May 15, 2003

BIRMINGHAM, AL — The UAB Comprehensive Cancer Center is the first in this area to offer an alternative to the usual seven weeks of radiation that follows lumpectomy for breast cancer. The new technology places the radiation source inside the breast 10 times over a period of only one week.

The internal radiation device, called the MammoSite Radiation Therapy System (RTS), minimizes radiation exposure to healthy tissue, according to Dr. Suzanne Russo, assistant professor of radiation oncology. "Recent evidence indicates that patients with tumors at low risk of recurrence may not require radiation to the entire breast," Russo said. The MammoSite device is designed to treat only the area surrounding the lumpectomy site, which carries the highest risk of tumor recurrence.

"We have performed two MammoSite procedures in recent weeks, and the patients have been very happy with the much shorter period of treatment. It has enabled them to get on with their lives more rapidly, and with fewer side effects," she said.

Dr. Helen Krontiras, a UAB breast surgeon, said availability of the minimally invasive radiation system will make it easier for more women to consider the choice of lumpectomy rather than removal of the whole breast. "Studies show that 50 percent of women with early-stage breast cancer will opt for a mastectomy, although a choice of lumpectomy plus radiation provides equivalent survival in the majority of cases," she said.

Krontiras estimated that at least one-fourth of patients with early-stage breast cancer would be offered the MammoSite option when they discuss treatment options with physicians at the UAB Breast Health Center at The Kirklin Clinic.

At the time of surgery, patients choosing the MammoSite option will have a balloon catheter inserted into the cavity created by a lumpectomy, said Krontiras. "The breast tissue that we removed is sent to a laboratory to determine how aggressive the cancer might be. It may take a couple of days for the pathologist's report to be available. If the cancer proves to be of an overly aggressive nature, we remove the catheter and schedule the patient for conventional radiation or other treatment. If it is the less aggressive early-stage breast cancer, the patient may begin the internal radiation."

Patients undergo this outpatient treatment twice daily for five days at the UAB Comprehensive Cancer Center's Wallace Tumor Institute. Russo inserts a tiny metal radioactive source into the tumor site through the catheter. The source is left in place for several minutes and then removed.

"This internal radiation, called brachytherapy, already is available for prostate cancer and some gynecological cancers," Russo said. "The radioactive seed delivers the specific dose of internal radiation to the exact site where the cancer is most likely to recur, minimizing the potential for exposure to the rest of the breast, skin, ribs, lungs and heart. As with conventional radiation, no radiation remains in the patient's body between treatments or after the final procedure."

Editor's Note: UAB's Cancer Center is the only one in Alabama to be designated as a "comprehensive" cancer center by the National Cancer Institute.