For women with early-stage breast cancer who have undergone breast augmentation, lumpectomy followed by brachytherapy appears to be effective and to provide better cosmetic outcomes than lumpectomy followed by whole-breast radiation therapy. These results were presented at the annual meeting of the Radiological Society of North America in Chicago, November 30-December 5, 2008.

For women with early-stage breast cancer, surgery may involve either a lumpectomy or a mastectomy. Because a lumpectomy alone is associated with a higher rate of cancer recurrence within the breast than a mastectomy, patients who elect to have a lumpectomy are also treated with radiation therapy to the breast. Long-term survival is similar for women treated with breast-conserving therapy and women treated with mastectomy.[1]

For women with breast implants, whole-breast radiation therapy can result in the formation of scar tissue around the breast implant (a condition known as capsular contracture). This can be painful and can also distort the appearance of the breast. As a result, women with breast implants and breast cancer often undergo mastectomy with implant exchange rather than breast-conserving therapy.

Because brachytherapy provides radiation to a more targeted area of the breast, it may reduce the risk of capsular contraction and allow more women with breast implants to undergo breast-conserving therapy.

To evaluate the effects of lumpectomy followed by brachytherapy, researchers conducted a study among 65 women with small, early-stage breast cancers and breast implants.[2] 

After lumpectomy, the women were treated with brachytherapy in two doses per day over a five-day period.

Study participants have now been followed for between six months and five years.

• Thus far none of the women has experienced a cancer recurrence.
• All of the study participants had good or excellent cosmetic outcomes.
• None of the study participants experienced capsular contracture.

Comments: These results suggest that lumpectomy followed by brachytherapy is effective and associated with good cosmetic outcomes in women with breast implants. Women with breast implants and early-stage breast cancer may wish to talk with their doctor about the range of cancer treatment options that are available.

References:

[1] Poggi MM, Danforth DN, Sciuto LC, et al. Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial. Cancer. 2003;98(4): 697-702.

[2] Kuske R. Breast brachytherapy improves cosmetic outcome and reduces the risk of capsular contracture in breast conservation therapy for women with breast cancer in the presence of augmentation mammoplasty. Presented at the 2008 annual meeting of the Radiological Society of North America. Presentation SSC19-02.