The term “permanent breast seed implants” (PBSI) refers to a partial breast irradiation technique that is performed in a single one-hour procedure under local freezing and neuroleptanalgesia. There are obvious advantages to this technique for the patient and medical personnel. If radiation safety is an issue with 1251, 103Pd is known to be theoretically and clinically safe for PBSI. To ensure very accurate placement of the seeds in a mobile target situated in a soft organ, a special implanting device was developed. This device involved the use of a “fiducial needle” that hooks the target volume and is attached to a template that is used to guide the insertion of the seeds. Various precautions are used to avoid seed motion, including the use of stranded seeds and a special algorithm to optimize seed placement. The chapter describes the PBSI technique and reports outcomes in terms of local control and side effects in a prospective cohort of 67 patients treated between 2004 and 2007. Finally, since not all patients are eligible for PBSI, the chapter compares PBSI to other partial breast irradiation techniques.
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References
Benitez PR, Keisch ME, Vicini F et al. (2007) Five-year results: the initial clinical trial of MammoSite balloon brachytherapy for partial breast irradiation in early-stage breast cancer. Am J Surg 194:456–62
Bloedorn FG (1956) Application of the Paterson—Parker system in interstitial radium therapy. Am J Roentgenol Radium Ther Nucl Med 75:457–75
Butler WM, Merrick GS (1996) I-125 rapid strand loading technique. Radiat Oncol Investig 4:48–9
Chen P Y, Vicini FA, Benitez P et al. (2006) Long-term cosmetic results and toxicity after accelerated partial-breast irradiation: a method of radiation delivery by interstitial brachytherapy for the treatment of early-stage breast carcinoma. Cancer 106:991–9
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 17:859–63
Cuttino LW, Keisch M, Jenrette JM et al. (2008) Multi-institutional experience using the mammosite radiation therapy system in the treatment of early-stage breast cancer: 2-year results. Int J Radiat Oncol Biol Phys 71:107–14
Freedman GM, Anderson PR, Li J et al. (2006) Intensity modulated radiation therapy (IMRT) decreases acute skin toxicity for women receiving radiation for breast cancer. Am J Clin Oncol 29:66–70
Fowler JF (1989) The linear—quadratic formula and progress in fractionated radiotherapy. Br J Radiol 62:679–94
Hall JD, Boyd JC, Lippert MC et al. (2003) Why patients choose prostatectomy or brachytherapy for localizedprostate cancer: results of a descriptive survey. Urology 61:402–7
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 67:1052–8
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 consideration. Int J Radiat Oncol Biol Phys 62:358–65
Keller B, 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 70:267–71
Kuske RR, Winter K, Arthur DW et al. (2006) Phase II trial of brachytherapy alone after lumpectomy for select breast cancer: toxicity analysis of RTOG 95–17. Int J Radiat Oncol Biol Phys. 65:45–51
Lilla C, Ambrosone CB, Kropp S et al. (2007) Predictive factors for late normal tissue complications following radiotherapy for breast cancer. Breast Cancer Res Treat 106:143–50
Ling CC, Chui CS (1993) Stereotactic treatment of brain tumors with radioactive implants or external photon beams: radiobiophysical aspects. Radioth Oncol 26:11–8
Nath S, Chen Z, Yue N et al. (2000) Dosimetric effects of needle divergence in prostate seed implant using I-125 and Pd-103 radioactive seeds. Med Phys 27:1058–66
NCRP (1995) Dose limits for individuals who receive exposure from radionuclide therapy patients (NCRP Commentary 11). National Council on Radiation Protection and Measurements, Bethesda
Orton CG, Ellis F (1973) A simplifi cation in the use of the NSD concept in practical radiotherapy. Br J Radiol 46:529–37
Orton CG, Webber BM (1977) Time-dose factor analysis of dose rate effects in permanent implant dosimetry. Int J Rad Oncol Biol Phys 2:55–60
Pignol JP, Keller B, Rakovitch E et al. (2006) First report of a Permanent Breast Seed Implant (PBSI) as adjuvant radiation for early stage breast cancer. Int J Radiat Oncol Biol Phys 64:176–81
Pignol JP, Olivoto I, Rakovitch E et al. (2008) A Phase III multicentre clinical trial of Breast Intensity Modulated Radiation Therapy (IMRT) to reduce skin radiation side effects. J Clin Oncol 26:2085–92
Pignol JP, Rakovitch E, Keller B et al. (2009) Tolerance and acceptance results of a palladium -103 permanent breast seed implant; phase I/II study. Int J Rad Oncol Biol Phys 73:1482–88
Rosenstein BS, Lymberis SC, Formenti SC (2004) Biologic comparison of partial breast irradiation protocols. Int J Radiat Oncol Biol Phys 60:1393–404
Smitt MC, Birdwell RL, Goffi net DR (2001) Breast electron boost planning: comparison of CT and US. Radiol 219:203–6
Vicini F, White J, Gustafson G et al. (1993) The use of iodine-125 seeds as a substitute for iridium-192 seeds in temporary interstitial breast implants. Int J Radiat Oncol Biol Phys 27:561–6
Vicini FA, Chen P, Wallace M et al. (2007) Interim cosmetic results and toxicity using 3D conformal external beam radiotherapy to deliver accelerated partial breast irradiation in patients with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 69:1124–30
Waterman FM, Yue N, Corn BW (1998) Edema associated with I-125 or Pd-103 prostate brachytherapy and its impact on post-implant dosimetry: an analysis based on serial CT acquisition. Int J Radiat Oncol Biol Phys. 41:1069–77
Weed DW, Edmundson GK, Vicini FA et al. (2005) Accelerated partial breast irradiation: a dosimetric comparison of three different techniques. Brachytherapy 4:121–9
Whitmore WF Jr, Hilaris B, Grabstald H (1972) Retropubic implantation to iodine 125 in the treatment of prostatic cancer. J Urol 108:918–20
Woolsey J, Miller N, Theodorescu D (2003) Permanent interstitial brachytherapy for prostate cancer: a current review. World J Urol 4:209–19
Zelefsky MJ, Wallner KE, Ling CC et al. (1999) Comparison of the 5-year outcome and morbidity of three-dimensional conformal radiotherapy versus transperineal permanent iodine-125 implantation for early-stage prostatic cancer. J Clin Oncol 17:517–22
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Pignol, JP., Keller, B.M. (2009). Permanent Breast Seed Implants. In: Wazer, D.E., Arthur, D.W., Vicini, F.A. (eds) Accelerated Partial Breast Irradiation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-88006-6_15
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