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 lumpectomy. The goal of this procedure, which may be performed as an adjunct to chemotherapy or hormonotherapy, is to irradiate and destroy any residual tumor cells while sparing normal breast tissue and preserving cosmetic appearance. A secondary goal of the use of brachytherapy for breast cancer is for accelerated partial breast irradiation, which makes breast-conserving approaches feasible for more patients by irradiating the tumor bed over a shorter time span than that required for conventional radiotherapy.

Controversy: Unlike WBRT with 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 and cancer that has spread to nearby lymph nodes. In addition, its relative efficacy versus WBRT is unclear. Brachytherapy is not as readily available as EBRT, so patients may have to travel and stay away from home to receive this treatment.

Relevant Questions:

  • Does accelerated partial breast irradiation (APBI) with brachytherapy provide effective long-term local tumor control and survival in patients who undergo breast-conserving surgery for early-stage breast cancer?

  • What complications are associated with APBI with brachytherapy for breast cancer patients?

  • How does the efficacy and safety of APBI with brachytherapy compare with standard WBRT and between different techniques for brachytherapy?

  • Have sufficient patient selection criteria for the use of APBI with brachytherapy for early-stage breast cancer been established?


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