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HF 7596

Breast Brachytherapy (Multi-Catheters)

Breast brachytherapy is a radiation treatment used in early stages of breast cancer. Small plastic catheters (tubes) are placed into the breast at the site of the cancer. A radioactive seed travels into the catheters 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 will be sedated for your 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.

You may get a prescription for EMLA® cream. This cream numbs the skin. Apply to your breast 2 hours before the procedure. Cover the cream with a clear plastic dressing (Tegaderm® ) or Saran® wrap and tape. The dressing will keep the cream on your skin.

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®)

  • some herbal medicines.

Day of Catheter Placement

Before coming to the hospital:

  • Do not eat or drink anything 6 hours before the appointment.

  • Apply the EMLA® cream 2 hours before the procedure if told to do so.

  • Take Valium® as directed 1 hour before the procedure. If you do not take as prescribed, tell your doctor before the catheter placement. 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 earlier than the time you were given. 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 2 hours. Your breast will be cleaned before towels are placed around the site.

A template or plastic grid will be placed on either side of your breast. This guides the placement of the catheters.

7596 Figure 1

The doctor will numb your breast. Three brachytherapy needles will then be placed to secure the template. A CT scan will be done right after this to show your doctor the best place to put the rest of the catheters.

After the CT scan, the doctor will continue to numb your breast and insert needles. When all the needles are in place, the template is removed.

Next, plastic catheters are slid through each needle. The needles are then removed. A plastic tab (button) will hold each catheter in place.

7596 Figure 2

After this, a nurse cleans the skin around the catheter. A new dressing is applied and secured by a special support bra.

Afternoon of Catheter Placement

You will rest for about an hour. You will then have a planning CT scan. A CT scan is a computerized x-ray. It will help with making a treatment plan. This will take about 30-60 minutes. You may eat and drink liquids before the CT scan.

You may want to take at least one pain pill before your CT scan. During the planning session, the catheters will be touched and trimmed. They might be slightly sore and tender.

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.

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 the pain medicine if you need it. An ice pack on top of the dressings may help relieve the pain.

Restrictions

Follow these restrictions while you have the catheter.

  • Do not shower.

  • Do not get the dressings or catheters 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. Each treatment lasts about an hour. You will see a doctor each time. Your doctor decides on the total number of treatments. Most patients receive 3-8 treatments.

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.

Each catheter will be connected to the radiation treatment machine by a cable. The radioactive seed goes into each catheter until the treatment is complete. You will hear a whirring sound from the treatment machine. After the treatment is over, the cables will be removed. A nurse will clean the catheters and apply a new dressing before you leave.

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 catheters are radioactive. You are not a risk to your family and friends.

End of Treatment

After the last treatment, a nurse removes the catheters. Most often there is little or no pain or bleeding. The nurse teaches you how to care for yourself after treatment and provides supplies if needed.

Housing/Lodging

If you need to stay overnight in Madison during your treatments and would like help finding a local hotel at a discount rate, please contact our patient housing coordinator at 608-263-0315. 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

Toll-Free: 1 (800) 323-8942.

Ask for the Radiation Oncology Clinic.

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.