Mammosite Rad vs. 6 wk Rad.??

There are plusses and minuses to both. I don't think I've ever read of someone having Mammosite (or Savi, or Contura) who was sorry she did that instead of WBI. But I've read remarks from a lot of women who had WBI who wished they could have had Mammosite. 

If you have Mammosite you won't be able to shower while it's in place, and there's some discomfort involved. I've suggested to some women that they plan to go to a salon and get their hair washed one or two times while the balloon is in place. 

In trying to decide for myself, I learned from my radiation oncologist that although mammosite is showing the same results as whole breast radiation, the difference is being somewhat age dependant.  What  was explained to me was that we have had mammosite available almost ten years, and initially it was done on women either 60 or 65 years old and older.  As it proved successful, they would lower the age that would be eligible.  I am 48 years old, and he said that we have much more data available showing the effectiveness of older women and not much long term data proving effectiveness for younger women.  He felt that ten years from now we will probably see that it will be as effective as whole breast radiation, but for now the data is not there.  Whole breast radiation has been done and studies to prove its effectiveness has been done for decades now.  Although, mammosite would certainly have been more convenient, I decided for whole breast radiation.  I even asked him if it were his wife and she was my age which would he prefer her to get, his response was he would want he to have whole breast radiation.

1942Kathy - I am 56 and was offered Mammosite rads last year after my lumpectomy.  My BS inserted the balloon catheter in his office in about 20 minutes and I was off to the RO for my simulation.  After trying for 3 days to get the balloon to fit properly in the lump cavity - we had to pull it out and proceed with whole breast rads.  Even though mammosite rads have been available for many years, in some places it is still considered experimental.  There is not enough information out there yet.  You have to meet certain criteria to even be eligible.  The actual success rate is not high as there are other factors that can get in the way - infections, etc.  Once the balloon was removed, I had to wait an additional 3 weeks for the scar to heal before I could get started.  Bottom line is the decision is entirely yours and I am certain you will make the one that you feel is the best for you.

An additional note:  I did 30 rad treatments and did not have too many side effects.  I did get a bit red - expected that as I am light skinned.  I do have permanent nerve damage from rad treatments but this can also happen with the mammo rads.  Please PM me anytime if you would like to hear more of my story. 

My onc pointed out that tumors are not always perfectly shaped to get equal doses of radiation w/ mammosite. But if there is another tumor in the same breast, the mammosite can possibly be repeated, while the whole breast rad cannot.  Also, where was the tumor?  Was it close to the chest wall or not? How much of the chest will be involved?  No answers  here but those are some of the considerations I made. Good luck with your surgery and your decision.

ps. My onc said the same thing, that mammosite may ultimately be the standard of care but he said that it was approved for use as a "procedure" which means it "does no harm" and that docs can charge for putting it in and taking it out.  

I finished brachytherapy a week ago. I meet all the criteria listed in the post above by redsox except that I am only 58. My extremely experienced breast surgeon believes that for women like me, it has the best chance of knocking out any leftover tumor cells (in spite of my good margins) while not attacking healthy cells, skin cells, and lymph nodes.

To answer a couple of specific issues raised above, I would say that if you are going to do this, do it with a surgeon who's experienced with it and has the ultrasound to guide placement of the balloon catheter. The wires are placed inside the balloon in a way to avoid irradiating the ribs or inside of the skin. I would absolutely ask about their infection rate. My radiation oncologist hasn't had an infection for three years. You don't want to take any more risk than you have to -- this thing is like a freeway into your chest, an open wound for 5 days.

 It is very efficient, and I would definitely do it again, rather than external radiation. That is partly because of work considerations... 6 or 7 weeks of 5x a week would have been terribly hard for me.

However, I underestimated how much the process would bother me. A steady regimen of ibuprofen (ask your doctor how many to take) was necessary for me to manage the constant mild discomfort. I had someone drive me on the first couple of days and that was important... Day One was exhausting (my husband said it lasted a month and I agreed). I didn't sleep very well with the catheter in me and sticking out one side. From the combination of that and the radiation, I was fatigued on Days 4-5 and through the weekend. Other than tiredness, the actual treatments after Day One are very quick and painless. At a week or so after finishing treatment, and about 3 weeks after my lumpectomy, I've just about got my energy back.The insertion site has been very healthy the whole time and it's healing up but the area is still tender and I'm still taking ibuprofen for it.

 Good luck with your decision and all your treatment. I hope this helped.

I just finished my 5-day treatment with the SAVI. I am so glad i chose this instead of traditional 6-week radiation. I was the first patient at IU in Indianapolis to receive treatment with the SAVI and two reps from the company came and oversaw my treatment. No pain from putting the device in, no pain from the treatment and no pain upon removal. One of the disadvantges of the MAMMO site is they can't custom design your treament. It radiates the whole tumor space. My SAVI had nine individual cathethers and each one was custom programmed to my tumor. If it is close to the skin I believe they can even not send radiation to that catheter.