Purpose of Technology: Brachytherapy involves temporary implantation of radioactive materials at the site of a tumor. For treatment of breast cancer, brachytherapy is generally performed after breast-conserving surgery such as lumpectomy, either in the form of accelerated partial breast irradiation, the sole type of radiation, or as a radiation boost in combination with a standard course of whole-breast radiation therapy (WBRT). The goal of this procedure is to irradiate and destroy any residual tumor cells at the tumor site while sparing normal breast tissue and preserving cosmetic appearance.
Controversy: Unlike external beam radiation therapy (EBRT), brachytherapy is invasive and its concentrated dosing can cause more local tissue damage while failing to adequately treat sites of multicentric or lobular tumors. In addition, brachytherapy is not as readily available as EBRT, so patients may have to travel and stay away from home to receive this treatment. In addition, its relative efficacy versus an EBRT boost along with WBRT is unclear.
Relevant Questions:
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Does brachytherapy as a radiation boost to standard WBRT improve long-term tumor control and survival compared with a boost delivered by EBRT in patients with early-stage breast cancer who undergo breast-conserving surgery, or compared with total mastectomy alone?
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Does brachytherapy as a radiation boost along with targeted EBRT improve long-term tumor control and survival compared with standard WBRT alone in patients with early-stage breast cancer who undergo breast-conserving surgery?
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Does brachytherapy as a radiation boost along with standard WBRT improve long-term tumor control and survival compared with WBRT and a boost with EBRT in patients with early-stage breast cancer who do not undergo breast cancer surgery?
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Is brachytherapy safe as a radiation boost and adjunct to WBRT or to EBRT in patients who undergo breast-conserving surgery?
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Is brachytherapy safe as a radiation boost and adjunct to WBRT in patients who do not undergo breast cancer surgery?
- Have patient selection criteria for the use of brachytherapy as an adjunct to other types of radiation therapy for early-stage breast cancer been established?
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