19296 Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy

Name of the Procedure:

Placement of Radiotherapy Afterloading Expandable Catheter (Single or Multichannel) into the Breast for Interstitial Radioelement Application

Summary

This procedure involves placing a specialized catheter into the breast tissue, which can later be filled (or "afterloaded") with radioactive material to deliver targeted radiation therapy. This typically follows partial mastectomy surgery and includes the use of imaging guidance for accurate placement.

Purpose

• Medical Condition: This is used for patients who need targeted radiation therapy after undergoing a partial mastectomy to treat breast cancer.
• Goals: The primary goal is to precisely deliver radiation to the area where the tumor was removed, minimizing exposure to surrounding healthy tissue, and thereby reducing the risk of cancer recurrence.

Indications

• Presence of breast cancer treated with a partial mastectomy.
• Need for targeted radiation therapy to reduce the risk of recurrence.
• Suitable patient anatomy and health status for catheter placement and radiotherapy.

Preparation

• Fasting may be required for several hours before the procedure.
• Adjustment of certain medications as advised by the healthcare provider.
• Pre-procedure imaging tests like a mammogram, ultrasound, or MRI to plan the catheter placement.
• Blood tests to check overall health and readiness for the procedure.

Procedure Description

1. Anesthesia: Local or general anesthesia is administered to minimize discomfort.
2. Imaging Guidance: Imaging techniques such as ultrasound or CT scans are used to guide the precise placement of the catheter.
3. Insertion: A small incision is made in the breast, through which the expandable catheter is inserted into the tissue where the tumor was located.
4. Expansion: The catheter is expanded to fit the cavity and to allow for optimal distribution of the radioactive material.
5. Secure Placement: The catheter is secured in place, ensuring it will not move.
6. Closure: The incision is closed, usually with sutures.

Duration

The procedure typically takes 1 to 2 hours to complete.

Setting

The procedure is usually performed in a hospital or a specialized surgical center.

Personnel

• A surgical oncologist or interventional radiologist performs the procedure.
• Anesthesiologist if general anesthesia is used.
• Nurses and radiology technicians to assist with imaging guidance and patient care.

Risks and Complications

• Common risks include bruising, bleeding, and infection at the incision site.
• Rare complications can include:
  • Anesthesia reactions
  • Injury to nearby nerves or tissues
  • Difficulty in catheter placement
  • Discomfort or pain

Benefits

• Targeted radiation reduces exposure to healthy tissue.
• Lower risk of cancer recurrence.
• Faster recovery and fewer side effects compared to traditional radiation therapy.

Recovery

• Patients may need to stay in the hospital for observation for a few hours post-procedure.
• Pain management may include prescribed medications.
• Avoid strenuous activities and heavy lifting for a few days.
• Follow-up appointments for catheter care and commencement of radiotherapy.

Alternatives

• Traditional external beam radiation therapy.
• Chemotherapy.
• More extensive surgical options like full mastectomy.
• Each alternative has its own benefits and risks which should be discussed with the healthcare provider.

Patient Experience

• Mild discomfort and bruising at the catheter site post-procedure.
• Pain can be managed with medication.
• Some patients may experience a sense of pressure or fullness in the breast area.
• Gradual return to normal activities as advised by the physician.