NARTI First to Have Cancer Treatment

Northwest Arkansas Radiation Treatment Institute is the only facility in Arkansas to offer the MammoSite Radiation Therapy System procedure. It was approved by the Food and Drug Administration in 2002, and about 200 centers offer it in the United States.

Although 50 percent of early stage breast cancer patients still choose to have a mastectomy, the new procedure offers another option in the breast conservation therapy (BCT) route. BCT normally involves a tumor excision via lumpectomy followed by breast radiation therapy to reduce the risk of the cancer returning. MammoSite offers an alternative to traditional external beam radiation for breast cancer patients who choose to follow the BCT course.

“We have been using radiation for more than 100 years,” said Dr. Joe Ross, radiation oncologist at NARTI, “but this is just a new method of preserving the breast/curing the cancer in a shorter period of time.”

So far, an estimated 1,700 MammoSite treatments have been performed in the United States. NARTI began offering the treatment in May 2003 and has since completed eight treatments.

“It is beneficial to our patients because it condenses a six-week treatment down to a week and a half,” said Brian Holt, president and CEO of NARTI. “The radiation is contained within a certain area so a large dose can go right to a specified place.”

Traditional external beam radiation required the patient to return to the office once per day for six weeks. Because it is in a concentrated area, MammoSite risks less damage to healthy organs and tissue around the affected area and less skin reaction. Holt said the cost to each patient is around $30,000 and is normally covered by health insurance.

To administer the treatment, medical centers must have a high-dose radiology machine. After the patient has had the lumpectomy, the MammoSite balloon is placed in the breast. An outside catheter or applicator shaft is inserted into the breast and connected with the balloon two days prior to treatment, said Ross.

“Two days later we do a CAT-scan and check it,” Ross said. “We typically begin treatments the next morning.”

The small balloon is inflated with saline to fill the breast cavity and will remain inflated throughout the treatment. A radioactive “seed” is then inserted into the balloon during treatment. The balloon must be at least 7 millimeters or roughly 1/3 of an inch from the skin.

“If the tumor is too close to the skin then those patients cannot have the procedure,” said Dr. Joe Ross, radiation oncologist on staff at NARTI.

Patients receive the 7-8 minute treatment twice per day for a week and a half. Each time, an X-ray is performed to ensure the balloon is still the proper size and positioned correctly. Once the therapy is complete, the balloon is easily removed.

Not every breast cancer patient qualifies for MammoSite. They must be in the early stages of breast-cancer and have had a lumpectomy. The patients also have to be in a low-risk category for the cancer to spread. Women over 45 make better candidates.

“The big disadvantage to the treatment is that it doesn’t have a proven track record,” Ross said. “When long-term data is available, I think that more and more physicians will adapt this into their practices.”