Internal Radiation

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Internal Radiation

Last modified on September 17, 2012 at 6:58 PM

Researchersare studyinginternal radiation, sometimes called partial-breast radiationor

brachytherapy, for use after lumpectomy to see how the benefits compare to the current

standard of external radiation to the whole breast. Internal radiation methods typically

use small pieces of radioactive material, called seeds, which are placed in the area

around where the cancer was. The seeds emit radiation into the surrounding tissue. The

area that's very close to the site of the original cancer is the area that is at highest risk of

recurrence.

Internal radiation is most commonly delivered using multiple small tubesor catheters, or

using a balloon-catheter device called MammoSite.

In multi-catheter internal radiation, tiny tubes (catheters) are sewn under the skin

in the area where the cancer was. The ends of the tubes stick out through little holes

in the skin. Tiny stitches hold the tubes in place.

The doctoror a machine placesradioactive seeds into the tubes just long enough to

deliver the prescribeddose. If low-dose radiation seeds are used, the treatment can

take a few days. During treatment, you stay in the hospitalbecause there is

radioactivity inside you. Special precautions are taken to keep you and those around

you safe from the radiation. Once the treatment is done, the radioactive seeds,

stitches, and tubes are removed. Then you can go home.

If high-dose radioactive seeds are used, each seed might be left in for up to 10

minutes. The seeds are then removed and you are free to leave the treatment

center. You do not remain radioactive after the seeds are removed. Once the course

of treatment is done, the tubes are removed. The course of internal radiation

treatmentis usually 1 week (5 days), with 2 treatments each day.

In balloon-catheter internal radiation(the MammoSite system), a special tube with

a balloon on the end is used. With careful planning, the balloon is placed into the

area where the cancer was. The tube comes out through a little hole in the skin. The

balloon is filled with fluid to hold the balloon and tube snugly in place. The

MammoSite can be inserted in anoperating roomor in a surgeon's office and stays

in place about a week and a half.

During each treatment, a machine places a radioactive seed into center of the

balloon for about 5 to 10 minutes just long enough to deliver the prescribed dose


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of radiation. A totalof 10 treatments are usually given over 5 days. That means 2

treatments per day, about 6 hours apart. When the final treatment is done, the

balloon is removed through the small hole in the skin.

Internal radiation boostInternal radiation can be used for giving a boost dose at the end of an external radiation

treatment regimen. A boost dose is a supplemental dose of radiation given towards the

end of your treatment to target the area around where the tumor was. The boost dose is

given in the same manner as regular internal radiation, using either small tubes or a

balloon-catheter, and radioactive seeds. The boost dose will be calculatedsuch that

youll get a slightly higher amount of radiation each day than you did for the first few

weeks of your regimen.

Benefits and drawbacks of internal radiationInternal radiation was developed to reduce risk of recurrencewhile shortening the

amount of time it takes to get radiation treatment. Internal radiation also limits the dose

of radiation (and associatedside effects) to surrounding normal tissue. Internal radiation

also MAY be able to be given again but only to another part of the breast if a new

breast cancer is diagnosed in the future. External, whole-breast radiation usually can't

be given again to the same breast.

Compared to external radiation, internal radiation has several benefits:

The treatment time is shorter 1 week versus up to 7 with external radiation.

Intraoperative internal radiation has an even shorter treatment time because it's

done during surgery.

Radiation is given only to the area where the cancer is most likely to come back.

Less of your body receives radiation, so there may be fewer side effects.

The preliminary results from the small number of studies done so far show a very

low risk of recurrence after internal radiation.

But there are some unknowns involved with internal radiation that should be discussed

with your doctor as you make your treatment decisions:

Internal radiation has no long-term track record. This means that the benefits and

side effects of internal radiation aren't completely understood. The benefits and side

effects of external, whole-breast radiation have been studied for more than 30 years

in thousands of people. Talk to your doctor about how to make a decision between a

new approach and an established approach.

Most internal radiation techniques require extra training and experience. Doctors

have to know how to select appropriate people for the treatment and how to properly

deliver the radiation.


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The early results from the first small studies on internal radiation look very promising. If

you are very interested in internal radiation, the NSABP B-39 clinical trial is comparing

internal radiation to external, whole-breast radiation. Ask your doctor about participating,

or find out more onclinical trials.

Good things come to those who wait. Better things come to those who dont give up, and the best

thing s come to those who believe. Hope for the best, expect the worst, and take whatever comes
http://www.breastcancer.org/treatment/clinical_trialshttp://www.breastcancer.org/treatment/clinical_trialshttp://www.breastcancer.org/treatment/clinical_trialshttp://www.breastcancer.org/treatment/clinical_trials

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Internal Radiation