Non-Surgical Treatment

Whole or Partial Breast Radiation

After lumpectomy procedure, your physician may recommend whole or partial breast radiation treatment to potentially reduce the recurrence of cancer cells in the lumpectomy site. There are new treatment options available that Dr. Lisa Curcio can discuss with you as briefly discussed below.

PARTIAL BREAST IRRADIATION

In the past there have been several modes of radiation therapy delivery to treat breast cancer. The standard treatment (whole breast radiation) involves radiation to the entire breast as well as a boost to the tumor bed to decrease the risk of local recurrence. Other methods (partial breast irradiation) have looked at just treatment of the lumpectomy cavity and a small area around it. The more common approach to provide partial breast radiation is through brachytherapy. This involves the placement of numerous small catheters into the breast to deliver the radiation to the tumor bed.

These catheters had several problems with cosmesis and patient tolerance.  At the present time, we are revisiting the use of partial breast irradiation for the treatment of small Stage I breast carcinomas.

This treatment involves the use of HDR (High Dose Radiation) to treat the tumor bed in women whose cancers have a low risk of local recurrence. Brachytherapy treatment lasts one week as opposed to six weeks for convention external beam radiation.

A balloon catheter (Mammosite by Proxima Therapeutics) is inserted either through an open procedure in the operating room or with US guidance in an out-patient setting. Once the position is confirmed by CT scan images the treatment is given twice a day for a week. The Radiation Oncologist can easily remove the catheter in their office once the treatment is completed.

Am I a candidate for this procedure?
Clearly you must discuss your particular case with your care management team to determine if you are eligible for this form of radiation.

Inclusion criteria:

• Age >55
• Tumor size < 2cm
• Lymph node status negative
• Breast size (varies with tumor size)
• Infiltrating lobular cancers are excluded
• Extensive DCIS are excluded

How do I find a Surgeon and Radiation Oncologist in my area that performs this procedure?
Go to www.mammosite.com for more information.

Currently we are involved in a multi-institutional trial looking at the difference between partial breast radiation and whole breast radiation. This will extend some of the indicators for treatment to pre-menopausal women and women with three or less positive nodes. This will allow select patients to be randomly selected to either modality and followed long term for the differences in local recurrence and survival.

What is accelerated partial breast irradiation?

Dr. Lisa Curcio works closely with SenoRx’s Contura™ system.  Contura™ is a, a multi-lumen radiation balloon applicator for accelerated partial breast irradiation. The radiation balloon uses vacuum to remove excess fluid and to adhere closely to often irregularly shaped lumpectomy cavities in order to deliver precise radiation dosing through multiple seed lumens.

Dr. Curcio notes that treatment time is reduced to days versus weeks, and accurate, targeted radiation dosing decreases potential recurrence of cancer cells in the lumpectomy site.

To learn more about Contura™ ask Dr. Lisa Curcio and visit www.senorx.com for more information.

Contact Dr. Lisa Curcio to discuss your risk for breast cancer . Dr. Curcio is a breast cancer heredity risk specialist and she can advise you on your breast cancer risk.

Visit "Advanced Breast Care Specialists of Orange County"  in Mission Viejo, California.