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"For those patients who have small tumors that are completely removed with a lumpectomy and have no evidence of [cancer] in the lymph node, it's an outpatient procedure," says Dr. Tina Hieken, a Mayo Clinic surgeon.
Patients leave the operating room the same day as surgery with a catheter in place, which is used to administer a type of radiation therapy called brachytherapy. "Treatments are delivered over five weekdays, twice a day, approximately six hours apart, for a total of 10 treatments," says Dr. Sean Park, a Mayo Clinic radiation oncologist.
Brachytherapy itself is not new, but this fast-track treatment option, developed by Dr. Park and Dr. Hieken, is. The expedited brachytherapy treatment process is for low-risk, early-stage breast cancer patients and involves a single surgery.
First, special dyes are injected to identify any cancer cells that may have spread beyond the tumor site. That allows a pathologist to immediately screen the lymph nodes under the arm, and a safe margin of tissue around the tumor, while the patient is still under anesthesia.
Once the all-clear is given, the surgery continues with a second incision to insert the brachytherapy catheter and expand it, filling the lumpectomy cavity.
The very next day, the patient's radiation plan is mapped out. The following morning, a computer-controlled robotic machine then manipulates a single radioactive seed, smaller than a grain of rice, within the implanted catheter. The seed stops at different locations for varying amounts of time, thus shaping the radiation dose.
Unlike externally-delivered radiation, brachytherapy strikes the target area more precisely, without passing through healthy tissues.
It's hoped the expedited brachytherapy option encourages more women to receive the full benefit of their recommended post-surgery radiation. Dr. Hieken says the completion rate for breast cancer patients, in general, may be as low as 60 to 70 percent.