Radioactive Seeds May Offer Treatment Option for Breast Cancer
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"Here, we have been doing it for three years, and the cancer has not recurred in the breast of any women that we have treated," Kelly says. "The side effects have been minimal, and I think most of the women have been happy that they choose it." Kelly has used this procedure on about 25 women in the past three years.
While it is not yet considered a standard of care for breast cancer in any way, Kelly says, "I think it's almost at a point where it may be offered as a routine option. There still are ongoing trials and still will be future trials, but we are getting to a point where it can be done off-trial."
There are some side effects of brachytherapy, including risk of infection and breast swelling, but they are generally not significant, says Michael Zelefsky, MD, chief of brachytherapy in the department of radiation oncology at Memorial Sloan-Kettering Cancer Center in New York City.
Zelefsky also has been using brachytherapy for selected women with breast cancer. "There have been substantial experiences from France where brachytherapy has been used for recurrent cancers after standard treatment has been tried," he tells WebMD. "In these situations, it is used for a further attempt at breast preservation.
"The results have been very good," he says. "If the treatments don't work, mastectomy can always be used as a salvage procedure after brachytherapy.
"Theoretically, the brachytherapy can be used as a treatment for primary disease after lumpectomy," says Zelefsky, but he stresses that this is by no means the standard of care for initial breast cancer. Mulrain did not undergo any surgery.
Still, many U.S. breast cancer experts are not sure what role brachytherapy should play in breast cancer treatment.
"The data are not available, and we are not sure how effective brachytherapy is for breast cancer," says Mitchell Gaynor, MD, medical director and director of medical oncology at the Cornell Center for Complementary and Integrative Medicine in New York City.
Sandra Swain, MD, acting branch chief of the medicine branch in the division of clinical sciences at the National Cancer Institute in Bethesda, Md., agrees. "Most people in the U.S. are not doing it," she says. "It is not the wave of [the] future and involves a lot of radiation precautions."