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Kambiz Dowlatshahi, MD; Howard C. Snider, MD; Mark A. Gittleman, MD; Cam Nguyen, MD; Phillip M. Vigneri, DO; Robert Lee Franklin, MD

Arch Surg. 2004;139:603-608.

Hypothesis  Partial-breast irradiation for carcinoma by a single source of radiation placed in the center of a balloon inserted in the lumpectomy cavity is an effective method of treating breast cancer. Previous interstitial radiation therapy using iridium seeds placed within multiple catheters has been shown to be effective but impractical and cosmetically unacceptable to women.

Design  Prospective registry study.

Setting  Three university and community hospitals.

Patients  Women 40 years and older with histologically diagnosed in situ and invasive T1 through T2 and N0 or N1 breast cancer treated with lumpectomy and axillary node sampling were invited to enter this institutional review board–approved study.

Main Outcome Measures  Evaluation of immediate and short-term complications, patients' acceptance of the treatment, and cosmesis are reported.

Results  Of the 129 eligible patients enrolled, 112 completed the treatment. Of these, transient skin erythema was noted in 28, localized edema in 3, and skin blisters adjacent to the balloon in 9. Infection developed in 7, necessitating drainage and antibiotic administration. In 10 patients, sonographically demonstrated seromas that developed after removal of the device were aspirated percutaneously. In 4 patients, punctured or ruptured balloons had to be replaced before the treatment could be completed. Patients quickly adjusted to the breast distension caused by the balloon, and their acceptance of the procedure was good. The cosmetic outcome was rated high. There were no recurrences during this very short follow-up.

Conclusions  Our early short-term experience indicates balloon brachytherapy to be an acceptable alternative to external beam radiation for selected operable breast cancers. The 1-week treatment time allows working women and those who live at a distance from radiation centers to choose breast conservation rather than mastectomy.

From the Departments of General Surgery (Dr Dowlatshahi) and Radiation Oncology (Dr Nguyen), Rush University Medical Center, Chicago, Ill; the Alabama Breast Center (Dr Snider) and Department of Radiation Oncology, Montgomery Cancer Center (Dr Franklin), Montgomery, Ala; and the Lanshe Breast Center (Dr Gittleman) and Center for Cancer Care (Dr Vigneri), Sacred Heart Hospital, Allentown, Pa.

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