New Technology for Breast-Conserving Treatment

A new technology designed to deliver localized, nonradioactive radiation treatment directly to cancer sites may considerably increase access to radiation treatment, and therefore, the demand for breast-conserving therapy, according to a multidisciplinary panel of physicians, who presented their findings at the annual meeting of the American Society of Breast Surgeons (ASBS), held in Los Angeles (CA, USA) in April 2005.

The panel stressed that breast surgeons and radiation oncologists must work together to educate women about breast-conserving treatment alternatives, and in so doing, effectively provide all of the clinical benefits associated with partial breast irradiation to an even greater percentage of patients with breast cancer.

"While surgeons and radiation oncologists approach the treatment of breast cancer from different points of view, we share one crucial and common goal--the precise targeting of the tumor to obtain the greatest clinical outcome,” said Darius Francescatti, M.D., assistant professor, Rush University Medical Center (Chicago, IL, USA). "Despite a growing body of research that unequivocally demonstrates the efficacy of breast-conserving therapy in conjunction with radiation therapy, tens of thousands of women still opt for a mastectomy or lumpectomy without radiation. It is important that surgeons and radiation oncologists work together to provide their breast cancer patients with the best treatment possible.”

The panel was sponsored by Xoft, Inc. (Freemont, CA,USA), developer of the Axxent electronic brachytherapy system, a proprietary platform designed to deliver nonradioactive, isotope-free radiation treatment in any clinical setting under the supervision of a radiation oncologist. According to Vivek Mehta, M.D., director for the Center of Advanced Targeted Radiation Therapy at the Swedish Center Institute (Seattle, WA, USA), "Electronic brachytherapy was designed to leverage the clinical benefits of traditional brachytherapy and external beam radiation while reducing the time required to deliver therapy from seven weeks to five days. The specific technology is still investigational, but we expect it could be a treatment that is convenient for both the patients and the oncology treatment team.”

The system uses disposable microminiature x-ray radiation sources to deliver the treatment. Designed to deliver electronically generated ionizing radiation directly to tumor beds, this localized approach minimizes exposure to the patient's healthy tissue to damaging radiation. An advantage is that it also minimizes radiation exposure to the treatment staff. Users can control the energy level, allowing more flexibility than an isotope-based brachytherapy system. Because this portable system does not require a shielded environment, it can be used in nearly any clinical setting.

In its first indication for use, the Axxent provides both the patient and the radiation oncologist the opportunity to reduce the time required for radiation therapy for early stage breast cancer from seven weeks (for external beam radiation therapy) down to five days. As a result, patients will have greater access to therapy that is delivered more conveniently and easily. This may increase the choice for breast-sparing lumpectomy surgery over the alternative full mastectomy (which does not require a long course of radiation).

This is the first system designed for use in accelerated partial breast irradiation for the treatment of early stage breast cancer, providing a therapeutic dose of intracavity radiation directly to the area at risk without the complicated handling and resource logistics necessary when performing brachytherapy using radioactive isotopes.


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