One in eight women is diagnosed with breast cancer in her lifetime in the U.S. The diagnosis brings along with it many decisions that need to be made.
One of the first decisions after a breast cancer diagnosis is whether or not to pursue breast conservation (lumpectomy, removing only the cancer and leaving the remaining breast tissue intact), or undergoing a full mastectomy (surgical removal of the whole breast).
Although treatment protocols may vary depending on the stage and type of cancer, when breast conservation is desired, surgery is often completed first, and this is often followed by three to six weeks of once-daily radiation treatment to the breast as an outpatient, requiring multiple trips to the radiation center. Other treatments may include chemotherapy or hormone therapy. Fortunately, more and more data has emerged on shortening the radiation course, including data to support a new technology offered at Wesley Medical Center called intraoperative radiation therapy, or IORT.
Certain early stage, low-risk cancers now can be treated in one day at the time of the lumpectomy operation. The concept and logistics behind using the Xoft machine for IORT are really quite simple—the goal is to target the highest risk area in the breast (the bed where the cancer formed) with a single high dose of radiation using a balloon applicator at the time of surgery.
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The patient initially is seen by her surgeon and, at that appointment, evaluated as to whether or not she is a potential candidate for IORT. The patient then is referred to one of Wesley’s radiation oncology doctors (who perform the procedure) for a consultation. If both the patient and the doctors decide to proceed, on the day of surgery, the surgeon performs a sentinel node biopsy and removes the cancerous lump from the breast. Then the radiation oncologist uses a balloon technology to apply radiation directly to the bed where the cancer once was, all while the patient is asleep under anesthesia.
The entire radiation treatment is completed in about 45 minutes. By the time the patient is in recovery, the balloon has been removed, the breast incision is closed and radiation is complete. Published outcomes are very good, with only a very small increase in the chance of local recurrence compared to traditional treatments. Side effects are minimal. In the majority of patients, the one-time radiation dose is enough to complete their radiation treatment. In rare circumstances, additional radiation as an outpatient may be necessary once the final pathology is available.
We are very excited about the opportunity to offer this service to patients in Kansas at Wesley Medical Center, and appreciate the significance of simplifying radiation, which allows for increased patient convenience and tolerance of treatment. Not all patients are candidates for this treatment, but a discussion with your surgeon will help determine suitability.
Ellen Cooke is a radiation oncologist with Wichita Radiological Group.