SAVI Breast Brachytherapy Device Art © Cianna Medical Inc

For small breast tumors that are non-invasive, a lumpectomy is often a great option. Just the affected tissue is removed, plus a margin of healthy tissue for good measure. This is often followed by external breast radiation - but that can take at least 6 weeks of daily treatments, a hardship for many patients. Breast brachytherapy treats the tumor area from the inside, affects less tissue, and can take only 5 days. But does it work well in preventing a recurrence, and does it have side effects that can add up to the need for a mastectomy? Dr. Catheryn Yashar has been leading a study that covers four years of 50 patients experiences with the SAVI breast brachytherapy device. Her team presented their research recently at the European Society for Radiotherapy & Oncology (ESTRO) World Congress of Brachytherapy in Barcelona, Spain. The results of this long-term study look very good.

Breast brachytherapy, when used after a lumpectomy, is done to preserve the breast and prevent a recurrence of breast cancer. Brachytherapy is a method of treating the surgical cavity with radiation from the inside, using the lowest effective dose of energy. You may have heard of balloon brachytherapy - there are several devices in this class  - a soft bundle of catheters is inserted into the breast as needed, and during treatments, the device is connected to a radiation machine. Targeted and controlled doses of radiation are sent to the areas that need it the most, while healthy tissues are less affected. The idea of this type of treatment is to harm the cancer without harming the fewest amount of other cells that are nearby, resulting in few side effects and good cosmetic results. Balloon brachytherapy applicators expand into uniform spheres or ellipses, so the patient's breast must conform to the device. Strut-based brachytherapy applicators such as the SAVI can be expanded inside the breast in a customized configuration, fitting into the surgical cavity.

Dr. Yashar and her colleagues have studied the effects of strut-based breast brachytherapy for some time, and have noted the results. Since breast brachytherapy is still a relatively new way to provide breast radiation, they wanted to study a group of patients over time to see how they fared in comparison to those who had other types of treatments. They found that the strut-based brachytherapy applicator could be used with small-breasted patients and women whose tumors were fairly close to the skin, an advantage over balloon-based devices. The rates of breast cancer recurrence compared favorably with that of patients who had 6 weeks of external breast radiation. A few patients did have fibrosis, breast pain and a darkening of the skin in the radiated area after treatment. None of the patients showed symptoms of seroma, fat necrosis, or breast asymmetry due to radiation given by the SAVI strut-based brachytherapy device.

More About this story:  Strut-Based Breast Brachytherapy Shows Favorable Outcomes at Four Years, Study Reports

Fake Cancer for Boob Job Art © Pam Stephan

Jami Lynn Toler, a 27-year old Arizona woman, told people that she had breast cancer. After successfully raising a bit more than $8,300, she handed over the money to a plastic surgeon, who performed "a standard boob job."

Toler told her cancer story to her family and co-workers, saying she would need a double mastectomy and immediate reconstruction, as treatment for her breast cancer. Apparently she did not consult an oncologist nor a general surgeon, and has not had a breast biopsy. She wanted a breast augmentation - not a double mastectomy - and since she had no insurance, turned to Hallmark Hospice for help with fund raising and participated in several events that provided more than the $7,800 that she originally requested. When medical records showed that she had never had cancer and had indeed used the funds for non-medically necessary cosmetic surgery, she was arrested and charged with fraud and theft.

Will Toler get to enjoy her new curves from behind bars? Or will she have to surrender her implants? Perhaps she will have to repay the funds that she fraudulently obtained, as well as serve some time for pretending to have a deadly disease and receiving funds as a result. And, I wonder what she told her plastic surgeon before the augmentation procedure - make me look expensive?

Cancer fraud is a nasty exploitation of caring people who are willing to give money to help others who claim to be fighting a life-threatening disease. In previous cases, such as Brian Bonniwell - faked male breast cancer, and Ashley Anne Kirilow - faked treatment side effects by self-mutilation; these frauds played on the sympathies of people who gave up their time, money, goods, services, and sympathy. Even worse, people who fake cancer in any way are hurting those of us who actually do suffer from cancer - any type of cancer - and need help with bills. Cancer treatment is very costly and insurance doesn't cover 100% of the expenses. Many people don't have health insurance, which makes a cancer diagnosis a double disaster. Burned once or twice by a cancer faker, generous everyday people may never help with fund-raising again. That's what hurts survivors most - the betrayal of public trust creates an atmosphere of skepticism that makes many of us hide our wallets when somebody cries "I have cancer!" Those patients and their families who are genuinely in need may suffer because of the cancer fraud perpetrated by folks like Toler, who wanted money for breast implants - not breast cancer. For shame! Enjoy the curves, Jami Lynn, and hope to Heaven that you never really do get breast cancer - because in young women, it can be very very aggressive.

What would you do with this case? Leave a comment!

FaceBook, the social media site, is hosting a new app called MBC Circle of Support. MBC in this case, stands for Metastatic Breast Cancer, and the app creates an online support community within FaceBook for metastatic patients. Genentech, a drug company that produces several cancer drugs, reports that research shows that most metastatic breast cancer patients feel left out of the annual Pink Ribbon cheeriness and Breast Cancer Awareness Month activities because their prognosis is much more serious.

Metastatic breast cancer patients have Stage 4 breast cancer, no matter which type of the disease they are diagnosed with. With a late stage diagnosis, the cancer has spread beyond the breast and may have affected organs such as lungs, bones, skin, liver, or brain. Even with the latest advances in treatments, conquering such a scattered enemy is difficult at best and long-term outlook is bleak for most patients. Some cases of metastatic breast cancer can be treated as a chronic disease and patients may live for several years while taking maintenance therapies, but most face a shorter timeline.

Late stage breast cancer patients have different concerns and needs than early stage survivors, and often feel misunderstood and isolated. MBC Circle of Support is meant to change that, in so far as social media can affect those experiencing metastatic disease. "The Facebook app was designed as a part of this overarching program to provide additional support for people with MBC," said Susan Willson, a spokeswoman for Genentech. "As a company, we felt there was more we could be doing outside of the lab to support people with the disease. We wanted to match the innovation inside the lab with innovation outside of the lab."

If you're already on FaceBook, search for MBC Circle of Support to sign up for the app. If you're just curious, go to the website Faces of MBC, where you can get the same information. Members who join this app must agree to terms and rules of etiquette to participate, and then start setting up their support community by inviting friends and family to help out with particular activities. You do not have to be a metastatic breast cancer patient to use this new app - if you are a friend or supporter of an MBC patient, you also are welcome to join and offer your encouragement and practical support. You don't have to let everybody on FaceBook know that you're using the Circle of Support app - just make sure you choose only those that need your information as members of your network.  As with any social media network, stay safe out there and don't give away too much personal information.

Computer Keyboard Photo © Microsoft

Life with breast cancer can get pretty overwhelming. You keep getting news about your condition, your treatments, and your prognosis. Sometimes you can understand what all that medicalese means, and sometimes it goes by so fast that you don't even know what questions to ask until hours after your latest appointment. If you took notes, or had a buddy along to write down what the doctor was saying, at least you can look up those terms and statistics later. But where do you turn, to get support and information when its late at night and you're feeling confused and can't sleep? Going on the internet for answers can result in an information overload, even harder to deal with if your brain is lost in chemo fog.

Tailor your internet info searches by using social media like Twitter, FaceBook, or MySpace. You can find sites that allow you to connect with other people who have a similar diagnosis, disability, or problem with side effects. Hopefully, you'll find several people who are farther along the road that you are, and are willing to share their tips and coping strategies. If you're new to social media or online networks, try just one or two for a start. If you stumble upon a blog that interests you, subscribe to get their updates and interact with the author. Feel like sharing your own story? Set up your own blog on Caring Bridge or other free blogging sites, and see how many of your supporters will sign up for regular news from you.

While you're at it, be sure to practice good internet safety rules. Don't give away too much of your private information to strangers, and be skeptical about miracle cures or that "one old weird tip" that promises to fix your worst problems. The benefits of using social media for cancer support are great: round-the-clock answers to your pressing questions, emotional support from other survivors, and the feeling that you are not alone in the fight. Find your way in the internet maze by customizing your online community, and use it to give and receive support.

• Social Media and Online Cancer Support