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Internal radiation for breast cancer patients

Erasmus MC is the first hospital in Europe to provide internal radiation treatments to breast cancer patients. Patients no longer need to visit the hospital for weeks for radiation treatment but will be done in a single visit.

Disrupted
radioactieve zaadjesProfessor Jean-Philippe Pignol of Erasmus MC Cancer Institute's Department of
Radiotherapy introduced this therapy years ago in Canada. "A diagnosis of breast cancer is truly a life-changing event," says Prof. Pignol "These women's lives are completely disrupted when faced with surgery to remove the tumor, followed by four weeks of daily radiation treatments at the hospital. This new therapy enables breast cancer patients to undergo radiation treatment at home, where life can continue more or less as normal."

The treatment, known as 'Permanent Breast Seed Implants' (PBSI), involves implanting seeds (small titanium capsules) in the breast using a hollow needle. The seeds irradiate the tumor internally. The physician uses echo images and a CT scan to accurately determine the precise locations for the seeds. The treatment takes about an hour, and the patient can go home right away.

"A lumpectomy is always followed by a period of radiation treatment to destroy any remaining tumor cells," explains physician-researcher Gerson Struik. "Internal irradiation is not only more accurate, but it is also far more pleasant for patients. The entire procedure can be completed during just a single visit to the hospital."

Risk of recurrence
The accuracy of this method of irradiation significantly reduces the risk of recurrence of breast cancer. Follow-up research in Canada has shown a risk of about 1% of cancer returning in the same breast within five years. Moreover, the PBSI technique does not damage heart or lung tissue, and there is less skin damage compared to external irradiation. Research has also shown that the treatment is safe for the patient's partner, who is only exposed to a low dose of radiation that remains within the legal limits.

"PBSI treatment is ideally suited to women over 50 with a low-risk tumor whose lymph nodes are cancer-free," says Gerda Verduijn, a radiotherapist-oncologist who administers the treatment. Statistics show that younger breast cancer patients often have a more aggressive type of cancer, requiring irradiation of the entire breast.

Erasmus MC is offering this innovative treatment in combination with the Franciscus Gasthuis & Vlietland Hospital in the context of a study being conducted by physician-researcher Gerson Struik. He is looking into a method to reduce the potential skin damage caused by radiation. This involves injecting a liquid between the area to be irradiated and the skin, thereby improving PBSI treatment even further.

For further information, see the manufacturer's video.

Date published: 25 October 2017.

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