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Overview


Breast cancer

Worldwide, breast cancer is the most common type of cancer in women.1

Estimates for 2002 indicate that in developed countries, there were over 700,000 incidences of breast cancer. In developing countries there were an estimated 500,000 incidences.1

Despite a rising incidence of breast cancer, survival rates have increased in recent decades thanks to screening programmes (mammography) and improvements in breast cancer treatment.1


Current treatment goals for breast cancer are to:

  • Achieve cancer cure (elimination of breast cancer tissue). 
  • Avoid damage to surrounding tissues and organs and preserving the natural appearance of the breast.
  • Prevent recurrence of disease.


Brachytherapy for breast cancer

Brachytherapy is an important part of treatment for many women with breast cancer.

Brachytherapy (high precision, targeted radiotherapy) enables breast preserving surgical techniques to be used (i.e., lumpectomy rather than mastectomy). This is made possible by the placement of radioactive sources directly in the breast tissue - providing targeted and effective radiation doses to kill any residual cancer cells.

The delivery of the brachytherapy radiation sources can be via:

  • Multiple catheters placed in the breast tissue (multicatheter interstitial therapy).
  • A balloon catheter, which is placed in the breast during surgery (lumpectomy) and inflated up to a week later, allows delivery of the radiation source (balloon-based interstitial therapy).

interstitial breast brachytherapy These highly localized methods of delivering the radiation source confine irradiation to the area of the lumpectomy and allow for increased dose fractions of radiation to be administered over shorter treatment times.

Breast brachytherapy uses high dose rate (HDR) brachytherapy. For further information on how brachytherapy works, see the background section. Brachytherapy, can be used after surgery (post lumpectomy), before chemotherapy, and alone or in combination with external beam radiotherapy (EBRT).

If brachytherapy is used as the sole method of radiation therapy after surgery, treatment times can be reduced from 5–6 weeks to just 5–7 days. This is known as accelerated partial breast irradiation (APBI). 



Indications

High dose rate (HDR) brachytherapy is indicated for the treatment of early breast cancer.

  • Interstitial ‘boost’ therapy after EBRT of the whole breast following surgery.2
  • Definitive radiotherapy following surgery – known as accelerated partial breast irradiation (APBI).3-5
  • Interstitial ‘boost’ therapy after initial systemic chemotherapy and/or EBRT of the whole breast in inoperable cases.2

image guided breast irradiation

There are a number of methods available to deliver the additional 'boost' dose of radiotherapy using brachytherapy. Multiple interstitial catheters or a balloon catheter can be used (as described above). There is also a newer method available that uses the dosimetry principles of brachytherapy to precisely target radiation using a radiation source placed around the breast. This non-invasive method is known as 'image guided breast irradiation'.



Summary

Brachytherapy for the treatment of breast cancer offers you:

  • A clinically effective treatment option for early breast cancers, comparable to EBRT and surgery.3,6,7
  • Good to excellent cosmetic results, comparable to EBRT.3,6,7
  • Shorter treatment times
  • Convenience for both patients and healthcare providers

“Accelerated partial breast irradiation is an attractive treatment
approach that shortens the 5–7-week course of conventional
radiotherapy to 4–5 days."

Polgar et al, 20078


References
  1. World Health Organization. World Cancer Report 2008. International Agency for Research on Cancer, Lyon, France.
  2. Van Limbergen E & Mazeron JJ. 18. Breast Cancer. In: The GEC ESTRO Handbook of Brachytherapy. Gerbaulet A, Pötter R, Mazeron J-J, Meertens H and Van Limbergen E (Eds). Leuven, Belgium, ACCO. 2002.
  3. Nelson JC, Beitsch PD, Vicini FA, et al. Am J Surg 2009;198(1):83–91.
  4. American Brachytherapy Society. Available at: http://www.americanbrachytherapy.org/guidelines/HDRTaskGroup.pdf. Accessed 30 December 2009.
  5. Polgár C & Major T. Int J Clin Oncol 2009;14(1):7–24.
  6. Polgár C, Major T, Fodor J, et al. Int J Radiat Oncol Biol Phys 2004;60(4):1173–81.
  7. Polgár C, Fodor J, Orosz Z, et al. Strahlenther Onkol 2002;178(11):615–23.
  8. Polgár C, Fodor J, Major T, et al. Int J Radiat Oncol Biol Phys 2007;69(3):694-702.
Page last updated on 14 January 2011.

Brachytherapy

and breast cancer

 

Cancer types



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