Seed implants are alternative to traditional breast cancer treatments

In In The News by Barbara Jacoby

LLH network pressBy:

From: Beacon News

Oncologists at the Tom Baker Cancer Centre are using an innovative treatment for breast cancer patients, and initial results look promising.

The treatment features radioactive seed implants that are designed  to eliminate all remaining breast cancer cells within weeks following surgical removal of a tumour.

The implants are each the size of a grain of rice and the treatment is known as breast brachytherapy, a one-day procedure that is part of a national study.

“This potentially may represent another advancement for breast cancer management,” says radiation oncologist Dr. Siraj Husain. “I think targeted treatment is what we’re going to move towards in everything we do.”

During breast brachytherapy, doctors radiate only part of the breast by inserting 50 to 80 radioactive seeds, made from the chemical element palladium, into various places around the former tumour site. Ultrasound is used to guide and gauge the depth of the needles used to insert the seeds. A computer program maps out the ideal placement of the seeds within the breast.

The seeds remain in the breast but lose their main radioactivity after about six weeks.

Specialized equipment needed to perform this procedure was acquired with $252,000 in funding from the Alberta Cancer Foundation.

Dr. Husain says breast brachytherapy offers many benefits to the patient.

“By not using external radiation beams, skin reaction may be reduced, as will the impact of radiation on other organs, including the lungs and the heart,” says Dr. Husain.

“The chance of the breast shrinking or changing shape is also diminished. It also means patients can avoid the daily trips to the hospital over the course of many weeks for traditional radiation treatment. They can carry on with their normal routines.”

The procedure, which was pioneered at Sunnybrook Health Sciences Centre in Toronto where the world’s first permanent breast seed implant was performed in 2004, builds on what Dr. Husain and his team have been doing for years to treat prostate cancer.

Last month, Doreen Thomson was the first patient to have the treatment in Alberta. When she woke up she knew the procedure was a success – her medical team was celebrating.

“They even had a little cupcake with Number 1 on it for me,” she says.

A routine mammogram last spring detected something suspicious in the left breast of the 58-year-old financial services manager.

A biopsy revealed carcinoma in her milk ducts and a lumpectomy was soon performed to remove the tumour. Without radiation treatment, patients face an increased chance of the breast cancer returning, but like many patients, Thomson wasn’t looking forward to 16 to 25 radiation treatments she faced over the course of up to five weeks.

Instead, the seeds were implanted while she was under general anesthetic for about two hours. Eventually Alberta doctors hope to perform the procedure with a local anesthetic in about 60 minutes – the pace of other facilities that have longer track records with the procedure. Already, Ontario has had success with this partial breast radiation procedure with very low recurrence rates, which were comparable to the traditional treatment with an external beam.

Thomson was sore at first, but she was soon back at work, and then enjoyed a vacation with her husband. “I do feel like it’s getting better,” she says.

According to the most recent statistics available, breast cancer was the most commonly diagnosed cancer among females in Alberta with about 2,250 cases in 2010. Incidence rates have been stable over the past two decades and the five-year relative survival ratio is high: about 89 per cent for those diagnosed between 2008 and 2010, according to CancerControl Alberta.

Myka Osinchuk, Alberta Cancer Foundation CEO, says she’s pleased the foundation is helping to fund advancements in breast cancer care in the province.

“It is important we invest our donor dollars in things that have a real impact for Albertans facing cancer,” said Osinchuk. “This innovative surgery improves treatment success and quality of life for breast cancer patients. We look forward to hearing about the continued success it will have in Alberta.”

Only patients with tumours smaller than three centimetres and who are considered low-risk qualify for the procedure, Dr Husain said.