Brachytherapy is a type of internal radiation that's used to treat breast cancer following a lumpectomy. Its purpose is two-fold: treat any possible microscopic cancer cells left behind and prevent the tumor from coming back. If your doctor has discussed this as a possible treatment option, you may wonder how it's done. Here are the three types of brachytherapy currently used and how to decide which one is best for you.
1) Multi-Catheter Internal Radiation
This type of brachytherapy is also known as interstitial needle-catheter brachytherapy, and it involves the placement of seeds into small catheter tubes. The tubes are then inserted under the skin to deliver radiation to the affected site where the tumor was. With multi-catheter internal radiation, the patient remains in the hospital while the seeds are in place, and the therapy usually takes place over the course of several hours or several days. If high-dose seeds are used, they are only left in place for about 10 minutes.
2) Balloon-Catheter Internal Radiation
These types of catheters are often put in place during the lumpectomy. It consists of a small tube with a balloon at one end. The balloon goes inside the breast tissue where the tumor was, and the other end of the tube remains open so that the radioactive seeds can be dropped inside the balloon.
Over the course of five days, two doses of radiation are delivered per day, six hours apart, for a total of 10 treatments. Once all treatments are complete, the balloon is removed.
3) 3-D Conformal External Beam Radiation
Before beginning this type of treatment, an MRI or CT scan is done to narrow down the appropriate treatment areas of the breast or the high-risk areas. Afterwards, the amount and type of radiation will be determined with the goal of maximizing radiation to the target areas while minimizing exposure to the surrounding tissue. At that point, radiation is delivered externally for a set period of time.
Which one is right for you?
You and your doctor will discuss which treatment option will likely work best for you. At this point, 3-D conformal external beam radiation is in the experimental phase, so this option probably won't be covered by most insurance companies and will require out of pocket payment.
The multi-catheter approach is often viewed as the most flexible option since the seeds can be moved to different locations along the breast. It has also been used the longest, making it a widely chosen option among both doctors and patients.
The balloon catheter method should only be used in patients that are ready for treatment soon after lumpectomy and have an appropriate-sized cavity in the breast once the lump is removed. This cavity cannot be too close to the surface of the skin in order for the patient to be a good candidate.