New treatment can spare breast cancer radiation


It's been a month now since doctors removed a cancerous lump from Elysa Yanowitz's right breast, but unlike most women, she never returned for radiation.

"The day after the procedure, I was in Napa," she said.

The reason is that doctors gave her radiation during her surgery. The dose was delivered through a special device, inserted directly into her breast. It is part of a system, known as "targeted intraoperative radio-therapy," that's been under clinical trial at UCSF.

Dr. Michael Alvarado is a principal investigator.

"So this is done one-time, while the patient is asleep which is very new exciting," he said.

Alvarado explains surgeons select a rounded fitting of the same dimension as the lump that was removed. Working through the original incision, doctors deliver a targeted dose inside the cavity directly to the tissue that was surrounding the tumor.

Patients in the trial all had lower risk forms of breast cancer.

"So those types of women who have lower risk of recurrence instead of having three-to-five courses of radiation Monday through Friday daily, only one dose appeared to be adequate," Alvarado said.

Results of the international trial have been published in the journal Lancet. With about 2,000 women participating, the group that received traditional external radiation had a recurrence rate of slightly less than one percent.

The internal radiation group was just more than one percent.

While the rates are nearly identical for those low-risk cancers, the question remains whether the technique would work as well for larger or more aggressive tumors.

"Not every single patient will be qualified for this type of radiation, so it is a type of radiation that's done for a lower risk type of population," Alvarado.

And even those low-risk patients will have to accept the slightly elevated risk in exchange for the convenience of a one-time only dose.

Yanowitz says it was an important trade-off for her.

"I had personal reasons because I have a mother who's quite ill, and the thought of doing the alternative with radiation for a number of weeks would have taken more of a toll, both time and physically, and I needed to be with my mother," she said.

Investigators now hope to expand the trial within the U.S., in the hopes of expanding this one-time radiation option to more breast cancer patients.

The treatment takes about 20 to 30 minutes at the time of surgery and because it's delivered inside the breast, investigators say there is less chance of the radiation spilling over to other organs.

Written and produced by Tim Didion

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