Placement of radiotherapy after loading brachytherapy catheters (multiple tube and button type) into the breast for interstitial radioelement application following (at the time of or subsequent to) partial mastectomy, includes imaging guidance
CPT4 code
Name of the Procedure:
Placement of Radiotherapy After Loading Brachytherapy Catheters (Multiple Tube and Button Type) into the Breast for Interstitial Radioelement Application Following Partial Mastectomy, Includes Imaging Guidance.
Summary
This procedure involves inserting special tubes and buttons (called catheters) into the breast tissue where a partial mastectomy has been performed. These catheters are used to deliver targeted radiation therapy, known as brachytherapy, to treat remaining cancer cells. Imaging is used to guide the placement of these catheters to ensure accuracy.
Purpose
Medical Condition
This procedure addresses the presence of residual cancer cells in the breast after a partial mastectomy.
Goals
- Target and kill remaining cancer cells.
- Minimize radiation exposure to surrounding healthy tissue.
- Reduce the risk of cancer recurrence.
Indications
- Patients who have undergone partial mastectomy for breast cancer.
- Patients with residual cancer cells in the breast tissue.
- Suitable for patients with early-stage breast cancer.
Preparation
- Fasting may be required if sedation is used.
- Medication adjustments might be necessary as advised by the physician.
- Pre-procedure imaging (e.g., mammogram, ultrasound, or MRI) may be conducted to plan the catheter placement.
Procedure Description
- Pre-procedure Imaging: Guidance is performed using imaging techniques to map the precise area for catheter placement.
- Anesthesia: Local or general anesthesia is administered, depending on the case.
- Insertion: Multiple catheters (tubes and button type) are inserted into the breast tissue at specific locations.
- Verification: The positions of the catheters are verified using imaging to ensure accurate placement.
- Radioactive Seeds: Once the catheters are appropriately placed, radioactive seeds are loaded into the catheters.
Radiotherapy Delivery: Radiation is delivered directly to the targeted tissue through the catheters over a specified time period.
Duration
The entire procedure typically takes several hours, depending on the complexity and number of catheters required.
Setting
This procedure is usually performed in a hospital or dedicated outpatient surgical center equipped with radiotherapy facilities.
Personnel
- A surgical oncologist or radiologist performs the procedure.
- A radiation oncologist oversees the radiotherapy.
- Nurses assist with the procedure and patient care.
- An anesthesiologist administers anesthesia, if necessary.
Risks and Complications
- Common: Bruising, swelling, discomfort at the catheter site.
- Rare: Infection, bleeding, accidental damage to surrounding tissues, misplacement of catheters, radiation-related side effects.
Benefits
- Precisely targets cancer cells, reducing likelihood of recurrence.
- Enhances the effectiveness of breast cancer treatment.
- Minimizes exposure and damage to surrounding healthy tissue.
Recovery
- Patients might experience some pain or discomfort, managed with prescribed medications.
- Recovery time is typically a few days to a week.
- Instructions may include care for the catheter site and limited physical activity.
- Follow-up appointments are necessary to monitor healing and effectiveness.
Alternatives
- External beam radiation therapy: Less invasive but may affect surrounding tissue more extensively.
- Chemotherapy: Systemic treatment but can have more significant side effects.
- Hormonal therapy: Depending on the type of breast cancer, this might be an option.
- Observation: In some cases, monitoring the condition without immediate further treatment may be considered.
Patient Experience
- During the procedure: Patients might feel pressure or mild discomfort, especially if local anesthesia is used.
- After the procedure: Pain and swelling at the catheter site are common but manageable with pain relief measures.
- Most patients can return to their normal routine within a few days, following post-procedure care instructions closely.