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Breast brachytherapy is a radiation treatment used in early stages of breast cancer. A plastic catheter (tube) is placed into the breast at the site of cancer. A radioactive seed travels into the catheter to deliver radiation directly to the cancer site. This limits the radiation to healthy tissues.
Before Catheter Placement
A nurse will call you 1 business day before your procedure. You will be told what time to arrive for your procedure. Tell the nurse about the medicines you take. Your nurse will tell you which medicines to take the morning of the procedure.
You may get a prescription for diazepam (Valium®). This is a sedative and anti-anxiety medicine. Pick up the medicine at your pharmacy. Follow instructions for taking on the day of the procedure. Do not drive after taking this medicine. You must have someone to drive you to and from the hospital.
Tell your doctor or nurse if you have allergies to any of these medicines:
diazepam (Valium®), lidocaine, epinephrine, contrast dye, or latex.
If you take any blood thinning medicines, talk with your doctor. These may need to be stopped at least 1 week before your procedure. This could include:
heparin,
warfarin (Coumadin®),
aspirin/products with aspirin (Ecotrin®, Excedrin®),
non-steroidal anti-inflammatory drugs (ibuprofen, Advil®, Motrin®, Aleve®, Nuprin®), and
some herbal medicines.
Day of Catheter Placement
Before coming to the hospital:
Do not eat or drink anything 6 hours before the appointment.
Take Valium® as directed 1 hour before the procedure. If you do not take this as prescribed, tell your doctor before the procedure. Do not drive or make important decisions until the day after taking this medicine.
Wear comfortable clothing. A button-down shirt will be easy to take off and put on.
Come to the hospital 15 minutes early. When you arrive, check in at Registration at UW Hospital. Then take the K elevators to Radiation Oncology Clinic (K4/B100).
About the Procedure
You will lie on your back for about 1 - 1 ½ hours. Your breast will be cleaned before towels are placed around the site. An ultrasound is used to find the space where your tumor was removed. This is called a lumpectomy cavity.
Your doctor draws on the skin to identify the lumpectomy cavity. The balloon catheter goes in this cavity.
After numbing your breast, your doctor makes a 1-inch cut and inserts the catheter. Ultrasound is used to do this. The balloon at the end of the catheter is deflated when inserted.
Once the catheter is in the right place, your doctor inflates the balloon. It fills the entire cavity. You may feel some pressure as the balloon is inflated. After that your doctor or nurse cleans your skin and applies a dressing.
After Catheter Placement
Next you will have a planning CT scan. A CT scan is a computerized x-ray. It will help with making a treatment plan. The CT scan takes about 20-30 minutes.
After the CT scan, a nurse cleans the skin around the catheter. A new dressing is applied and secured by a special support bra. You will get a schedule for your treatment times. You may eat and drink liquids after the CT scan.
If you have a treatment in the afternoon after catheter placement, you may leave the clinic or stay and wait for treatment.
If you do not have your first treatment on the day of catheter placement, you can go home after your planning CT scan.
Evening After Catheter Placement
The medicine you took before and during the procedure may make you feel tired. Plan to take it easy the rest of the evening.
You may have some pain when the numbing medicine wears off. This is normal. Your nurse will discuss pain medicine options with you. Take pain medicine if you need it. An ice pack on top of the dressings may help to relieve pain.
Restrictions
Follow these restrictions while you have the catheter.
Do not shower.
Do not get the dressings or catheter wet.
Do not remove the support bra.
The dressings may shift. Wash your hands before adjusting the dressings.
Your arm motion might be slightly limited. Avoid lifting more than 10 pounds with the arm on the treatment side.
If you would like to have your hair washed, we have a contract at William Jon Salon for you to pay $5 for a hair wash and dry when you are on treatment. If you are interested, call them at (608) 238-3334 to set up appointments once you know your treatment schedule. Ask us for a letter to give to them.
Radiation Treatments
Treatment schedules vary. You may have 2 treatments a day. There will be at least 6 hours between treatments. You will see a doctor each time. Your doctor decides on the number of treatments. Most patients have 3-10 treatments total. Each treatment lasts about 45-60 minutes.
Check in at Patient Registration in the hospital every morning of your treatment. Check in twice a day at the Radiation Oncology Clinic (K4/B100) before each treatment.
Before your morning treatment, you will have an ultrasound or a CT scan. You may or may not be scheduled for a CT or ultrasound before every treatment. This is to make sure the balloon catheter has not deflated or moved. If it has moved, your doctor will rotate it back into position.
There are smaller catheters inside the larger balloon catheter. These catheters connect to the radiation treatment machine by several cables. The radiation goes into each catheter until the treatment is complete. You will hear a whirring sound from the treatment machine. At the end of treatment, we remove the cables. A nurse cleans around the catheter and applies a new dressing.
Most people do not feel pain during the treatment. You will be alone in the room, but the staff can see you on a TV monitor and talk with you.
Neither you nor the catheter are radioactive. You are not a risk to your family and friends.
End of Treatment
After the last treatment, your doctor deflates the balloon and removes the catheter. Most often there is little or no pain or bleeding. You may want to take at least 1 pain pill before you arrive for your last treatment.
The nurse teaches you how to care for yourself after treatment and provides supplies, if needed.
Housing/ Lodging
If you need a place to stay in Madison during your treatments, contact our patient housing coordinator at 608-263-0315. They can help you find a local hotel at a discounted rate. Some local hotels offer shuttle service to and from the hospital.
Who to Call
Please call with questions or concerns.
Radiation Oncology Clinic
608-263-8500 or 1-800-323-8942
If the clinic is closed, you will reach the paging operator. Ask for the Radiation Oncology doctor on call. Leave your name and phone number with the area code. The doctor will call you back.
