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Brachytherapy treatment for Breast Cancer

Brachytherapy- Breast Cancer treatment in India from world class cancer Hospitals

Brachytherapy treatment for Breast Cancer

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Brachytherapy offers hope to many patients with Early Stage Breast Cancer. It is an advanced form of radiation therapy, an effective alternative to Conventional Whole Breast External Beam Radiation Therapy. Radiation therapy is usually recommended after lumpectomy for treatment of Early Stage Breast Cancer and lower the risk of cancer's recurrence. Brachytherapy is also referred to as Accelerated Partial Breast Irradiation (APBI). As compared to the Conventional Whole Breast External Beam Radiation Therapy, Brachytherapy involves delivery of high dose radiation from within, to a small region of breast for a short period of time.

 

Brachytherapy is USFDA approved advanced radiation treatment for cancer in which radioactive source is placed in the form of seeds,wires and ribbons directly into or near the cancerous tissue.It is also known as an internal radiation therapy by which tumor is targeted with high dose of radiation that kills cancer cells by damaging their DNA. As a consequence the tumor shrinks in size since the cells now stop dividing and eventually die. The good part of the brachytherapy is that the surrounding healthy tissue is spared to a large extent. The term "Brachy" has been derived from a Greek word that means"Short distance". Brachytherapy may be used alone or in combination with other cancer treatment modalities for best outcome.

 

 

 

Q1 How does Brachytherapy work?

 

A1 Brachytherapy involves the placement of the source of radiation in or near the cancerous tissue. Brachytherapy, this word is derived from Greek Word, "Brachy", which means "Short distance" and "Therapy"that implies Treatment. Hence, Brachytherapy implies, treatment from a short distance.

 

 

Brachytherapy works on the laws of physics according to which the radiation intensity is the maximum near the source of radiation eg. Radioactive seeds and the more the distance from the radioactive source, the intensity of the radiation diminishes significantly. This places Brachytherapy at an advantageous position over External Beam Radiation Therapy because it spares the surrounding healthy tissues such as heart, lungs, skin, ribs from harmful effects of radiation. Thousands of patients suffering from Breast cancer have reaped its benefits over conventional External Beam radiation Therapy and found it to be a safe and effective alternative for breast cancer treatment. Although the overall patient survival in both cases is similar yet the convenience and compliance is better in Brachytherapy. Brachytherapy has a shorter course of treatment , usually 5 days as compared to 6 to 7 weeks of daily radiation therapy in case of External Beam Radiation Therapy.

 

 

Q2 What are the advantages of Brachytherapy?

 

 

A2. The several advantages that Brachytherapy can offer to the patient are:

 

  • Radiation Dose delivery is optimal and precise.

  • Surrounding healthy tissue is spared of the radiation effects.

  • Short duration of treatment resulting in patient compliance and convenience.

Q3 What is the role of Brachytherapy in Breast Cancer Treatment?

 

 

A3 Brachytherapy offers hope to many patients with Early Stage Breast Cancer. It is an advanced form of radiation therapy, an effective alternative to Conventional Whole Breast External Beam Radiation Therapy. Radiation therapy is usually recommended after lumpectomy for treatment of Early Stage Breast Cancer and lower the risk of cancer's recurrence. Brachytherapy is also referred to as Accelerated Partial Breast Irradiation (APBI). As compared to the Conventional Whole Breast External Beam Radiation Therapy, Brachytherapy involves delivery of high dose radiation from within, to a small region of breast for a short period of time.

 

 

Q4 Am I the right candidate for Brachytherapy for Breast Cancer Treatment?

 

 

A4 Every woman with breast cancer is not the suitable candidate for Brachytherapy. Some women may need conventional whole breast radiation instead. However, the decision of the most appropriate treatment protocol for you will be determined by your team of specialists after taking into account the characteristics of your breast cancer.

 

 

Conventional EBRT(External Beam Radiation Therapy), as the name implies, involves radiation given from source placed outside the breast. It causes destruction of the cancer cells by radiating either the whole breast or the target area where the tumor was.

 

 

The following general guidelines have been laid down to evaluate patient's eligibility for Brachytherapy as an option for treating breast cancer. They can be summarized as follows:

 

 

  • Invasive breast cancer or DCIS(Ductal carcinoma in Situ) diagnosis with a size equal to or smaller than 3cm.

  • Clean surgical margins, 1mm at least

  • Breast cancer with single centre of origin(Unicentric)

  • No pregnancy

  • Negative lymph node or at the most 3 positive lymph nodes in the armpit region and with no penetration of the capsule of the lymph node by the tumor.

  • Maximum 6 weeks interval from Lumpectomy surgery or Breast USG and CT scan evidence showing clear lumpectomy cavity edge. ​

​This is for information purpose only. Your specialist is the best person to advise you on the best treatment protocol for you specially customized as per your needs.

 

 

 

Q5 What are the disadvantages of conventional External Beam Radiation Therapy to breast as compared to Brachytherapy?

 

 

A5 The disadvantages of Conventional EBRT as compared to Brachytherapy treatment for breast cancer can be summarized as follows:

 

  • Inconvenience to the patient and her family- Traditional radiation therapy involves daily visit to the hospital for usually 5 days a week for nearly 4 to 6 weeks, which is cumbersome.

  • Large area of work- Conventional radiation therapy generally expose large area to the harmful effects of radiation compromising the safety of heart and lungs.

Q6 What are the different types of Brachytherapy used for treating breast cancer?

 

 

A6 Brachytherapy for Breast Cancer treatment is an advanced radiation treatment for breast cancer, wherein the radiation source is placed inside the breast. It is of three types. Out of three types, only two types are currently in use and third one is still experimental. 

 

 

  • Interstitial Needle-Catheter Brachytherapy, also referred to as Multi catheter Internal Radiation

    • It involves the use of Radioactive seeds to deliver radiation directly to the cancer affected area of the breast. The seeds are placed in tiny tubes known as catheters. The catheters are then put into place and stitched under the skin for the duration of the treatment in the hospital, which may last for few hours or few days. Once the treatment is over, the seeds, catheters and the stitches are taken out and the patient is discharged.

 

  • Balloon Internal Radiation

    • This type involves the placement of the special tube with a balloon at one end, in the cancer affected area of the breast. The other end comes out of the skin through a hole. This tube is placed during the Lumpectomy surgery or afterwards at the specialist's office. Each treatment session involves placing a radioactive seed in the centre of the balloon through a machine, for 5 to 10 minutes, or long enough to deliver requisite radiation to the cancer affected area of concern. Patient is discharged from the hospital after the seed is removed. 10 treatment sessions are usually carried out over a span of 5 days. That makes 2 treatment sessions per day, generally 6 hrs apart. Once the final treatment is over, the tube and the balloon are taken out through the small hole in the skin.

​​

  • ​3-D conformal External Beam Radiation (3-D CRT)

    • This experimental method involves planning session wherein a special MRI/CAT scan of the breast is carried out in order to elicit those small treatment areas of the breast that are at risk. The goal of the therapy is to maximize the delivery dosage of the radiation to the target area while protecting the surrounding healthy tissue at the same time from harmful effects of the radiation. The type and distribution of the radiation is taken into account while planning the therapy to meet the above goal. Linear accelerator machine, the machine that is used for external beam radiation therapy, is utilized to deliver radiation twice a day for around 1 week.

 

Brachytherapy- Breast Cancer Treatment in India:

 

  • Low cost quality treatment.

  • Best Super Specialty hospitals with state of the art infrastructure equipped with most advanced technology.

  • Globally trained, highly experienced Radiation Oncologists and Surgical Oncologists.

  • Great ambience

  • Compassionate staff to look after

  • Hospitals accredited with international organizations such as JCI(Joint commission International) for quality standards.

  • Language no barrier. English speaking people and if required,translators are available for your convenience.

  • Most economical accommodation available at a walking distance from the hospital. Wide range of options starting from guest house, service apartments to five star hotels, best suited to your budget and choice.

 

 

Dr Tejinder Kataria

MBBS,MD (Radiotherapy),DNB (Radiotherapy)

CCST (Clinical Oncology), British Institute of Radiology (UK)

FIMSA, International Medical Science Academy

Commonwealth Scholar, British Council 

Chairperson, Radiation Oncology

Medanta,The Medicity,Gurgaon, Delhi, NCR

 

Prof. Sasindran P.R 

MBBS, MD (Radiation Oncology)

Senior Consultant, Radiation Oncology

Baby Memorial Hospital,Kozhikode(Calicut), Kerala, India

 

Dr Vishnu Rajan Nambiar

MBBS, MD (Radiation Oncology)

Radiation Oncologist, Institute of Oncology

Baby Memorial Hospital,Kozhikode(Calicut), Kerala, India

 

Dr Sandeep K.Jain

MBBS, MD (Radiation Oncology)

Associate Director, Radiation Oncology

Jaypee Hospital, Noida, Delhi-NCR


Dr Robin Khosa
MBBS, MD (Radiotherapy)
Radiation Oncologist
Indraprastha Apollo Hospital, New Delhi

 

 

 

 

 

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