Mammosite and you

So many things we have to decide when it comes to treating breast cancer with radiation therapy. It used to be so simple. After lumpectomy a woman underwent 6 weeks of daily radiation and that was that.

Oh, things have changed. And mostly for the better. But like everything else there is always more to the story. So, here is the story on partial breast radiation and mammosite.

Firstly, it is in widespread use and remains controversial. For select women it is an excellent option - but only if the patient understands the controversy, risks, and benefits and then decides it is for her.

What is the controversy? Read the New York Times recent article which does a great job of explaining. Read it here.

Basically, the track record is not long. It is based on data from few women compared to the standard treatment. And the device was "fast tracked" by the FDA which means it was not determined if it is actually effective at treating breast cancer. The fast track approval means the Mammosite was actually approved because it performed as advertised - it delivered radiation to the resection cavity. It was not approved because it was proven to be better or equal to the standard 6 week course of radiation.

Secondly, it is not for everyone. It should be offered to the selection of women who meet the strict criteria. This prevents placing women at increased risk of local failure, skin damage, lung/rib damage when a safer alternative is available.

Partial breast techniques include mammosite, other implant techniques/devices, external beam with 3D or IMRT and all should only be delivered in an institution with expertise and perhaps in a study setting. The informed consent should make sure the patient clearly understands the procedure is controversial, not tested in the long term, and the side effects may be differnet than the standard 6 week course of radiation.

On the other hand, for the women who are good candidates for mammosite it can be a great idea. I've used the mammosite personally with many women and generally it is well tolerated and side effects minimal.

The leaders in partial breast techniques in the country are doing a great service to women who may need or want this approach. But like anything else in this world - there is more to the story than meets the eye. Please read the NY Times article for more info - here.