MammoSite® breast brachytherapy is a type of accelerated breast radiation treatment. Sometimes called balloon catheter radiation, MammoSite treats breast cancer from within your breast in 5 days - with fewer side effects than the standard six or seven week course of external beam radiation.
Breast Radiation After Lumpectomy
Radiation may be used to treat breast cancer after your tumor has been removed with a lumpectomy. Radiation treatments are done to prevent recurrence by ensuring that any cancer cells that may remain in the tumor area are destroyed. Intracavity brachytherapy is different than external beam radiation - it delivers radiation from inside your breast, and affects only a very small portion of healthy tissue.
MammoSite Breast Brachytherapy
MammoSite was FDA approved in 2002 for post-lumpectomy breast cancer treatment. The MammoSite Radiation Therapy System uses a special balloon catheter, placed in your lumpectomy cavity and inflated with saline solution. Your surgeon can place a MammoSite balloon catheter at the time of your lumpectomy, or it may be inserted at a later time.
Advantages and Disadvantages of MammoSite Brachytherapy
MammoSite brachytherapy treatments can be completed in five to seven days, as compared to six to seven weeks of standard external radiation. This means less disruption of your schedule, less travel time, and fewer copayments. Your breast will have a surgical scar, but otherwise none of the skin burns or tissue thickening that may occur with standard radiation. A very small portion of your breast will be treated by the radiation, and healthy tissue will be unaffected. Standard radiation may cause fatigue, but with brachytherapy you will be able to go about life as usual. Patients say that having to avoid showers for a week is a disadvantage, and that the sensation of having a saline-filled balloon within a breast feels odd. Infections can occur around the catheter insertion site, but you can take antibiotics to combat that. Because a catheter line will extend out of your breast while the device is in place, you'll need to wear a sports bra or a very comfortable bra to accommodate it, and adjust your sleeping position for comfort.
What to Expect During MammoSite Radiation Treatments
MammoSite treatments are done twice a day for five consecutive days. Your treatment appointment will take about 30 minutes. During radiation treatments, your radiation oncologist will connect your MammoSite catheter line with a radiation machine, and put a small radioactive seed through the catheter into the balloon, where it emits your radiation dose. You won't feel any heat or vibration during the treatment. At the end of each treatment session, the seed is removed and you won't carry the radiation around with you in between treatments. If any cancer cells are lingering in the tissue around your surgical margin, the radiation should kill them. After 5 days, the balloon catheter is drained of saline and then removed through a small incision that is closed with a dressing.
Recovery After MammoSite Treatment
You may have some side effects during or after MammoSite brachytherapy treatments. These will clear up with proper care, but make sure to go to your follow-up appointments and let your doctor know if you have concerns about recovery. You can expect some redness or bruising around the catheter insertion site. There may also be some pain or drainage from the scar before it heals. Take care to keep this area clean and dry. If skin redness persists, or the area becomes puffy or looks inflamed, see your doctor to determine if you may have an infection. You can take antibiotics to clear up the problem.
MammoSite Has A Good Track Record
MammoSite has been tested in clinical trials and the company that makes the device continues to improve the balloon for more precise radiation. Very few local recurrences have been reported after MammoSite brachytherapy. This treatment compares well with ClearPath and other accelerated partial breast radiation techniques. Medicare and most private health insurance policies cover MammoSite treatments.
Requirements For MammoSite Radiation Therapy
MammoSite is intended for the treatment of early-stage breast cancer. In order to qualify for MammoSite brachytherapy, you should be 45 years old or older, plan to have a lumpectomy, have no lymph nodes involved, and your tumor size must be three centimeters in diameter or smaller. Your surgeon must be able to leave at least seven millimeters of tissue between your skin and the fully inflated balloon. Your lumpectomy cavity needs to be as globular as possible to accommodate the balloon; otherwise the treatment won't work properly. In some cases, the MammoSite device must be repositioned for optimal results. Choose a surgeon who is very experienced in placing the MammoSite device, and ask if the hospital has all the proper equipment needed to implant and position the catheter.
Review of MammoSite brachytherapy: Advantages, disadvantages and clinical outcomes. Bensaleh, Saleh, Bezak, Eva, Borg, Martin. Acta Oncologica, Volume 48, Number 4, May 2009 , pp. 487-494(8)
Initial outcomes for patients treated on the American Society of Breast Surgeons MammoSite clinical trial for ductal carcinoma-in-situ of the breast. Jeruss, J.S., et al., Ann Surg Oncol, 2006. 13(7): p. 967-76.
SU-FF-T-72: Dosimetric Comparison of SAVI, MammoSite, Contura and Clearpath for Accelerated Partial Breast Irradiation. D Scanderbeg, P Barna, S Jiang, T Pawlicki, and C Yashar. Med. Phys. Volume 36, Issue 6, pp. 2536-2536 (June 2009).