CHICAGO (Reuters Health) - Using a cancer treatment approach called
brachytherapy, the contraction of tissue around breast implants in women with
breast cancer augmentation can be avoided.
This method achieves better tumor control with fewer complications and entails a
significantly shorter treatment course than whole breast irradiation, according
to a surgeon from the University of Arizona in Scottsdale, who reported the
findings here Monday at the annual meeting of the Radiological Society of North
America (RSNA 2008).
Brachytherapy involves radiation doses directed to specific sites inside the
breast around the tumor. The procedure is less invasive and the results are
better than those of whole breast radiation therapy.
"I think this will ultimately become the treatment of choice for women with
breast augmentation," Dr. Robert R. Kuske, also affiliated with the Arizona
Oncology Services, told Reuters Health. "At the moment, though, I am the only
one on the planet doing this."
Kuske presented his results with brachytherapy in 70 women with breast
augmentation who developed breast cancers and had undergone lumpectomy, removal
of the breast cancer only, rather than the whole breast.
"These women received their augmentations 10 to 20 years ago, and they are now
getting to the age where breast cancer becomes an issue. These women literally
comprise one third of my practice," he said.
"Whole breast irradiation means that radiation wraps around the augmentation.
The tissue around it can contract, which can be very painful," he explained.
"With brachytherapy, only a very small percentage of the augmentation is
exposed. Catheters deliver biologically intense radiation to the area around the
lumpectomy only. We get better tumor control, fewer complications, better
cosmetic outcome -- and the kicker is that it requires a five-day course of
treatment as opposed to six and a half weeks (with whole breast irradiation)."
The cosmetic effect was rated excellent in 91 percent of patients and good in
the remaining 9 percent. There were no fair-to-poor results. "Normally, with
whole breast irradiation, 15 percent to 20 percent of patients have a
fair-to-poor outcome and 55 percent of women with augmentations have a
fair-to-poor outcome."
"I place the brachytherapy catheters under CT guidance. I haven't had any cases
of implant puncture and I've never had to replace an implant," Kuske said.
"I use brachytherapy in my nonaugmented patients as well, because it is so
incredibly accurate," he added. "We are enrolling patients without implants now
to study the efficacy of brachytherapy in the general breast cancer population."
Approximately 3,300 of the goal of 4,300 patients have been enrolled to date.
Source : Reuters Limited
