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Radiation Therapies

Over the past decade, Weill Cornell breast surgeons, in collaboration with radiation oncologists, have been employing radiation therapy technology, including the most current intraoperative techniques, to treat certain types of breast cancer. These include:

Intraoperative Radiation Therapy

NewYork-Presbyterian/Weill Cornell is the first and only hospital in the five boroughs of New York City to offer women with early stage breast cancer INTRABEAM radiotherapy, an innovative radiation treatment delivered in a single dose at the time of surgery. Women with early stage breast cancer often have breast-conserving surgery, otherwise known as a lumpectomy, to remove a cancerous tumor. Lumpectomy is followed by a regimen of daily doses of radiation therapy to the entire breast, generally lasting six to seven consecutive weeks.

INTRABEAM radiotherapy may be an effective alternative to a six to seven week regimen following surgery for select patients because it allows precise targeting of any remaining cancer cells right inside the tumor bed, where the tumor is most likely to recur.

Immediately following removal of the tumor, while the patient is still on the operating table, the INTRABEAM applicator's small, cylindrical tip is placed inside the tumor cavity to deliver a superficial dose of radiation for 20-30 minutes, while limiting exposure to healthy surrounding tissue and organs. After the applicator is removed, the surgical incision is closed.

"Our ability to use this radiation technique in such a timely manner may add to its effectiveness since the area in need of treatment can be directly visualized at the moment the tumor is removed," say Dr. Alexander J. Swistel.

This alternative to conventional full-breast radiation therapy is in step with the Hospital's longstanding practice of tailoring partial breast cancer treatments to a growing number of patients with a small, early stage tumor. Eliminating an additional six to seven weeks of radiation therapy is particularly convenient for patients who do not live in close proximity to a hospital or an established radiation therapy facility.

With this targeted approach, which is collaboration with breast surgeons and radiation oncologists, there is no need for radiation therapy follow-up. However, if tissue samples removed during surgery prove more aggressive than preliminary tests revealed, the patient will still be able to undergo conventional full-breast radiation. Since the radiation is targeted and does not affect the entire breast, intraoperative radiation also allows a patient to have another lumpectomy with localized radiation if the tumor returns.

MammoSite Breast Treatment

This technique involves the insertion of a balloon catheter into the breast tissue immediately following removal of a tumor. The catheter is inflated and is used to deliver the radiation to the tissue that surrounds the space formerly containing the tumor. With this method, therapeutic doses of radiation can be delivered to breast tissue in a relatively short time -- typically over five days -- and with minimal discomfort, providing the patient with a full dose of radiation that would otherwise take six weeks. When treatment is complete, the catheter is then removed in an outpatient procedure.

CRYOABLATION THERAPY

"We are looking for a way to treat breast cancer in the future without surgery."
- Rache M. Simmons, MD, Chief of Breast Surgery, Weill Cornell Breast Center

At the forefront of ablating tumors with extreme temperatures -- now a viable option to treat fibroadenomas -- the Weill Cornell Breast Center is currently leading a multicenter National Institutes of Health trial to evaluate cryoablation therapy, which uses extreme cold to freeze and destroy small breast cancer cells, providing the possibility of avoiding surgery in the future.

Cryoablation is performed under local anesthesia. Guided by ultrasound imaging, the surgeon inserts a thin probe into the tumor within the breast. The probe causes the cancerous tumor to freeze and within minutes, the cancer is destroyed. The destroyed cells are later removed with surgery.

"This procedure is much easier for the patient," says Dr. Simmons. "It can be done in the surgeon's office and takes about 20 minutes." According to Dr. Simmons, pre-clinical studies have shown that freezing the cancer may release DNA into the body, which helps the immune system fight cancer throughout the body.

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