After a lumpectomy,
you may need radiation treatments to kill off any possible remaining cancer cells. Radiation is done to help prevent a recurrence, or return, of breast cancer. Brachytherapy, or internally-delivered radiation, is a technique that spares healthy tissue and treats only the tissue around your tumor cavity.
Fighting Breast Cancer From Outside and Inside
Radiation treatments for breast cancer can be given with external or internal radiation
. External radiation, also called whole-breast irradiation (WBI), treats the whole breast from the outside, by aiming highly penetrating x-rays at your tumor cavity. Breast brachytherapy uses special catheters (tiny tubes) to deliver the radiation from within your breast to your tumor cavity and a small margin of surrounding tissue.
Breast Brachytherapy AdvantagesWhole-breast irradiation (external radiation) affects healthy tissue as well as cancer cells, and may cause side effects in healthy tissue. These treatments are usually given daily Monday through Friday for about 6 weeks in a cancer clinic. Breast brachytherapy affects a smaller amount of breast tissue, and delivers a targeted dose of radiation to your lumpectomy site. Brachytherapy can be done with a specially designed device that is temporarily implanted in your breast, allowing your radiation oncologist to give you customized treatment over a 5-day period. You can expect minimal side effects and faster recovery from brachytherapy than from external radiation.
SAVI™ Accelerated Partial Breast Irradiation (APBI)
SAVI Applicator - Photo © Cianna Medical
The SAVI, which was was FDA approved in 2006, is a breast radiation device that can be custom-fitted to your lumpectomy cavity, regardless of what shape or size it may be. This device is a bundle of soft, tiny catheters. The SAVI is inserted through a small incision, and the catheter bundle expands uniformly, but its unique design allows it to be opened in a way that truly conforms to the size and shape of your tumor cavity. The radiation dose can be individually controlled through each catheter, allowing precise targeting by the radiation oncologist. This device is more customizable than a traditional balloon catheter device
, so women with small breasts may be eligible for this type of treatment.
What You Can Expect From A SAVI Applicator
Placement - Photo © Cianna Medical
Your surgeon can place a SAVI radiation applicator at the time of your lumpectomy, or it may be inserted during a separate surgery. Only a small incision is needed, to allow the compact catheter bundle to be placed within your breast. The incision area will be secured with a dressing, and part of each catheter line will extend outside your breast, until your treatment is complete. The catheters are very flexible and soft, so they should be comfortable for you during the five days of radiation. Your site dressings will be changed twice a day during treatment, and must be kept dry. To prevent infections, you may be given antibiotics to take.
Radiation Dosing During Treatments
Dosing - Photo © Cianna Medical
You will report to your radiation oncology facility twice a day for five days, to have treatments. Plan on spending about 30 minutes for each visit, about 5-10 minutes of your appointment will be used for the radiation treatment time. Your radiation oncology team will make you comfortable, and connect your SAVI applicator to the radiation source. During each treatment, the radiation source is sent down each catheter one at a time. A different amount of radiation dose will be given at different points along the length of each catheter. This gives you the best dose for the affected tissue, and the most protection for surrounding healthy tissue.
Completing Radiation and Removing Your SAVI Applicator
Removal - Photo © Cianna Medical
After your final radiation treatment, your radiation oncologist can remove the SAVI device. It should take about two minutes to remove the device, clean your incision site, and close the skin with adhesive strips. A bandage or dressing be placed on top, and you will be free to go. Be sure to go to your follow-up visits, so your doctor can see that your incision is healing properly.
Is SAVI Available to Me?
SAVI breast brachytherapy is available across America, but it's not in every state yet. It will work for large or small breasts, but other factors may make it unsuitable for some patients. Check with your doctor about this device or email Cianna Medical
, to see if SAVI is available in your state or location.
Use of the Breast Brachytherapy Device, SAVI, to Obtain Flexible Dose Modulation for Normal Structures in Close Proximity to Device. C. Yashar, et al. Poster presented at 2008 Breast Cancer Symposium, Washington, DC.
FDA. 5. 510(k) Summary of Safety and Effectiveness, SAVI Applicator. April 4, 2008. PDF document.
Correspondence with Liz Dowling, Dowling & Dennis PR, representing Cianna Medical. Sept. 15, 2008 - Sept. 17, 2008.