title: Cosmetic outcome and incidence of infection with the MammoSite breast brachytherapy applicator.
abstract: We present our results regarding the cosmetic outcome achieved and the rate of infection using the MammoSite breast brachytherapy applicator to treat patients with partial breast irradiation. In addition, factors associated with cosmetic outcome and infection are analyzed. The study population consisted of 30 patients with early stage breast cancer treated using the MammoSite device from October 28, 2002, to February 13, 2004. Cosmetic outcome was analyzed for its association with the following parameters: volume of the balloon, balloon-to-skin distance, maximal skin point dose per fraction, V100 (percent of volume that received 100% of the prescription dose), V150 (percent of volume that received 150% of the prescription dose), and V200 (percent of volume that received 200% of the prescription dose). The occurrence of infection at the time of treatment and during follow-up was also recorded. At a median follow-up of 13 months (range 1-16 months), 53.3% of the patients (16/30) were reported to have an excellent cosmetic outcome and 40.0% (12/30) had a good cosmetic outcome. Excellent cosmetic outcome was associated with a greater mean balloon-to-skin distance compared to those who achieved a good cosmetic outcome (1.5 cm versus 1.2 cm) (p = 0.164). The mean V100, V150, and V200 of those in the excellent cosmetic outcome group were 92.1%, 34.5%, and 7.6% versus 93.0%, 34.7%, and 7.6% in the good cosmetic outcome group (p = 0.642, 0.926, and 0.853), The mean balloon volumes were 47.7 cm3 and 56.9 cm3, respectively (p = 0.063) in the excellent and good outcome groups. The mean maximal skin doses per fraction in the excellent and good outcome groups were 354.8 cGy and 422.3 cGy (p = 0.286), respectively. Infection occurred in 13.3% of the patients (4/30). An excellent or good cosmetic outcome was achieved in 93.3% of patients and infection occurred in 13.3% of patients treated with the MammoSite breast brachytherapy applicator. Excellent cosmetic outcome was associated with a greater balloon-to-skin distance, lower maximal skin dose per fraction, and smaller mean balloon volume; however, the results did not reach statistical significance.
authors.affiliation: Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois 60612, USA. atd22_99@yahoo.com
authors.forename: Adam
authors.initials: A
authors.lastname: Dickler
authors.forename: Michael C
authors.initials: MC
authors.lastname: Kirk
authors.forename: Julia
authors.initials: J
authors.lastname: Choo
authors.forename: Wen Chien
authors.initials: WC
authors.lastname: Hsi
authors.forename: James
authors.initials: J
authors.lastname: Chu
authors.forename: Kambiz
authors.initials: K
authors.lastname: Dowlatshahi
authors.forename: Darius
authors.initials: D
authors.lastname: Francescatti
authors.forename: Susan
authors.initials: S
authors.lastname: Shott
authors.forename: Cam
authors.initials: C
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology*; D001918:Brachytherapy / Q000009:adverse effects* / Q000295:instrumentation*; D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D015331:Cohort Studies; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D011832:Radiation Injuries / Q000175:diagnosis / Q000453:epidemiology; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome