Balloon breast brachytherapy (BBB) is a technique for delivering radiation treatment in women with early stage breast cancer. It is given after lumpectomy, or surgical removal of a small breast neoplasm, and is a shorter alternative to the more traditional method of external beam radiation for seven weeks.
Balloon breast brachytherapy is performed with the Mammosite® device, a single soft catheter with a balloon at the tip, placed in the lumpectomy cavity, either at the time of lumpectomy, or as an office procedure following surgery. The balloon is then inflated with saline solution up to a diameter of about 2 inches to accommodate the individual cavity, after which an 192Ir radiation source, connected to a computer-controlled high-dose rate remote afterloader, is inserted into the inflated balloon and left in situ for several minutes to deliver the radiation dose.
The treatments, which takes about 20 minutes each, are usually given in outpatient fashion twice daily for five days. Once the therapy is concluded, the balloon is deflated and the catheter is removed. This method is similar to that used for prostate cancer brachytherapy, using radioactive seeds, and is completely painless.
The major advantages of balloon breast brachytherapy are a substantial decrease in the duration of therapy (five days compared to seven weeks for external beam radiation), a reduction of the amount of healthy tissue exposed to radiation, and an excellent cosmetic outcome. The main factors limiting the use of the balloon breast brachytherapy are inadequate skin distance and poor cavity conformance.
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