Patients who have had breast-conserving surgery such as a lumpectomy to remove a tumor may receive radiation therapy after the surgery to destroy any cancer cells that remain. External beam radiation is the most frequently used radiation treatment for breast cancer, and in this method the radiation comes from a machine outside the body. Mammosite radiation therapy is a form of brachytherapy, or internal radiation, in which the source of radiation is placed inside the breast tissue in the space left by the lumpectomy.
Procedure
According to the Cleveland Clinic, certain breast cancer patients who have had lumpectomy surgery can receive mammosite radiation treatments as an additional therapy to reduce the risk of a recurrence of the cancer. At the end of the lumpectomy procedure, the surgeon places a balloon attached to a catheter inside the breast in the space left after the tumor has been removed. A small part of the catheter remains outside the breast, protruding through a small incision. Using the external part of the catheter, doctors fill the balloon with a saline solution, and when treatment begins, they use a device that sends radioactive seeds into the balloon using the catheter. Patients get two treatment sessions a day for five days, and the process is performed on an outpatient basis. The radioactive seeds are removed from the balloon after each session, but the saline remains in the balloon for the entire five-day regimen. When the mammosite radiation treatment regimen ends, doctors deflate the balloon by draining the saline and remove the balloon and catheter via the small incision.
Benefits
Patients who get mammosite radiation treatment suffer fewer radiation burns relative to those who receive the standard external radiation treatment, notes the Cleveland Clinic. In addition, the side effects of mammosite treatment are not as troublesome as those of the standard treatment, and they do not last as long. Finally, the mammosite treatment occurs over only five days as opposed to the six weeks required for the standard treatment.
Considerations
Not all breast cancer patients are candidates for mammosite radiation treatments. First, any form of internal radiation therapy for breast cancer is limited to patients who have had a lumpectomy. Furthermore, according to the criteria given by the American Society of Breast Surgeons, the patients should be 45 years of age or older, they should have invasive ductal carcinoma, their tumor size should be 3 cm or less, they should have no cancer cells present at the edge of the tumor, and the cancer should not have spread to lymph nodes under the arm or in the breast.
Warning
The Brody School of Medicine notes that patients can expect some side effects from mammosite radiation treatment. These may include redness, bruising, breast pain and drainage from the site where the catheter protrudes from the breast.
Misconceptions
An article in the Oct. 27, 2008, issue of the Seattle Times offers some perspective on the U.S. Food and Drug Administration approval process for medical devices and how that process was applied to the mammosite radiation treatment system, which was approved in 2002. The article points out that the FDA often gives approval to medical devices, mammosite included, without requiring proof of effectiveness. The article further states that the public often holds the mistaken notion that if the FDA has cleared a medical device, then that device has been shown to be medically effective. Clinical data that can prove that mammosite radiation treatment is as effective as the standard external beam treatment are still being gathered.
