The advantage of this is that you can finish in five days and spare the breasts. So MammoSite
is a way to give radiation to the breast after a lumpectomy or the tumor’s been excised
from the breast for breast cancer. What happens is that after surgery a device can be left
in the breast that keeps the cavity, where the tumor was, open. And after we’ve found
out the patient’s a true candidate for the procedure, a MammoSite balloon can be then
placed in the surgeon’s office. This device allows us to give the radiation to just a
small area around the tumor bed. The device is actually a balloon. So it’s inserted
through the incision made in the breast; it goes into the cavity. We inflate the balloon
with water to keep the balloon in place but also to keep the breast tissue away from where
the radiation will be going.
This kind of radiation literally is limited to an area two centimeters along the cancer;
nothing else gets in the radiation. When some of the balloon is in contact with the cavity,
in which the cancer used to be, we want to sterilize an area of up to two centimeters
around that with the use of additional radiation therapy.
We recommend to all women who are post-menopause, whose tumors are small (two centimeters),
or who have inaudible.
Typically, it’s patients with early stage small breast cancers that have undergone the
lumpectomy or the procedure. And they go through several other [look at their] pathology to
see what they find under the microscope, to see if things like lymph nodes are involved
or if the tumor is the appropriate size. After we know that information, we will be able
to discuss with the patients whether or not they are true candidates for the procedure.
There are some reluctance for this in very young women, because if they live a long time,
there are some instances that their local recurrences may be a little higher than if
they had regular radiation. But again, they hasn’t been established because we only
follow these women for about five years. We don’t have the 40 years following like we
do in other patients. And, of course, all of them are being followed closely by us just
like we follow every patient every three to four months for the first two years and every
six months for the next three years and then you leave for the rest of their life, so we
know what’s going on in this patient all the time.
One of the benefits is when we compare what we’ve traditionally treated to breast cancer,
it’s more convenient for the patients. One of the main things is it’s a five-day treatment.
Before, traditionally, breast cancer’s been treated with a six to seven week course of
radiation, where we treat the entire breast. When we’re able to cut that down into a
week, it give patients a little bit easier access to having breast radiation in a rural
state like Nebraska that does have benefits.
We know that if you have regular lumpectomy and regular radiation, if your cancer comes
back, which is not supposed to happen, if it were to happen, three percent, six percent,
eight percent depending on which data used, because all of the breast has already been
radiated the subsequent operation should have a recurrence has to have a mastectomy because
you cannot have a radiation twice. But with this approach, you will be able to do that
because radiation is limited to that spot so that if you were to develop a problem elsewhere,
that spot has not been radiated, therefore you can still treat the breast.
When we treat in the six to seven week course, one of the side effects is reddening of the
skin. Generally, it’s very well-tolerated. In general, most patients don’t have too
much discomfort, although it can happen. When we do the MammoSite procedure, in general,
some of the side effects of the skin can be less.
Most patients say it’s relatively painless. There can be some discomfort. Usually it doesn’t
happen during the week; it’s usually upon the removal. There’s some mind discomfort
but it’s very brief. Most patients do not need pain medication during their treatment;
they don’t even need Tylenol or ibuprofen.