Anyone know anything about External Partial Breast Irradiation?

Harplu13

Has anyone had partial breast external radiation for pure DCIS?  Just met with my RO and he said I was a candidate for a trial on PBI or I could have the accelerated "Canadian" treatment of 3 weeks full breast with one week of boosts.  Not sure what to do.  I dont want to make a decision based on what is convenient for me, I want to make a decision based on what is best to prevent a recurrence.  So confused.....

ICanDoThis

I had IDC, but am likely to be one of the few people you meet who had external partial beam radiation - it's part of the same trial that Mammosite is in, but it is getting more attention now, as it has had no company with a financial interest in it, and now people have seen some problems with Mammosite.

I really liked only getting radiation for a week. I waited about 3 months for my mammogram, and I had pretty much had it with cancerland by the time I got to radiation.

The actual time on the table is a little longer, because they have to shoot a number of different angles, so you get radiation specifically on the spot where cancer was. They move you.

You get the same amount of radiation that you would get during regular radiation. But, you are in a trial, that means that there is no long term proof that it works. But I am 4 years out, and still fine. My rad onc has told me that the study results show that properly selected patients are doing as well as patients who do the whole 6 weeks.

Hope this helps

ej01

I had the external beam partial breast radiation too.  (not part of a trial).   I had a very small (3mm or less) spot of DCIS which was apparently all removed with the initial needle biopsy, because when i had my lumpectomy, the pathology did not find any evidence of cancer.   According to the radiologist the vast majority of reoccurances (maybe 80%...dont remember the exact % he told me) are in the area of the breast directly around the original tumor, which is why partial breast radiation makes sense.  They orignially talked to me about mamosite, but because of the location of my tumor (too close to the surface) this was not an option for me.  And because my cancer was on the left side I was not open to whole breast radiation, which would have had a greater chance of impacting heart/lungs.     The 2x per day, for 5 days was easy.  No real pain.  No skin discomfort or skin changes.  No fatigue (well I was tired one day but who knows why).    I agree with Sue that the long term recurrance stats are not available for this type of radiation, but, as Sue indicated the short term (5-10 years out) it seems to have similar impact on recurrance as the whole breast radiation.  For me the decision was easy, because I would have declined the WBI (I think) if that was my only radiation option. The EB-PBI radiation gave me a bit of extra protection with a risk profile that I was willing to accept.

When I looked at the advances in treating DCIS over the past 10-20 years, radiation changes seem to be the only place there are advances.  There are now a few different types of partial breast radiation that  are starting to gain some traction....the EB-PBI, IORT, Mamosite, and another one (cant remember the name).  Its nice to see that there at least have been some advances over the years.

Good luck with your decision. 

ee01

Where is this type of radiation being offered?

Harplu13

At Sloan-Kettering. At their outpost in Sleepy Hollow but I think it is available at their main hospital as well. Decided not to participate in the trial.

xocwjjb

I was offered external partial breast irradiation at CPMC in San Francisco.  If I remember correctly, the rad onc said that to date all the indications were that this was as effective as whole breast irradiation but simply because of the shorter time that the partial had been around, he could not say definitively that the two were equally effective.  He reckoned it would be about five years before there were sufficient data to say that without caveats.  Me, I decided to do the whole breast irradiation, but that was because after all the rational weighing of pros and cons, I went with my gut and my gut was driven by a family experience with another (non-breast) cancer.  Also, because I was told that whether partial or whole, I could not do radiation again in that breast if cancer recurred so I figured WTH might as well zonk any stray bugger lurking undisclosed.

Good luck with your decision, and I hope all goes well for you however you decide.

Caroline

ej01

ee01,   here is a link to the clinical trials for this.  It is being done at lots of locations.    http://www.cancer.gov/clinicaltrials/search/view?cdrid=409590&version=HealthProfessional

I did not participate in a clinical trial and had this treatment in Dallas, TX.  Where are you located?

ee01

I'm in Tucson, AZ.  What was your experience your experience with the EPBI?  Was it called "cyberknife"?  Was there any pain or cosmetic issues?  I had a lumpectomy for DCIS intermediate grade and apparently have some close margins.  I am going back in a couple of days to see my surgeon and expect that she will recommend either a reexcision, radiation therapy or both, so I want to be ready to understand all the possibilities of treatment.

ej01

ee01,   it was not called cyberknife.   I had 2 session per day (6 hours apart) for 5 days.  No pain or cosmteic issues.