University of Maryland Medical Center is first in Baltimore area to offer MammoSite
The University of Maryland Medical Center is the first hospital in the Baltimore area to offer a targeted "internal" radiation therapy called MammoSite to patients with early-stage breast cancer who choose to have lumpectomies. Approved by the U.S. Food and Drug Administration last year, the MammoSite system delivers high-dose radiation directly to the site where the tumor was removed, targeting the area where the cancer would most likely recur and sparing nearby healthy tissue.
"We are very excited to be the first in the Baltimore area to offer this new internal treatment option to women with breast cancer who are confronting difficult choices regarding their care," says William F. Regine, M.D., professor and chairman of the Department of Radiation Oncology at the University of Maryland School of Medicine and chief of radiation oncology at the University of Maryland Medical Center.
He says that MammoSite, used in conjunction with conventional "external beam" radiation, cuts the length of daily radiation treatment following surgery from seven weeks to five weeks. Patients can receive a higher dose because the radiation is concentrated in one area.
"MammoSite represents the next generation of internal radiation therapy. It is minimally invasive, has been shown to be safe and can be performed as an outpatient procedure. Patients tolerate the treatment very well," Dr. Regine says.
With the MammoSite system, doctors place a thin spaghetti-like catheter with a balloon on the end into the cavity created by the lumpectomy. The balloon is inflated with saline solution, and then a radioactive "seed" that is attached to a thin wire is threaded through the catheter into the balloon, where it remains for only a few minutes until the wire is withdrawn. The catheter is removed after the final treatment, and no radiation remains in the body.
"This technology is much more patient-friendly than conventional internal radiation therapy for breast cancer, in which radioactive seeds and 14 to 20 catheters are placed in the breast for each treatment. This is a simpler, much more localized treatment, with less risk of bleeding," Dr. Regine says.
Internal radiation therapy, or brachytherapy, has been used successfully for years to treat prostate, gynecologic, lung, soft tissue and many other types of cancer. It has been used only sporadically to treat breast cancer, but may now be much simpler due to the ease of inserting a single, flexible catheter that allows outpatient treatment.
Dr. Regine says that with further study, MammoSite might eventually eliminate the need to expose the entire breast to radiation, which would cut the treatment time even more dramatically. The device's manufacturer, Proxima Therapeutics, Inc., has marketed MammoSite as a five-day therapy, with patients receiving treatments twice a day. But since this is a new therapy, doctors may choose to use MammoSite alone or in conjunction with other treatment.
The company has established a national registry to track how well patients fare over the coming years. To date, more than 280 patients have enrolled in the data collection program.
At the University of Maryland Greenebaum Cancer Center, doctors are using MammoSite to boost conventional radiation therapy. Patients receive two MammoSite treatments over a day and a half, followed by five weeks of daily radiation treatments to the whole breast.
MammoSite may make it easier for some women with breast cancer to choose to have a lumpectomy, followed by radiation therapy, rather than undergoing a mastectomy. Recent studies have shown that patients with early-stage breast cancer who have lumpectomies have the same success rate as those who have a modified radical mastectomy to remove their breast. But an estimated 50 percent of women diagnosed with early-stage cancer still choose to have a mastectomy.
According to the American Cancer Society, breast cancer is the second-leading cause of cancer death in women. More than 255,000 women will be diagnosed with breast cancer this year in the United States, with 55,700 of them found to have early-stage cancers. Now, with the availability of MammoSite, many patients with early-stage breast cancer have a treatment option that may improve their quality of life while they are receiving state-of-the-art radiation therapy.