First report of a permanent breast 103Pd seed implant as adjuvant radiation treatment for early-stage breast cancer.
OBJECTIVE
A new technique of adjuvant partial breast irradiation using 103Pd permanent breast seed implants (PBSI) is presented. The procedure is performed in a single 1-hour session under local anesthesia.


METHODS
Patients referred to a single institution for adjuvant radiotherapy after lumpectomy for an infiltrating ductal carcinoma < or = 3 cm in diameter, surgical margin > or = 2 mm, no extensive in situ carcinoma, no lymphovascular invasion, and minimal or negative lymph node involvement were offered a PBSI.


RESULTS
Between May and December 2004, 31 eligible patients underwent CT scan and ultrasound simulations assessing PBSI feasibility. Fifteen were excluded because of feasibility issues, and 16 received PBSI. A minimal peripheral dose of 90 Gy was prescribed to the planning target volume corresponding to the clinical target volume identified on the CT scan plus a margin of 1 cm. The procedure was well tolerated; 56% of the patients reported no pain during the procedure, and 46% of the patients developed National Cancer Institute Common Toxicity Criteria Grade 1 acute reaction. None experienced toxicity Grade 2 or 3.


CONCLUSIONS
Permanent breast seed implantation seems feasible and well tolerated on these preliminary clinical data and represents an ultimate step in the reduction of treatment fraction for partial breast irradiation.
Pignol
Jean-Philippe
JP
Department of Radiation Oncology, Sunnybrook and Women's Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. Jean-Philippe.Pignol@sw.ca
Keller
Brian
B
Rakovitch
Eileen
E
Sankreacha
Raxa
R
Easton
Harry
H
Que
William
W
D001918:Brachytherapy / Q000379:methods*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D010147:Pain Measurement; D010165:Palladium / Q000627:therapeutic use*; D011868:Radioisotopes / Q000627:therapeutic use*; D018714:Radiotherapy, Adjuvant; D014057:Tomography, X-Ray Computed
D011868:Radioisotopes; D010165:Palladium