Women with early-stage breast cancer who have undergone breast augmentation may be treated successfully with brachytherapy, according to a study presented at the annual meeting of the Radiological Society of North America (RSNA). Patients treated with brachytherapy have better cosmetic outcomes and avoid the risk of the implant hardening, compared to patients who undergo whole-breast radiation therapy.

"We are seeing an increasing number of breast cancer patients with augmentation," said Robert R. Kuske Jr., M.D., clinical professor at the University of Arizona Health Sciences Center and radiation oncologist at Arizona Oncology Services in Scottsdale, Ariz. "By nature, these women are concerned about their appearance and we need to have options for them."

Approximately one in eight women who undergo breast augmentation will develop breast cancer at some point in their lives.

The most common breast cancer treatment for patients with breast implants is skin-sparing mastectomy and implant exchange. Whole-breast radiation therapy after lumpectomy is an option, but carries a substantial risk of capsular contracture, which is both painful and distorts the appearance of the breast.

Dr. Kuske set out to determine if partial-breast radiation with brachytherapy might offer a better outcome for women with implants wishing to avoid mastectomy.

Breast brachytherapy can be given in higher doses to a small, targeted area of the breast after lumpectomy. Scar tissue is minimal, the implant remains unaffected and treatment time is shortened from 6½ weeks with whole-breast radiation therapy to five days with brachytherapy.

For the study, 65 women who were diagnosed with small, early stage malignant tumors were treated with brachytherapy after a lumpectomy. The women received two doses per day, separated by six hours, over a five-day period. Follow-up was six months to five years. None of the patients experienced tumor recurrence during the follow-up period. Cosmetic outcome was determined to be good to excellent in 100 percent of patients with 95 percent judged excellent. Implant hardening was not observed in any of the patients.

"Compared to traditional treatments, brachytherapy offers an excellent alternative for these women," Dr. Kuske said. "It offers very high rates of tumor control with fewer side effects and is easier on their lifestyle."