Another option for women needing partial breast irradiation after their
lumpectomy is the Contura® balloon. The innovative design of the Contura balloon allows the doctor to fill the empty space left by the lumpectomy procedure.
Illustration: The Contura® balloon
Contura's radiation balloon creates a vacuum to conform and adhere closely to the lumpectomy site.A targeted radiation dose will then be administered only where it is needed in the breast, sparing exposure to otherwise normal breast tissue. Treatment time is reduced to just five days instead of over six weeks.
This illustration shows 4 offset catheters inside the balloon to sculpt the dose away from the skin or chest wall and provides suction to remove fluid or air in the breast tissue around the balloon.
Compared to traditional radiation therapy, Contura's benefits are greater accuracy and refinement.
- Highly focused radiation often cuts treatment time dramatically (5 days vs. 6-7 weeks of treatment)
- Refined placement of radiation sources and targeted radiation doses will minimize damage to healthy breast and surrounding tissues
Allows for dose shaping by using 5 catheters located inside the balloon.
- FDA approved May 2007
Contura 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. Multiple catheters help sculpt the dose away from skin or ribs.
- 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.
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 oncologistto determine suitability and feasibility of breast brachytherapy.
- An ultrasound and/or CT 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 Contura device, we will make arrangements for placement of the catheter on a separate day.
Illustration: The pink area on these photos show the approximate area that was irradiated using the Contura Balloon (left) and with traditional whole-breast irradiation (right.)
The device 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 device 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 the catheter insertion.
Treatments usually last between 6-15 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 Contura device is in the exact position.
The overall duration with the catheter in place is usually 8 to 9 days. After the last treatment, we remove the catheter and you go home. You will come back for a follow-up 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.