South Nassau Communities Hospital

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South Nassau in the Community

01/21/2009

Less Invasive Breast Cancer Radiation Treatment is Less Invasive on Patient’s Daily Life As Well


Breast health specialists at South Nassau Communities Hospital are performing a new procedure that alleviates the copious time and energy that breast cancer patients normally devote to receive radiation therapy after a lumpectomy.

The procedure, Contura™ multi-channel balloon brachytherapy for partial-breast irradiation, requires just five days and two treatment sessions per day to complete the prescribed radiation therapy plan as compared to the six to seven weeks required for traditional whole-breast irradiation. South Nassau also offers Mammosite® Radiation Therapy, which is a single channel balloon brachytherapy technique that is also completed in the same number of days and treatment sessions as the Contura technique.

The Contura balloon has five separate channels through which a radioactive seed, at the end of a motor driven wire, travels. The radioactive seed is inside the patient for only a few minutes, before returning to the brachytherapy treatment unit. The result is the delivery of internally targeted radiation to the breast tissue surrounding the lumpectomy cavity, while sparing healthy tissue nearby from high radiation doses. The procedure also employs vacuum suction to help the balloon fit closely within the often irregularly shaped lumpectomy cavity, so the targeted areas receive the prescribed therapeutic dose.

“The multiple channels and the vacuum feature help the physician to shape or contour the radiation dose to obtain a more optimal result,” said Leester Wu, MD, Associate, Radiation Oncology Department. “We are able to better target the radiation to the areas in most need of treatment.”

Brachytherapy is from the Greek word meaning ‘close’ or ‘internal,’ referring to a way of delivering treatment from inside rather than outside. “By targeting treatment from inside the breast, we can complete radiation treatment in 5 days, allowing patients to return more quickly to their day-to-day lives,” said Christine Hodyl, DO, Director of Breast Surgery.

To perform Contura balloon breast brachytherapy, Dr. Hodyl and breast health specialists at South Nassau insert a small balloon-based device into the breast to treat the “rind” of tissue surrounding the cavity left by lumpectomy surgery. After being inserted, the balloon is inflated and filled with saline and a vacuum is used to help the balloon fit closely within the often irregularly shaped lumpectomy cavity. Planning of the treatment is conducted by South Nassau’s medical physics staff, using specialized optimization software to determine the best dwell locations and times for the radiation seed. The delivery of the treatment plan is also computer controlled, whereby the radiation seed is sent through five separate “lumens” or channels inside the balloon, allowing the shape of the radiation dose to conform to the targeted area.

“The dose is directed by where the seed sits in the balloon, allowing us to concentrate the radiation dose on the tumor area,” said Dr. Wu. “If the seed were too close to the skin in channel one, we might place the seed in channels three or four for a longer time than in channel one.”

With Contura, as well as Mammosite, patients experience greater comfort and convenience with their breast cancer care. More importantly, a growing body of clinical data continues to support this form of radiotherapy as an alternative to whole-breast irradiation for qualified breast cancer patients. As with any medical treatment, a thorough discussion with a breast surgeon and radiation oncologist is necessary to determine if a patient is a candidate for Contura or Mammosite.



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