Low recurrence rate of breast cancer with Brachytherapy

Accelerated partial breast irradiation with Brachyltherapy yields a lower recurrence rate and spares much more of he breast and surrounding tissues than does external beam radiation.

Dr Robert Kuske of the University of Wisconsin presented a 10-year follow-up data on more than 300 women with breast cancer that he had treated with brachytherapy following lumpectomy since 1991.

There have been only three recurrences in the group during that time and ‘if you combine my data with (others performing brachytherapy) more than 500 women have been treated with eight recurrences’, Dr Kuske said.

Compared with external beam radiation for breast cancer, there is less acute toxicity with brachytherapy because less radiation is delivered to the skin and surrounding tissue.

Brachytherapy involves the insertion of multiple catheters into the site of a lumpectomy, through which a high dose Iridium-192 is delivered. This procedure takes four to five days compared to conventional external beam radiation which takes six weeks.

‘A lot of people thought it would be more toxic than external beam (radiation) because it is an invasive procedure… But brachytherpay is delivered only to the tumor site. It spares healthy breast tissue and the underlying lung’.

‘There is no delay in the delivery of chemotherapy’ since the procedure only takes four to five days. If external beam radiation is used first, there is an eight week delay in chemotherapy and 3.5 month delay if chemotherapy is given first.

Brachytherapy is effective in tumours up to 3cm in diameter with negative margins and nodes that are negative of positive nodes of minimal size, Dr Kuske said.

‘We’re talking about a paradigm shift here… it is appropriate to treat only part of the breast. We don’t need to treat every piece of tissue’.

Nucleotron Corp’s Kuske Breast Template, a device that allows for more precise dosimetry received FDA approval on 7th October.

(Source: ASCO & Reuters Health)