Early experience with balloon brachytherapy for breast cancer

Kambiz Dowlatshahi, Howard C. Snider, Mark A. Gittleman, Cam Nguyen, Phillip M. Vigneri, Robert Lee Franklin, John H. Donohue, Edward H. Phillips, James E Goodnight Jr, Norman C. Estes, Nora M. Hansen

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Hypothesis: Partial-breast irradiation for carcinoma by a single source of radiation placed in the center of a balloon inserted in the lumpectomy cavity is an effective method of treating breast cancer. Previous interstitial radiation therapy using iridium seeds placed within multiple catheters has been shown to be effective but impractical and cosmetically unacceptable to women. Design: Prospective registry study. Setting: Three university and community hospitals. Patients: Women 40 years and older with histologically diagnosed in situ and invasive T1 through T2 and N0 or N1 breast cancer treated with lumpectomy and axillary node sampling were invited to enter this institutional review board-approved study. Main Outcome Measures: Evaluation of immediate and short-term complications, patients' acceptance of the treatment, and cosmesis are reported. Results: Of the 129 eligible patients enrolled, 112 completed the treatment. Of these, transient skin erythema was noted in 28, localized edema in 3, and skin blisters adjacent to the balloon in 9. Infection developed in 7, necessitating drainage and antibiotic administration. In 10 patients, sonographically demonstrated seromas that developed after removal of the device were aspirated percutaneously. In 4 patients, punctured or ruptured balloons had to be replaced before the treatment could be completed. Patients quickly adjusted to the breast distension caused by the balloon, and their acceptance of the procedure was good. The cosmetic outcome was rated high. There were no recurrences during this very short follow-up. Conclusions: Our early short-term experience indicates balloon brachytherapy to be an acceptable alternative to external beam radiation for selected operable breast cancers. The 1-week treatment time allows working women and those who live at a distance from radiation centers to choose breast conservation rather than mastectomy.

Original languageEnglish (US)
Pages (from-to)603-608
Number of pages6
JournalArchives of Surgery
Volume139
Issue number6
DOIs
StatePublished - Jun 2004

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Brachytherapy
Breast Neoplasms
Segmental Mastectomy
Radiation
Breast
Device Removal
Working Women
Seroma
Iridium
Skin
Research Ethics Committees
Mastectomy
Community Hospital
Therapeutics
Erythema
Blister
Cosmetics
Registries
Drainage
Edema

ASJC Scopus subject areas

  • Surgery

Cite this

Dowlatshahi, K., Snider, H. C., Gittleman, M. A., Nguyen, C., Vigneri, P. M., Franklin, R. L., ... Hansen, N. M. (2004). Early experience with balloon brachytherapy for breast cancer. Archives of Surgery, 139(6), 603-608. https://doi.org/10.1001/archsurg.139.6.603

Early experience with balloon brachytherapy for breast cancer. / Dowlatshahi, Kambiz; Snider, Howard C.; Gittleman, Mark A.; Nguyen, Cam; Vigneri, Phillip M.; Franklin, Robert Lee; Donohue, John H.; Phillips, Edward H.; Goodnight Jr, James E; Estes, Norman C.; Hansen, Nora M.

In: Archives of Surgery, Vol. 139, No. 6, 06.2004, p. 603-608.

Research output: Contribution to journalArticle

Dowlatshahi, K, Snider, HC, Gittleman, MA, Nguyen, C, Vigneri, PM, Franklin, RL, Donohue, JH, Phillips, EH, Goodnight Jr, JE, Estes, NC & Hansen, NM 2004, 'Early experience with balloon brachytherapy for breast cancer', Archives of Surgery, vol. 139, no. 6, pp. 603-608. https://doi.org/10.1001/archsurg.139.6.603
Dowlatshahi K, Snider HC, Gittleman MA, Nguyen C, Vigneri PM, Franklin RL et al. Early experience with balloon brachytherapy for breast cancer. Archives of Surgery. 2004 Jun;139(6):603-608. https://doi.org/10.1001/archsurg.139.6.603
Dowlatshahi, Kambiz ; Snider, Howard C. ; Gittleman, Mark A. ; Nguyen, Cam ; Vigneri, Phillip M. ; Franklin, Robert Lee ; Donohue, John H. ; Phillips, Edward H. ; Goodnight Jr, James E ; Estes, Norman C. ; Hansen, Nora M. / Early experience with balloon brachytherapy for breast cancer. In: Archives of Surgery. 2004 ; Vol. 139, No. 6. pp. 603-608.
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AU - Franklin, Robert Lee

AU - Donohue, John H.

AU - Phillips, Edward H.

AU - Goodnight Jr, James E

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AU - Hansen, Nora M.

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N2 - Hypothesis: Partial-breast irradiation for carcinoma by a single source of radiation placed in the center of a balloon inserted in the lumpectomy cavity is an effective method of treating breast cancer. Previous interstitial radiation therapy using iridium seeds placed within multiple catheters has been shown to be effective but impractical and cosmetically unacceptable to women. Design: Prospective registry study. Setting: Three university and community hospitals. Patients: Women 40 years and older with histologically diagnosed in situ and invasive T1 through T2 and N0 or N1 breast cancer treated with lumpectomy and axillary node sampling were invited to enter this institutional review board-approved study. Main Outcome Measures: Evaluation of immediate and short-term complications, patients' acceptance of the treatment, and cosmesis are reported. Results: Of the 129 eligible patients enrolled, 112 completed the treatment. Of these, transient skin erythema was noted in 28, localized edema in 3, and skin blisters adjacent to the balloon in 9. Infection developed in 7, necessitating drainage and antibiotic administration. In 10 patients, sonographically demonstrated seromas that developed after removal of the device were aspirated percutaneously. In 4 patients, punctured or ruptured balloons had to be replaced before the treatment could be completed. Patients quickly adjusted to the breast distension caused by the balloon, and their acceptance of the procedure was good. The cosmetic outcome was rated high. There were no recurrences during this very short follow-up. Conclusions: Our early short-term experience indicates balloon brachytherapy to be an acceptable alternative to external beam radiation for selected operable breast cancers. The 1-week treatment time allows working women and those who live at a distance from radiation centers to choose breast conservation rather than mastectomy.

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