title: Descriptions and outcomes of insertion techniques of a breast brachytherapy balloon catheter in 1403 patients enrolled in the American Society of Breast Surgeons MammoSite breast brachytherapy registry trial.
abstract: BACKGROUND
  The use of the MammoSite brachytherapy balloon catheter is 1 option for the delivery of accelerated partial breast irradiation during breast cancer therapy. The device can be inserted into the breast using 3 different techniques. This report describes these methods of insertion and correlates the technique with outcome data collected in a multi-institutional registry trial.
  
  
  METHODS
  In the registry trial, MammoSite catheters were inserted either (1) at the time of lumpectomy into an open cavity, (2) after surgery with ultrasound guidance through a separate small lateral incision into a closed cavity, or (3) after surgery by entering directly through the lumpectomy wound (the scar entry technique). Device placement techniques in 1403 patients with early stage breast cancer treated at 87 institutions by 223 different investigators were documented in the registry. Data collected included number of cases of each technique, age of patient, tumor size, skin spacing, catheter pull rates and reasons, infection, radiation recall, cosmesis, and recurrence.
  
  
  RESULTS
  Catheter placement at the time of lumpectomy was performed in 619 patients (44%), after surgery with ultrasound guidance in 576 patients (41%), and the scar entry technique technique in 197 patients (14%). The type of technique was not associated with age of patient, tumor size, bra size, catheter size, skin spacing, infection, radiation recall, cosmesis, or recurrence. There was a statistically significant increased incidence of premature catheter removals for pathologically related reasons with the open-cavity technique compared with the 2 postoperative methods secondary to final histology reports disqualifying the patient after MammoSite placement.
  
  
  CONCLUSIONS
  These registry data show that the MammoSite catheter can be inserted with any 1 of 3 different techniques. A postoperative placement, after the final pathology report is issued, decreases the incidence of premature removal of the catheter because of disqualifying pathology.
authors.affiliation: Breast Care Center of the Southwest, 2525 W. Greenway, Suite 130, Phoenix, AZ 85023, USA. zannis@worldnet.att.net
authors.forename: Victor
authors.initials: V
authors.lastname: Zannis
authors.forename: Peter
authors.initials: P
authors.lastname: Beitsch
authors.forename: Frank
authors.initials: F
authors.lastname: Vicini
authors.forename: Coral
authors.initials: C
authors.lastname: Quiet
authors.forename: Angela
authors.initials: A
authors.lastname: Keleher
authors.forename: Delia
authors.initials: D
authors.lastname: Garcia
authors.forename: Howard
authors.initials: H
authors.lastname: Snider
authors.forename: Mark
authors.initials: M
authors.lastname: Gittleman
authors.forename: Henry
authors.initials: H
authors.lastname: Kuerer
authors.forename: Eric
authors.initials: E
authors.lastname: Whitacre
authors.forename: Patrick
authors.initials: P
authors.lastname: Whitworth
authors.forename: Richard
authors.initials: R
authors.lastname: Fine
authors.forename: Bruce
authors.initials: B
authors.lastname: Haffty
authors.forename: Alan
authors.initials: A
authors.lastname: Stolier
authors.forename: John
authors.initials: J
authors.lastname: Mabie
mesh_terms: D000368:Aged; D001706:Biopsy; D001918:Brachytherapy / Q000295:instrumentation / Q000379:methods*; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000532:radiotherapy*; D020878:Device Removal; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome