Problems of brachytherapy treatment for breast cancer

It’s important for any woman really to discuss with her physician the risks and benefits of either approach,”

More women need breasts removed after brachytherapy  By Genevra Pittman NEW YORK   May 1, 2012   (Reuters Health) – Women who got seed radiation as part of their breast cancer treatment were more likely to have an infection or breast pain than those who were treated with whole-breast irradiation, in a new study.

And more patients treated with the quicker and more local radiation technique, also called brachytherapy, went on to need a mastectomy as well — but there was no difference in their chance of dying in the few years after treatment. ”The decision of whether a patient was treated with brachytherapy or whole-breast irradiation was the single most important factor in whether a patient had a mastectomy,” said study author Dr. Benjamin Smith, who called that result “surprising.”

“It had generally been thought that if it was used carefully in the appropriate patients, the risks of mastectomy or recurrence would be basically the same in patients treated with brachytherapy or whole-breast irradiation,” Smith, from the MD Anderson Cancer Center in Houston, Texas, told Reuters Health.

Brachytherapy involves putting a small device — a balloon or a catheter — into the breast, where it delivers a dose of radiation to kill any extra cancer around the cavity where a tumor was removed.

The technique is frequently used to treat prostate and cervical cancer, but it’s only in the last decade that devices have been available to use in the breast, Smith said……

For the new study, Smith and his colleagues analyzed Medicare insurance claims for close to 93,000 older women with cancer who got breast-conserving surgery followed by radiation in 2003 through 2007. About 7,000 of them were treated with brachytherapy, and the rest with whole-breast irradiation.

Over the next five years, four percent of women who’d had brachytherapy got their breasts removed because of a cancer recurrence or for another reason. That compared to about two percent of those who got whole-breast irradiation and needed a mastectomy.

Patients treated with brachytherapy were also more likely to get an infection over the next year, or to have breast pain or fracture a rib during study follow-up, the researchers reported in the Journal of the American Medical Association…..  because the treatment “can be a little bit risky,” patients should make sure they’re having it done by experienced doctors who will monitor them carefully, Smith added.

And women should be educated about all of their radiation options before going forward with any treatment, according to Hattangadi, who wasn’t involved in the new study.

“It’s important for any woman really to discuss with her physician the risks and benefits of either approach,”  she said

SOURCE: Journal of the American Medical Association, online May 1, 2012.

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