Skip to main content
SpringerLink
Log in

Breast Brachytherapy: Permanent Breast Seed Implants – How and Why?

  • Chapter
  • First Online:
Brachytherapy

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

Abstract

This chapter reports patient selection criteria, planning, technique, and results of permanent breast seed implant. In a single 1 h procedure, this technique uses stereotactic localization to permanently implant stranded 103Pd seeds in and around the seroma cavity after lumpectomy for early stage breast cancer. Five-year results for a cohort of 137 patients are excellent in terms of both local control and tolerance.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Peto R, Boreham J, Clarke M et al (2002) UK and USA breast cancer deaths down 25% in year 2000 at ages 20–69 years. Lancet 355:1822

    Article  Google Scholar 

  2. Nystrom L, Andersson I, Bjurstam N et al (2002) Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet 359:909–919

    Article  PubMed  Google Scholar 

  3. SEER. http://seer.cancer.gov/csr/1975_2011/results_merged/sect_04_breast.pdf

  4. Early Breast Cancer Trialists' Collaborative Group (EBCTCG), Darby S, McGale P et al (2011) Effect of radiotherapy after breast-conserving surgery on 10 year recurrence and 15 year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378:1707–1716

    Article  Google Scholar 

  5. Bartelink H, Horiot JC, Poortmans PM et al (2007) Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10 year results of the randomized boost versus no boost EORTC 22881–10882 trial. J Clin Oncol 25(22):3259–3265

    Article  PubMed  Google Scholar 

  6. Whelan TJ, Pignol JP, Levine MN et al (2010) Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med 362:513–520

    Article  CAS  PubMed  Google Scholar 

  7. Fisher ER, Sass R, Fisher B et al (1986) Pathologic findings from the National Surgical Adjuvant Breast and Bowel Project (Protocol 6). II. Relation of local breast recurrence to multicentricity. Cancer 57:1717–1724

    Article  CAS  PubMed  Google Scholar 

  8. Bethune WA (1991) Partial breast irradiation for early breast cancer. J Natl Med Assoc 83:768–800, 808

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Pawlik TM, Bucholz TA, Kuerer HM (2004) The biologic rationale for and emerging role of accelerated partial breast irradiation for breast cancer. J Am Coll Surg 199:479–492

    Article  PubMed  Google Scholar 

  10. Vicini FA, Kestin L, Chen P et al (2003) Limited-field radiation therapy in the management of early stage breast cancer. J Natl Canc Inst 95:1205–1211

    Article  Google Scholar 

  11. Mannino M, Yarnold J (2009) Accelerated partial breast irradiation trials: diversity in rationale and design. Radiother Oncol 91:16–22

    Article  PubMed  Google Scholar 

  12. Olivotto IA, Whelan TJ, Parpia S et al (2013) Interim cosmetic and toxicity results from RAPID: a randomized trial of accelerated partial breast irradiation using three-dimensional conformal external beam radiation therapy. J Clin Oncol 31:4038–4045

    Article  PubMed  Google Scholar 

  13. Vaidya JS, Wenz F, Bulsara M et al (2014) Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer: 5 year results for local control and overall survival from the TARGIT-A randomised trial. Lancet 383:603–613

    Article  PubMed  Google Scholar 

  14. Beitsch PD, Shaitelman SF, Vicini FA (2011) Accelerated partial breast irradiation. J Surg Oncol 103:362–368

    Article  PubMed  Google Scholar 

  15. Clarke DH, Edmundson GK, Martinez A et al (1989) The clinical advantages of I-125 seeds as a substitute for Ir-192 seeds in temporary plastic tube implants. Int J Radiat Oncol Biol Phys 17:859–863

    Article  CAS  PubMed  Google Scholar 

  16. Nelson JC, Beitsch PD, Vicini FA et al (2009) Four-year clinical update from the American society of breast surgeons MammoSite® brachytherapy trial. Am J Surg 98:83–91

    Article  Google Scholar 

  17. Smith BD, Arthur DW, Buchholz TA et al (2009) Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO). Int J Radiat Oncol Biol Phys 74:987–1001

    Article  PubMed  Google Scholar 

  18. Pignol JP, Keller B, Rakovitch E et al (2006) First report of a permanent breast 103Pd seed implant as adjuvant radiation treatment for early-stage breast cancer. Int J Radiat Oncol Biol Phys 64:176–181

    Article  PubMed  Google Scholar 

  19. Jansen N, Deneufbourg JM, Nickers P (2007) Adjuvant stereotactic permanent seed breast implant: a boost series in view of partial breast irradiation. Int J Radiat Oncol Biol Phys 67:1052–1058

    Article  PubMed  Google Scholar 

  20. Wazer DE, Berle L, Graham R et al (2002) Preliminary results of a phase I/II study of HDR brachytherapy alone for T1/T2 breast cancer. Int J Radiat Oncol Biol Phys 53:889–897

    Article  PubMed  Google Scholar 

  21. Smith GL, Jiang J, Buchholz TA et al (2014) Benefit of adjuvant brachytherapy versus external beam radiation for early breast cancer: impact of patient stratification on breast preservation. Int J Radiat Oncol Biol Phys 88:274–284

    Article  PubMed  PubMed Central  Google Scholar 

  22. Polgár C, Van Limbergen E, Pötter R et al (2009) Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: recommendations of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group based on clinical evidence. Radiother Oncol 94:264–273

    Article  Google Scholar 

  23. Shah C, Vicini F, Wazer DE et al (2013) The American Brachytherapy Society consensus statement for accelerated partial breast irradiation. Brachytherapy 12:267–277

    Article  PubMed  Google Scholar 

  24. ASBS. https://www.breastsurgeons.org/statements/PDF_Statements/APBI.pdf. Accessed on Feb 2015

  25. Buchholz TA, Somerfield MR, Griggs JJ et al (2014) Margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive breast cancer: American Society of Clinical Oncology endorsement of the Society of Surgical Oncology/American Society for Radiation Oncology consensus guideline. J Clin Oncol 32:1502–1506

    Article  PubMed  Google Scholar 

  26. Keller BM, Ravi A, Sankreacha R et al (2012) Permanent breast seed implant dosimetry quality assurance. Int J Radiat Oncol Biol Phys 83:84–92

    Article  PubMed  Google Scholar 

  27. Afsharpour H, Pignol JP, Keller B et al (2010) Influence of breast composition and interseed attenuation in dose calculations for post-implant assessment of permanent breast 103Pd seed implant. Phys Med Biol 55:4547–4561

    Article  PubMed  Google Scholar 

  28. Furstoss C, Reniers B, Bertrand MJ et al (2009) Monte Carlo study of LDR seed dosimetry with an application in a clinical brachytherapy breast implant. Med Phys 36:1848–1858

    Article  CAS  PubMed  Google Scholar 

  29. Mashouf S, Lechtman E, Beaulieu L et al (2013) A simplified analytical dose calculation algorithm accounting for tissue heterogeneity for low-energy brachytherapy sources. Phys Med Biol 58:6299–6315

    Article  PubMed  Google Scholar 

  30. Orton CG, Ellis F (1973) A simplification in the use of the NSD concept in practical radiotherapy. Br J Radiol 46:529–537

    Article  CAS  PubMed  Google Scholar 

  31. Orton CG, Webber BM (1977) Time-dose factor analysis of dose rate effects in permanent implant dosimetry. Int J Radiat Oncol Biol Phys 2:55–60

    Article  CAS  PubMed  Google Scholar 

  32. Fowler JF (1989) The linear-quadratic formula and progress in fractionated radiotherapy. Br J Radiol 62:679–694

    Article  CAS  PubMed  Google Scholar 

  33. Ling CC, Chui CS (1993) Stereotactic treatment of brain tumors with radioactive implants or external photon beams: radiobiophysical aspects. Radiother Oncol 26:11–18

    Article  CAS  PubMed  Google Scholar 

  34. Keller BM, Pignol JP, Rakovitch E et al (2008) A radiation badge survey for family members living with patients treated with a 103Pd permanent breast seed implant. Int J Radiat Oncol Biol Phys 70:267–271

    Article  CAS  PubMed  Google Scholar 

  35. Keller B, Sankreacha R, Rakovitch E et al (2005) A permanent breast seed implant as partial breast radiation therapy for early-stage patients: a comparison of palladium-103 and iodine-125 isotopes based on radiation safety considerations. Int J Radiat Oncol Biol Phys 62:358–365

    Article  CAS  PubMed  Google Scholar 

  36. NCRP Commentary #11. http://www.ncrponline.org/Publications/Commentaries/Comm11press.html. Accessed on Feb 2015

  37. Hilts M, Batchelar D, Rose J et al (2015) Deformable image registration for defining the post-implant seroma in permanent breast seed implant brachytherapy. Brachytherapy 14(3):409–418

    Article  PubMed  Google Scholar 

  38. Pignol JP, Rakovitch E, Keller BM et al (2009) Tolerance and acceptance results of a palladium-103 permanent breast seed implant Phase I/II study. Int J Radiat Oncol Biol Phys 73:1482–1488

    Article  PubMed  Google Scholar 

  39. Pignol JP, Keller BM, Ravi A (2011) Doses to internal organs for various breast radiation techniques--implications on the risk of secondary cancers and cardiomyopathy. Radiat Oncol 6:5

    Article  PubMed  PubMed Central  Google Scholar 

  40. Bentzen SM, Overgaard M (1991) Relationship between early and late normal-tissue injury after postmastectomy radiotherapy. Radiother Oncol 20:159–165

    Article  CAS  PubMed  Google Scholar 

  41. Amichetti M, Caffo O (2003) Pain after quadrantectomy and radiotherapy for early-stage breast cancer: incidence, characteristics and influence on quality of life. Oncology 65:23–28

    Article  PubMed  Google Scholar 

  42. Pignol JP, Olivotto I, Rakovitch E (2008) A multicenter randomized trial of breast intensity-modulated radiation therapy to reduce acute radiation dermatitis. J Clin Oncol 26:2085–2092

    Article  PubMed  Google Scholar 

  43. Vargo JA, Verma V, Kim H et al (2014) Extended (5-year) outcomes of accelerated partial breast irradiation using MammoSite balloon brachytherapy: patterns of failure, patient selection, and dosimetric correlates for late toxicity. Int J Radiat Oncol Biol Phys 88:285–291

    Article  PubMed  Google Scholar 

  44. Ajkay N, Collett AE, Bloomquist EV et al (2015) A comparison of complication rates in early-stage breast cancer patients treated with brachytherapy versus whole-breast irradiation. Ann Surg Oncol 22(4):1140–1145

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Radiation Oncology Department, Erasmus Medical Center, Rotterdam, The Netherlands

    Jean-Philippe Pignol MD, PhD

  2. Department of Radiation Oncology, University of British Columbia, British Columbia Cancer Agency Centre for the Southern Interior, Kelowna, BC, Canada

    Juanita Crook MD, FRCPC

Authors
  1. Jean-Philippe Pignol MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juanita Crook MD, FRCPC
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-Philippe Pignol MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA

    Paolo Montemaggi

  2. AlleghenyHealthNetworkCancer Ins,Divi RO, Drexel Univ, College of Medi, Pittsburgh, Pennsylvania, USA

    Mark Trombetta

  3. Dept Radiation Oncology, Drexel Univ, College of Medi, Philadelphia, Pennsylvania, USA

    Luther W. Brady

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Pignol, JP., Crook, J. (2016). Breast Brachytherapy: Permanent Breast Seed Implants – How and Why?. In: Montemaggi, P., Trombetta, M., Brady, L. (eds) Brachytherapy. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-319-26791-3_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26791-3_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26789-0

  • Online ISBN: 978-3-319-26791-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation