Departmental News


Our breast surgeons at the Carol M. Baldwin Breast Care Center are now certified to provide a targeted "internal" radiation therapy called partial breast irradiation (PBI) to patients with early-stage breast cancer who choose to have lumpectomies. The new FDA-approved PBI system delivers high-dose radiation directly to the site where a tumor has been removed, targeting the area where the cancer would most likely recur.

PBI represents the next generation of internal radiation therapy. It is minimally invasive, has been shown to be safe, and can be performed as an outpatient procedure. Patients generally tolerate the treatment very well.

The typical breast cancer recurrence rate after the traditional therapy using external beam radiation for six weeks is 15% over 20 years. The recurrence rate in the breast after PBI treatment is unknown. Short-term results are encouraging, though long-term results are still unknown.

l Treatment with PBI may be completed in five days, compared to six weeks with conventional radiation techniques.
l PBI places the radiation source inside the space left when a tumor is removed and delivers radiation to the area where cancer is most likely to recur.
l PBI delivers a high dose of radiation to the area most at risk for recurrence and spares the entire breast from radiation, potentially minimizing side effects and improving cosmesis.
l The therapy is given on an outpatient basis and no hospital stay is required.
l Cosmetic results have been shown to be good/excellent in most patients.
l Patient satisfaction has been very positive.

With the PBI system used by our breast care specialists, a thin flexible catheter with a balloon on the end is placed into the cavity created by the lumpectomy. The balloon is inflated with saline solution, and then a radioactive "seed" that is attached to a thin wire is threaded through the catheter into the balloon, where it remains for only a few minutes until the wire is withdrawn. The catheter is removed after the final treatment, and no radiation remains in the body.

More Patient-Friendly Internal Radiation Therapy

PBI is much more patient-friendly than conventional internal radiation therapy for breast cancer, in which radioactive seeds and 14 to 20 catheters are placed in the breast for each treatment. PBI is a simpler, much more localized treatment, with less risk of bleeding.

Internal radiation therapy, or brachytherapy, has been used successfully for years to treat prostate, gynecologic, lung, soft tissue, and many other types of cancer. It has been used only sporadically to treat breast cancer, but may now be much simpler because of the ease of inserting a single, flexible catheter that allows outpatient treatment.

After tumor removal surgery, an uninflated PBI balloon is placed inside the tumor resection cavity.

Once in place, the balloon is inflated with saline and a contrast agent, inserted through the applicator.

A radioactive seed attached to a wire delivers a precise dose of radiation.

After radiation treatment, the balloon is deflated and easily removed.

PBI may make it easier for some women with breast cancer to choose to have a lumpectomy, followed by radiation therapy, rather than undergoing a mastectomy. Recent studies have shown that patients with early breast cancer who have lumpectomies have the same success rate as those who have a modified radical mastectomy to remove their breast. But an estimated 50% of women diagnosed with early cancer still choose to have a mastectomy.

According to the American Cancer Society, breast cancer is the second-leading cause of cancer death in women. Approximately 270,000 women will be diagnosed with breast cancer this year in the United States, with 58,500 of them found to have early cancers.

Now, with the availability of PBI, many patients with early breast cancer have a treatment option that may improve their quality of life while they are receiving state-of-the-art radiation therapy as part of their multidisciplinary care.

For more information about partial breast irradiation therapy at Stony Brook, please call 631-444-4550.

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