BrachyBytes
In This Issue
Use of APBI in Patients with CVD
APBI & CVD Patients in the Literature
First Male Patient Treated with SAVI in Texas
BrachyBytes Editorial Advisory Board
Deanna Attai, M.D.
Robert Kuske, M.D.

Jay Reiff, Ph.D.
Dan Scanderbeg, Ph.D.
Catheryn Yashar, M.D.
Vic Zannis, M.D.
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January 2012

Use of APBI in Patients with Collagen Vascular Disease  

S. Eric Olyejar, MD

The use of radiation therapy in patients with breast cancer and collagen vascular disease (CVD) is quite controversial. Current data indicate that in the presence of CVD, whole breast irradiation poses an increased risk of acute and chronic toxicities, including fibrosis, poor wound healing and inferior cosmesis. As a result, many physicians view radiation therapy to be contraindicated in patients with CVD, leaving mastectomy as the only surgical option.

However, a paper published in Brachytherapy presents a possible alternative for patients who have a strong desire for breast conserving treatment. Researchers examined the use of accelerated partial breast irradiation (APBI) via high-dose-rate (HDR) brachytherapy – including toxicity and cosmesis – in patients with CVD. Co-author and radiation oncologist S. Eric Olyejar, MD, discusses his experience treating CVD patients with APBI, including patient selection, dosimetric parameters and long-term follow up. Read more

APBI & CVD Patients in the Literature

Though the use of APBI in patients with CVD has not been widely evaluated in the literature, two recent publications have begun to examine the topic and shed greater light on the potential for making breast conserving treatment a possibility for CVD patients.

The use of adjuvant high-dose-rate breast brachytherapy in patients with collagen vascular disease: A collaborative experience

Anthony E. Dragun, Jennifer L. Harper, S. Eric Olyejar, et al.
Brachytherapy, March 2011

A pooled analysis of patients with early stage and in situ breast cancer with CVD treated with adjuvant multicatheter or balloon brachtherapy to evaluate toxicity and cosmesis. Read paper

Partial breast irradiation in a patient with bilateral breast cancers and CREST syndrome

Nicole Kounalakis, Richard Pezner, Cecil L. Staud, Laura Kruper
Brachytherapy, November/December 2011

A case report describing the first documented use of partial breast irradiation in a patient with calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyl, and telangiectasias (CREST) syndrome. Read paper

First Male Patient Treated with SAVI in Texas

According to the American Cancer Society, approximately 2,140 cases of invasive breast cancer were diagnosed among men in 2011.

Alf Pitts was one of those men. He was also the first man in Texas – and only the second in the nation – to receive radiation therapy with the SAVI applicator. He was treated at the Texas Oncology – Methodist Dallas Cancer Center.

First Male in Texas to Receive SAVI Advanced Breast Cancer Treatment
Watch video

“While male breast cancer is much less common than its female counterpart, we are pleased to offer the same leading edge technology for both men and women,” says Arve Gillette, MD, an independently practicing radiation oncologist on the medical staff at Methodist Health System. “We look forward to participating in other advances in treating this disease, whether for women, or the rare but increasingly frequent occurrences among men.”