Permanent breast seed implants

Abstract

The term permanent breast seed implants (PBSI) refers to a partial breast irradiation technique that is performed in a single one-hour procedure under local freezing and neuroleptanalgesia. There are obvious advantages to this technique for the patient and medical personnel. If radiation safety is an issue with 1251, 103Pd is known to be theoretically and clinically safe for PBSI. To ensure very accurate placement of the seeds in a mobile target situated in a soft organ, a special implanting device was developed. This device involved the use of a fiducial needle that hooks the target volume and is attached to a template that is used to guide the insertion of the seeds. Various precautions are used to avoid seed motion, including the use of stranded seeds and a special algorithm to optimize seed placement. The chapter describes the PBSI technique and reports outcomes in terms of local control and side effects in a prospective cohort of 67 patients treated between 2004 and 2007. Finally, since not all patients are eligible for PBSI, the chapter compares PBSI to other partial breast irradiation techniques. © 2009 Springer Berlin Heidelberg.