mamosite/brachyotherapy

lorena · New User Joined: 27 Feb 2005 Posts: 3

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Hi all,

Has anyone had the catheters put in while they were having there lumpectomy? The whole idea of quick effective treatment heck they can do the first one in the operating room Shocked

Maybe Im kidding Wink

I want these little monsters dead and out of my body NOW!
_________________
Lorena

AlaskaAngel · Posted: Mon Feb 28, 2005 1:45 pm Post subject: Brachytherapy

I'd like to hear the docs ideas on this too. At time of my dx several years ago I looked high and low to try to find a clinical trial for brachytherapy so that I could get access to it. I asked my onc about that, too. But it wasn't there at the time for me. I agree with you. I did the conventional rads treatments (left breast). The ONLY sensation my breast has is discomfort... Also, I ended up with "fatty necrosis" at the base of the breast, which is a very hard ridge of tissue that feels like a bone sticking out from the chest. I also have repeated bouts of costochondritis every time I have a chest x-ray or other rads that take a while to settle down again. I am NED, which counts of course, but I wish I could have found access to brachytherapy.

A.A.
_________________
Dx Dec 2001 at age 50
Lumpectomy Jan 2002, 1.6 cm IDC plus some DCIS
Node neg
ER+, PR+, HER2+++
CAF x 6, 35 rads+boost
NED
Tamoxfen 1 3/4 yrs
In 2 clinical trials
bc for mom and 1 sis and 1 aunt and 1 granny
ovarian cancer for 1 aunt

hhmv73a · Experienced user Joined: 16 Jan 2005 Posts: 95

Dear All:
First of all, mammosite brachytherapy is not the standard type of radiation to be used after surgery (lumpectomy or mastectomy). Mammosite is a type of brachytherapy that use very localized radiation to treat the tumor bed. However, recent researches have shown that it may be used but it is still under study. For your reference I have attached a link to a recently published article for the topic.
Regards,
Dr. J. Jay Lu

Acute complications of MammoSite brachytherapy: a single institution's initial clinical experience.

Harper JL, Jenrette JM, Vanek KN, Aguero EG, Gillanders WE.

Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC 29425, USA. harper@radonc.musc.edu

PURPOSE: To report the acute complications incurred by the initial 37 patients who underwent accelerated partial breast irradiation with the MammoSite balloon breast brachytherapy applicator at the Medical University of South Carolina. METHODS AND MATERIALS: Between May 2002 and March 2003, 37 patients with ductal carcinoma in situ or invasive carcinoma had MammoSite brachytherapy catheters successfully place after lumpectomy by one of four surgeons and were deemed eligible for high-dose-rate brachytherapy. An open technique was used in 32 implants and the scar entry technique was used in 5 implants. Patients had Stage pTis-pT2N1 with negative margins. A dose of 34 Gy was prescribed to 1 cm from the balloon surface using (192)Ir high-dose-rate brachytherapy and was delivered in 10 fractions twice daily. CT was used to confirm that the balloon surface was adherent to the lumpectomy cavity and to measure the balloon surface to skin surface distance. CT images and daily fluoroscopic simulations were used for treatment planning. Patients were assessed for acute toxicity on the day of therapy completion and 4 weeks after therapy by the radiation oncologist. In addition, all available data from radiation, surgical, and medical oncology were retrospectively reviewed for documentation of complications. All patients in this series had a minimal follow-up of 3 months; the mean follow-up for all patients was 7 months. RESULTS: The acute complications were categorized as operative wound complications, infections, skin toxicity, seromas, or catheter failures. Operative wound complications occurred in 3 patients (8%). Radiation Therapy Oncology Group Grade 2 and Grade 3 toxicity occurred in 2 (5.4%) and 1 (2.7%) patient, respectively. Six (16.2%) developed wound infections and 12 (32.4%) seromas. Catheter failures due to leak occurred in 2 patients (5.4%) and rupture in 3 (8%). CONCLUSION: The types of complications in this experience were similar to those in the Phase I trial of the MammoSite brachytherapy applicator. However, catheter failure due to leak occurred in our experience and was not described in the Phase I trial. The incidence of complications was greater in our series than in the Phase I trial; however, differences in toxicity scoring and the length of follow-up between the two series impeded direct comparisons. The incidences of complications over time reflect the steep learning curve for accelerated partial breast irradiation using the MammoSite brachytherapy applicator. Finally, radiation recall dermatitis developed in 1 patient treated after this review was completed.

Ref: Int J Radiat Oncol Biol Phys. 2005 Jan 1;61(1):169-74.

AlaskaAngel · Posted: Tue Mar 01, 2005 12:25 pm Post subject: Mammosite

Thank you very much Dr. Lu.

The article explains the complications for this type of brachytherapy. Is there any kind of comparison available to the current common radiatoin treatments and the complications experienced with that form of treatment?

A.A.

Roxi1 · Posted: Wed Mar 02, 2005 6:12 pm Post subject: Re: mamosite/brachyotherapy

Thank you Dr. Lu
I especially appreciate that you posted the article which your inference was based on in your response. This approach is extremely helpful for those of us who are trying to understand the underlying pinnings of why certain decisions are made.

Thank you again,
Roxanne
_________________
Roxanne
Lumpectomy R. Breast 1/5/05, Post-Menopausal
1.2 cm invasive ductal CA
Histology Grade 2
Estrogen/Progesterone +
Her-2/neu Negative
Nodes negative, 2 Sentinel, 8 other nodes
RT 28+5, Tamoxifen (as osteoporosis)

hhmv73a · Experienced user Joined: 16 Jan 2005 Posts: 95

You are very welcome.
At this time there is no direct comparison between any brachytherapy modality and conventional external beam radiation treatment. And EBRT is still the standard of the RT adjuvant treatment.
Dr. Lu

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