HY 03/07: A New Approach to Breast Cancer Radiation

Shorter treatment makes breast-saving option available to more women

When Janet Huber had breast cancer in 1991, she had surgery to remove the lump and six weeks of daily radiation to ensure the cancer was gone. Fifteen years later, the 72-year-old Whitehall woman developed a cancer in her other breast. She again had a lumpectomy, but thanks to a new technology, her follow-up radiation treatment was much easier. “I had the disruption of daily hospital visits for only five days this time,” she says. “I went back to work the next week.”

Instead of radiating the whole breast, the new technology—called accelerated partial breast irradiation, or APBI—radiates only the lumpectomy site. “That is where most cancers recur,” says oncology (cancer) surgeon Aaron Bleznak, M.D., of Lehigh Valley Hospital and Health Network.

About a week after the lumpectomy, the surgeon inserts a catheter (thin tube) through the breast to the lumpectomy site. The catheter’s position is checked two days later by CT scan. “We then insert a radioactive seed through the catheter to the tumor site twice a day for five days,” says Bleznak’s colleague, radiation oncologist Jeanette Blauth, M.D. “The seed remains in place for 6-10 minutes, and then we remove it. Six hours later, we repeat the procedure.”

Because APBI is new, researchers are still collecting data on how its survival rates compare with full breast irradiation. “In terms of cancer recurrence in the breast, the outlook for APBI appears good in carefully selected patients,” Blauth says. She cautions that the new treatment should not routinely replace standard radiation, “which most patients tolerate very well.”

APBI is not for everyone. To be eligible, a breast cancer patient must be over age 50, have a specific type of cancer, and have a small tumor (less than 2 centimeters) with enough cancer-free breast tissue around the tumor site and no evidence of cancer spreading to the lymph nodes.

APBI may be most helpful for patients who can’t get to the hospital every weekday for six weeks—for example, those who live far away. “Many of these women have to choose a mastectomy instead of lumpectomy and radiation,” Bleznak says. “We want all patients, especially those in rural areas, to be able to choose a breast-conserving lumpectomy if their doctors advise it.”

“Even though I’m 15 years older, I was much less tired with APBI than I was last time,” Huber says. Initially, she worried about having the catheter inside her breast for several days, but after a few days, she hardly noticed it. “I’ll be happy to have more years of health,” she says. “I want to enjoy my grandchildren.”

Want to Know More about making decisions and getting a second opinion on breast cancer treatment? Call 610-402-CARE or click on the link in the column on the right side of this page.