MammoSite® targets radiation to the tissue adjacent to the lumpectomy site.MammoSite® places the radiation source inside the lumpectomy cavity (the space left when a tumor is removed). This delivers radiation to the area where cancer is most likely to recur.
Drs. Robert Kuske and Coral Quiet were among the first physicians to use this balloon. In fact, Dr. Kuske developed the balloon and did the original experiements with MammoSite® in goats! He still has a scar from where a goat expressed her dissatisfaction with the placement of her balloon.
The balloon has been well researched. In addition to the original clinical trial for the FDA, another trial enrolled 1500 women treated and followed. Dr. Quiet was one of the lead investigators in this study. These trials for the
MammoSite have shown it to be well tolerated, with mild side effects for a short period of time.
The therapy is given on an outpatient basis. No hospital stay is required. Treatment is twice a day (usually 6 hours between treatments). Treatments are painless and usually take about 10 minutes.
5-year clinical trial data shows:
- no local recurrences.
- 82% of the patients had good/excellent cosmetic results.
- 100% of patients in the initial clinical trial would recommend MammoSite® to a friend or family member.
- 100% of patients in the initial clinical trial would use MammoSite® again if they had to do it over.
What to Expect
A typical evaluation and treatment sequence would be:
Consultation with physical exam by the radiation oncologist.
- Review of pathology, mammography, ultrasound, and MRI results by the radiation oncologist to determine suitability and feasibility of breast brachytherapy.
- An ultrasound and/or CT scan will be done in our office to evaluate the surgical cavity size and shape. This step confirms that the size and shape of the surgical cavity is appropriate for this procedure.
- Discussion with the radiation oncologist regarding possible techniques: interstitial multiple-catheter technique vs. SAVI® vs. Contura® vs MammoSite®.
- If you are a candidate for the
MammoSite catheter,we will make arrangements for placement of the device on a separate day.
Illustration: Mammosite catheter treatment.
The catheter placement procedure is performed either by your surgeon or one of our physicians. Sometimes a temporary balloon device is placed at the time of surgery. If you are a good candidate for this technique, your surgeon will switch out the temporary catheter to the treatment device. Placement of the catheter is done with ultrasound. A small area is numbed up and a nick is made in the skin. A tunnel is created from the skin to the cavity and the device is placed into the cavity. Placement is done in the office and does not require pain medication, only local anesthesia.
The radiation planning CT is done the day of, or the day after, the catheter insertion. This is a special type of CT scan done in our clinic. Sometimes the catheter may need extra tweaking to get it in the perfect place to allow radiation to be given safely and most effectively.
Our Physics Team requires one full day to plan and create the perfect treatment. Treatment begins usually 2 working business days after catheter insertion.
Treatments usually last between 6 and 15 minutes each, and the patient is in the clinic for about 40 minutes each time, including nursing time to clean and dress the catheter entry sites. Treatments are generally 6 hours apart. Treatments typically, but not always, are completed in 5 business days (Monday through Friday). Before each treatment, an ultrasound or CT scan will be done to ensure the MammoSite catheter is in the exact position.
The overall duration with the catheter in place is usually between 8 and 9 days. After the last treatment, we remove the catheter and you go home. You will come in for a follow-up appointment one week later to check the healing of your breast, and again one month later. The first follow-up mammogram is 6 months after treatment: sign out your films and bring them in to the radiation oncologist for a "second over-reading" of your films with the physician explaining what we look for on the breast images. We integrate your future follow-up visits with the surgeon and medical oncologist; we believe your radiation oncologist is a vital part of your follow-up evaluation and strive to participate in your follow-up long term.