Breast cancer is the most common cancer in women, worldwide (men can also get the disease). Western Europe has the highest incident rate of breast cancer and the incident of the disease has risen steadily over the past 20 – 30 years. The highest incident of breast cancer is found in women 50 – 70 years old. However, due to better and more efficient screening programs as well as improvements in breasts cancer treatment, the survival rate keeps increasing.
Breast cancer starts in the tissues of the breast. There are two main types of breast cancer:
- Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.
- Lobular carcinoma starts in the parts of the breast, called lobules, which produce milk.
In rare cases, breast cancer can start in other areas of the breast. It can be invasive or noninvasive. Invasive means it has spread from the milk duct or lobule to other tissues in the breast. Noninvasive means it has not yet invaded other breast tissue. Noninvasive breast cancer is also called “in situ”.
Ductal carcinoma in situ (DCIS), or intra-ductal carcinoma, is breast cancer in the lining of the milk ducts that has not yet invaded nearby tissues. It may progress to invasive cancer if untreated.
Lobular carcinoma in situ (LCIS) is a marker for an increased risk of invasive cancer in the same or both breasts.
Once a woman has been diagnosed with breast cancer, a series of tests will be done to ensure that the stage and classification of the cancer is accurate. Today, breast cancer can be treated in several ways, which will depend on the type and how far it has spread.
The most common treatments include surgery, chemotherapy and radiation. The best treatment option for a patient should be discussed with an oncologist, a doctor who specializes in the treatment of cancer. Also, in order to make sure that the cancer has been completely removed, it is common that people with breast cancer get a combination of treatments. Therefore, doctors from different specialties often work together in treating the disease.
The most common treatment for breast cancer is surgery either with partial removal of the breast tissue where the tumor is located (lumpectomy) or complete removal of the breast (mastectomy). The surgery is often combined with radiation treatment.
One of the most promising and efficient radiation treatment options for breast cancer, today, is HDR brachytherapy. In general, there are three types of breast cancer patients who qualify for HDR brachytherapy:
- Those who have early stage breast cancer.
- Those who have locally advanced breast disease, but no metastasis.
- Those who have recurrent breast cancer to the chest wall (these patients may not be candidates for surgery or choose not to have surgery).
HDR brachytherapy was developed to reduce risk of recurrence while shortening the amount of time it takes to complete the radiation treatment.
Planning for multi-catheter interstitial radiation therapy involves meeting with your radiation oncologist and possibly having additional imaging test, such as ultrasound (US), computed tomography (CT) or magnetic resonance imaging (MRI) done to plan exactly where the radiation will be delivered.
After the planning is completed, a series of catheters or needles are placed temporarily through the breast at the place of surgery. To ensure a homogeneous dose distribution and an optimal placement of catheters or needles a template with a defined pattern of holes is used.
Each catheter or needle is connected to the afterloader that moves the radioactive source through each of them. Computer controlled, the afterloader performs the given treatment plan to achieve the predetermined dose and optimal protection for the skin.
With a few well-placed catheters, HDR brachytherapy can provide a targeted treatment. If high dose radiotherapy is used, it typically requires one to two treatments per day for about one week. Each treatment session will last about one hour. However, during the treatment, the radioactive source is inside your breast for only a few minutes. Once the course of the treatment is completed, the catheters are removed.
As compared to external beam radiation therapy (EBRT), the most important advantages of HDR brachytherapy are:
- Overall treatment time is one week versus six to seven weeks for EBRT.
- Yields excellent cosmetic results.
- It delivers a precise, highly concentrated dose of Radiation directly to the tumor bed, for a short time.
- Reduces radiation dose and possible damage to adjacent organs such as the opposite breast and the lungs.
- Very low risk of cancer recurrence.
More information can be found in our HDR Brachytherapy - Patient Information, English.