

Previous reports have shown that this limited surgery, called breast-conserving therapy, when followed by radiation is just as good as mastectomy at improving patient survival. Unfortunately, because radiation typically takes 6 weeks to administer and is only offered at special centers, many women are forced to undergo mastectomy simply because they don’t have the time to travel to one of these centers for treatment. Usually, radiation is given from the outside in — that is, by an external beam of radiation. Balloon brachytherapy, by contrast, delivers radiation from the inside out, according to the report in the Archives of Surgery. The procedure involves the insertion of a balloon device, called the MammoSite catheter, through the skin incision and into the area where the cancer was removed. The balloon is then inflated and radioactive material is poured in to provide radiation to the area. After treatment is completed, the balloon is deflated and the device is removed. By reducing the radiation treatment time to just 1 week, balloon brachytherapy may help women with logistic problems of time and distance opt for breast-conserving therapy and avoid mastectomy. In the current study, Dr. Kambiz Dowlatshahi, from Rush University Medical Center in Chicago, and colleagues describe the short-term outcomes of 112 women treated with balloon brachytherapy. The subjects adjusted quickly to the breast distension caused by the device and rated the cosmetic outcome as high. There was no evidence of cancer recurrence during follow-up. There were some complications with the new technique. Four women had a punctured or ruptured balloon that required replacement before treatment could be completed, the investigators point out. Also, seven women developed a wound infection that required drainage and antibiotics, the researchers note. Less serious complications included temporary reddening of the skin and blisters. After the device was removed, 10 women had ultrasound-detected fluid collections that were drained with a needle, Dowlatshahi’s team reports. “Brachytherapy with the MammoSite catheter has distinct advantages compared with (standard radiation), including a much shorter treatment time that enables working women and those at a distance from radiation centers to consider breast conservation,” the researchers conclude. (SOURCE: Archives of Surgery: Reuters Health News: June 2004.)