The Newest Life-Saving Breast Cancer Treatments
Partial Breast Irradiation (PBI)
What it is: A five-day treatment that delivers radiation directly to the pocket where your original tumor was removed by surgery -- the area in which cancer is most likely to come back. Unlike conventional radiation therapy, in which an external beam is targeted over a large area of your entire breast (just like a diagnostic x-ray for a broken bone, say) and which requires a much longer, physically draining course of treatment, the most widely used form of PBI is delivered internally. A "balloon" attached to a tube that leads to the outside of your breast is placed inside the cavity. For each treatment, a radioactive "seed" is inserted into the tube and then travels to the balloon, where it delivers a prescribed dose of radiation to the specific site of the original tumor. The balloon and tube can be inserted in a doctor's office in less than 15 minutes using local anesthetic; removal, which occurs as soon as you're done with your treatment, is just as easy. The most common side effects are some breast tenderness and mild burns on the skin.
In a study conducted at William Beaumont Hospital, in Royal Oak, Michigan, women treated with five days of PBI did just as well over the course of five years as those treated with a seven-week course of external beam radiation. "It will take another eight to 10 years of follow-up study on patients before we have definitive data on how PBI compares with traditional radiation," says Martin Keisch, MD, radiation oncologist at Mount Sinai Medical Center, in Miami Beach, Florida, "although all the evidence so far suggests this shorter, more targeted approach is just as effective."
Who can consider it: Someone with early-stage breast cancer that hasn't spread to more than two lymph nodes and who has chosen breast-conserving lumpectomy with radiation instead of a mastectomy. To find a doctor who does PBI (and to learn more about the procedure, including details about how it feels to have the balloon inserted), go to www.proximatherapeutics.com, a Web site sponsored by the company that makes the most widely used form of PBI, called MammoSite. Since it was approved by the FDA, in May 2002, more than 2,000 physicians have been trained to use the technology and more than 9,000 patients have been treated.
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