SAVI® Accelerated Partial Breast Irradiation
The SAVI is a breast radiation device that targets radiation to the tissue adjacent to the lumpectomy site.It is a single entry device that allows sculping of the dose to avoid the skin, rib or other normal tissue that does not need radiation. It can be custom-fitted to your lumpectomy cavity, regardless of what shape or size it may be. This device is a bundle of soft, tiny catheters. The
SAVI is inserted through a small incision, and the catheter bundleexpands uniformly, but its unique design allows it to be opened in a way that truly conforms to the size and shape of your tumor cavity. The radiation dose can be individually controlled through each catheter, allowing precise targeting by our radiation oncologist.
The SAVI catheter. Photo by Cianna Medical.
The SAVI applicator is an evolution in radiation therapy for early-stage breast cancer.
Delivering treatment from inside the breast, SAVI uses multiple catheters to direct radiation where it is needed most.
This unique design allows for unparalleled dose sculpting ability that minimizes exposure to healthy tissue and reduces complications, making the benefits of breast brachytherapy available to more women.
The SAVI radiation applicator can be placed at the time of the patient's lumpectomy, or it may be inserted during a separate surgery. Only a small incision is needed, to allow the compact catheter bundle to be placed within the breast. The incision area and the section of the cather bundle that extends outside the breast will be secured with a dressing until treatment is complete. The catheters are very flexible and soft, so they should be comfortable during the five days of radiation. Please click on the photo to the left to enlarge the diagram.
Treatments are given twice a day for five days and take approximately 30 minutes for each visit. Between 5 to 10 minutes of the appointment will be used for the radiation treatment time. During each treatment, the radiation source is sent down each catheter one at a time. A different amount of radiation dose will be given at different points along the length of each catheter. This provides the best dose for the affected tissue, and the most protection for surrounding healthy tissue. The illustration shows that only a small incision is needed to place the SAVI applicator in the breast. Please click on the photo to the left to enlarge the diagram.
After the final radiation treatment, the SAVI device is removed, which takes about two minutes. It is simple and quick. The incision site is then cleaned and closed with adhesive strips. A bandage or dressing is then placed on top to keep the area clean. Please click on the photo to the left to enlarge the diagram.
Drs. Robert Kuske and Coral Quiet were the first to use the SAVI® catheter and have treated over 100 women with the device with excellent results.
Take a moment and watch this excellent video of Dr. Robert Kuske discussing radiation therapy options, including the SAVI applicator, for early stage breast cancers. Just click on the arrow in the video and it will begin.
Learn More about a Typical Treatment Sequence
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 in our office will be done 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 SAVI catheter, we will make arrangements for placement of the catheter on a separate day.
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 device is done with ultrasound guidance. 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 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 5 business days (Monday through Friday). Before each treatment, a CT scan will be done to ensure the SAVI catheter is in the exact position.
Overall duration with the catheter in place: usually 8 to 9 days. After the last treatment, we remove the catheter and you go home. You are scheduled for a one-week follow-up 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.