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Partial breast brachytherapy

Breast cancer - partial radiation therapy; Carcinoma of the breast - partial radiation therapy; Brachytherapy - breast; Adjuvant partial breast radiation - brachytherapy; APBI - brachytherapy; Accelerated partial breast irradiation - brachytherapy; Partial breast radiation therapy - brachytherapy; Permanent breast seed implant; PBSI; Low-dose radiotherapy - breast; High-dose radiotherapy - breast; Electronic balloon brachytherapy; EBB; Intracavitary brachytherapy; IBB; Interstitial brachytherapy; IMB

Brachytherapy for breast cancer involves placing radioactive material directly in the area where breast cancer has been removed from the breast.

Cancer cells multiply faster than normal cells in the body. Because radiation is most harmful to quickly growing cells, radiation therapy damages cancer cells more easily than normal cells. This prevents the cancer cells from growing and dividing, and leads to cell death.

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Description

Brachytherapy delivers radiation therapy directly to where cancer cells inside the breast are located. It may involve placing a radioactive source into the surgical site after the surgeon removes a breast lump. The radiation only reaches a small area around the surgical site. It does not treat the entire breast, which is why it is called "partial breast" radiation therapy or partial breast brachytherapy. The goal is to limit side effects of radiation to a smaller volume of normal tissue.

There are different types of brachytherapy. There are at least two ways to deliver radiation from inside the breast.

INTERSTITIAL BRACHYTHERAPY (IMB)

INTRACAVITARY BRACHYTHERAPY (IBB)

Brachytherapy may be given as "low dose" or "high dose."

Other techniques include:

Why the Procedure Is Performed

Experts learned that certain cancers are most likely to return near the original surgical site. Therefore, in some cases, the whole breast may not need to receive radiation. Partial breast irradiation only treats some but not all of the breast, focusing on the area where the cancer is most likely to return.

Breast brachytherapy helps prevent breast cancer from returning. The radiation therapy is given after lumpectomy or partial mastectomy. This approach is called adjuvant (additional) radiation therapy because it is adding a treatment beyond surgery.

Because these techniques are not as well studied as whole-breast radiation therapy, there is not full agreement about who is most likely to benefit.

Types of breast cancer that may be treated with partial breast radiation include:

Other factors that may lead to the use of brachytherapy include:

Before the Procedure

Tell your provider what medicines you are taking.

Wear loose-fitting clothes to the treatments.

After the Procedure

Radiation therapy can also damage or kill healthy cells. The death of healthy cells can lead to side effects. These side effects depend on the dose of radiation, and how often you have the therapy.

Long-term side effects may include:

Outlook (Prognosis)

There have been no high-quality studies comparing brachytherapy to whole breast radiation. However, other studies have shown outcomes to be the same for women with localized breast cancer.

References

National Cancer Institute website. Breast cancer treatment (adult) (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-treatment-pdq. Updated February 11, 2021. Accessed March 11, 2021.

National Cancer Institute website. Radiation therapy and you: support for people who have cancer. www.cancer.gov/publications/patient-education/radiationttherapy.pdf. Updated October 2016. Accessed October 5, 2020.

Otter SJ, Holloway CL, O'Farrell DA, Devlin PM, Stewart AJ. Brachytherapy. In: Tepper JE, Foote RL, Michalski JM, eds. Gunderson and Tepper's Clinical Radiation Oncology. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 20.

Shah C, Harris EE, Holmes D, Vicini FA. Partial breast irradiation: accelerated and intraoperative. In: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, eds. The Breast: Comprehensive Management of Benign and Malignant Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 51.

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Review Date: 7/19/2020  

Reviewed By: David Herold, MD, radiation oncologist in Jupiter, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 03/11/2021.

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