Better Treatment Options for Breast Cancer in Women with Implants

Women with early-stage breast cancer who have undergone breast augmentation may be treated successfully with a partial-breast radiation treatment that can be given in higher doses to a small, targeted area of the breast, claims a new study.

Researchers at the University of Arizona Health Sciences Center (AHSC, Tucson, USA) treated 65 women with breast implants who were diagnosed with small, early stage malignant tumors. The women were treated with brachytherapy following a lumpectomy. Radioactive seeds were image-guided into place via catheters, where they proceeded to emit high doses of radiation in short bursts. The women received two doses of radiation per day, separated by six hours, over a five-day period; follow-up was between six months to five years. The study results showed that none of the patients experienced tumor recurrence during the follow-up period. Cosmetic outcome was determined to be good to excellent in 100% percent of the patients, with 95% judged excellent. Implant hardening was not observed in any of the patients. The study was presented at the annual meeting of the Radiological Society of North America (RSNA) held during November-December 2008 in Chicago (IL, USA).

"We are seeing an increasing number of breast cancer patients with augmentation. By nature, these women are concerned about their appearance and we need to have options for them," said study presenter Robert R. Kuske Jr., M.D., a clinical professor at the AHSC. "Compared to traditional treatments, brachytherapy offers an excellent alternative for these women. It offers very high rates of tumor control with fewer side effects and is easier on their lifestyle."

Breast augmentation is the most popular cosmetic surgery in the United States, with 347,500 procedures performed in 2007. This represents an increase of 64% since the year 2000. Approximately one in eight women who undergo breast augmentation will develop breast cancer at some point in their lives. The most common breast cancer treatment for patients with breast implants is skin-sparing mastectomy and implant exchange. While whole-breast radiation therapy after lumpectomy is an option, it carries a substantial risk during the healing process of scar tissue wrapping around the implant, causing it to become rock-hard and extremely painful; this condition, known as capsular contracture, also distorts the appearance of the breast. With bracytherapy, however, scar tissue is minimal, the implant remains unaffected, and treatment time is shortened from 6 1/2 weeks with whole-breast radiation therapy to just 5 days with brachytherapy.

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University of Arizona Health Sciences Center