Permanent seed implants for breast cancer
A new radiation procedure that maximizes quality of life

Jean-Philippe Pignol, MD, PhD, FRCPC; Brian Keller, MSc;
Eileen Rakovitch, MD, MSc, FRCPC and Raxa Sankreacha, MSc

Today, due to mammography screening, a majority of women with breast cancer are diagnosed at an early stage. Treatment for many of these women includes breast-conserving surgery that removes the bulk of the tumour, followed by adjuvant irradiation for locoregional control.

 

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Top-line summary
Many women with early-stage breast cancer are treated with breast-conserving surgery followed by radiation. Standard whole breast external beam radiation therapy achieves the best results but is inconvenient and carries a risk of painful skin reactions. A number of methods for delivering partial breast irradiation have been developed, and usually offer improved convenience. This article describes a technique for delivering partial breast irradiation using permanent breast seed implants (PBSI) — which takes only 1 hour and requires no overnight stay in hospital — and summarizes procedures for assessing patient eligibility, seed implantation, and followup care. Results to date indicate good coverage of the targeted area, with excellent patient safety, tolerance and satisfaction. A registry is being formed so that the treatment can be offered to other women while results mature, especially regarding disease recurrence. Plans are under way to study PBSI in other centres and in treatment of women with ductal carcinoma in situ.
 
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