Acute toxicity of high-dose-rate intracavitary brachytherapy with the MammoSite applicator in patients with early-stage breast cancer.
BACKGROUND
Intracavitary brachytherapy with the MammoSite applicator as the sole radiation treatment in breast-conserving therapy is an option for women with early-stage breast cancer; we evaluated the acute toxicities associated with this treatment method.


METHODS
Thirty-one patients with 32 stage I or II breast carcinomas underwent breast-conserving therapy, which included lumpectomy with negative margins, sentinel node biopsy, or axillary dissection, followed by brachytherapy with the MammoSite applicator. Acute radiation skin complications were graded on the day of radiotherapy completion and at weeks 2, 4, 6, and 12 after radiation treatment. Cosmesis was graded on the Harvard Scale at all follow-ups.


RESULTS
The median follow-up was 11 months (range, 4-15 months). Twenty-seven of the 31 patients were treated with the device as the sole method of radiotherapy. No acute toxicities occurred during the 5 days of treatment. Nineteen patients (68%) had no to mild acute skin reactions, and 25% developed bright erythema and patchy moist desquamation. Two patients (7%) developed confluent moist desquamation within the first 4 weeks (grade 3); this healed by week 12. All skin reactions were localized to the area overlying the balloon. Sixteen percent (5 of 32) of all breasts with implants developed infection. Cosmesis was good to excellent in 86% of cases.


CONCLUSIONS
Most acute skin toxicities were mild. Our infection rate was higher than in prior studies that used interstitial brachytherapy. Cosmesis was good to excellent in most patients. Breast brachytherapy with the MammoSite catheter was well tolerated; further investigations of breast brachytherapy with this system are warranted.
Richards
Gregory M
GM
Department of Radiation Oncology, St. Vincent's Comprehensive Cancer Center, 325 W. 15th Street, New York, NY 10011, USA.
Berson
Anthony M
AM
Rescigno
John
J
Sanghavi
Seema
S
Siegel
Beth
B
Axelrod
Deborah
D
Bernik
Stephanie
S
Scarpinato
Vincent
V
Mills
Christopher
C
D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000601:surgery; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002404:Catheterization / Q000009:adverse effects; D005260:Female; D049671:History, 18th Century; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011832:Radiation Injuries / Q000453:epidemiology*; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome