Brachytherapy considered for treating breast cancer

VICUS.COM (24 May 2000) -- The word "brachy" comes from the Greek word for short, or close. For men with prostate cancer that is confined to the prostate gland, the option to position radioactive isotopes close to the cancer, while sparing surrounding noncancerous tissues, has become an accepted alternative to the surgical procedure, radical prostatectomy.

A variation of this procedure has been under investigation for a number of years to treat women with early breast cancer, and new follow-up data on brachytherapy is very promising. During the 53rd Annual Meeting of the Society of Surgical Oncology, held in March 2000 in New Orleans, La., Robert Kuske, M.D., from The Ochsner Center for Radiation Oncology in New Orleans, La., presented the results of a pilot clinical trial that may point the way to a new alternative treatment for breast cancer. 

Breast cancer is the most common cancer among women, excluding nonmelanoma skin cancers. The American Cancer Society estimates that in 2000, about 182,800 new cases of invasive breast cancer (Stages  I-IV) will be diagnosed among women in the United States. It is the second leading cause of cancer-related death in women, after lung cancer. Statistically, one in every eight women in the United States will develop breast cancer during her lifetime. This figure represents average lifetime risk and may over- or underestimate risk for certain individuals. 

Putting aside the cold statistical facts of breast cancer, the reality of the situation is that breast malignancy is the most feared cancer in women, the most self-discovered cancer in women and the most written-about cancer in lay and scientific literature.

Some would say it also has the most controversial options for treatment.

Brachytherapy is an alternative to external beam radiation therapy treatment: Instead of using external beams that pass through the breast, brachytherapy allows radioactive implants to be placed inside the breast at the lumpectomy site. This technique ensures the maximum radiation dose is given where it is needed most, while allowing little radiation to reach the ribs, lung, heart and healthy breast tissue.

Another benefit, according to Kuske, is an improved cosmetic outcome because it is a non-disfiguring procedure and allows for a faster recovery. The procedure also allows the radiation series to be completed in about one week's time vs. six weeks with conventional external beam radiation therapy.  

Kuske is completing data analysis of 50 women (51 breast cancers) who range in age between 31 and 84 years old. These women had relatively early breast cancer, with three or fewer positive nodes and tumor size of 4 cm or less. After follow-up ranging between five and eight years, there have been just nine cases of tumor recurrence (less that a 2% recurrence rate), according to Kuske. 

Kuske estimated that if additional studies confirm these early results, 40% of women who are diagnosed with breast cancer would be candidates for brachytherapy. Additional trials are being developed and a number of studies are taking place worldwide to assess the potential role of this treatment as an alternative to external beam radiation therapy as well as to assess the optimum radiation dosage needed in each case. 

John Russo Jr. is senior vice president of medical communications at Vicus.com. He is a pharmacist and medical writer with more than 20 years of experience in medical education.  

American Cancer Society. Cancer Resource Center. 
http://www3.cancer.org/cancerinfo/

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