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A One-Day Treatment for Breast Cancer

For the past couple of years, Elizabeth*, 55, of Alexandria, had been monitored for changes in her breast tissue, but now she felt it was time to seek a second opinion. “I talked it over with my trusted OB/GYN, Mary Crowther, MD, and asked her who she would recommend. She referred me to breast surgeon Molly Sebastian, MD, FACS, Medical Director of The Reinsch Pierce Family Center for Breast Health at Virginia Hospital Center.”

“I liked that Dr. Sebastian performed the biopsy and ultrasound right in her office,” says Elizabeth. When the pathology report confirmed Elizabeth had a small, early-stage tumor, Dr. Sebastian recommended that she have a lumpectomy followed by radiation therapy. “Dr. Sebastian’s staff literally took me by the hand and guided me through the entire process, arranging appointments for consultations, scheduling tests and doing follow-up,” adds Elizabeth. “They made me feel like part of the family.”

“Elizabeth was a good candidate for Intraoperative Radiation Therapy (IORT) because she had early-stage, low-risk cancer with no lymph node involvement,” says Nadim Nasr, MD, radiation oncologist. IORT is administered during lumpectomy surgery after the tumor is removed. A single, high dose of radiation is delivered directly to the area where the cancer was, which is the most likely site for future cancer recurrence. IORT treats only the area surrounding the tumor, while doing as little damage as possible to normal tissue.

“Not all breast cancer is the same,” says Dr. Nasr. “IORT is yet another tool we can use to customize treatments for each patient’s individual needs. And, it’s convenient. A woman’s entire course of radiation treatment is completed at the same time as her lumpectomy.”

At Virginia Hospital Center, Dr. Sebastian, Dr. Nasr and their team are combining multiple technologies with IORT in innovative ways for better treatment outcomes. “In the operating room, we use the high-tech MarginProbe™ during lumpectomy to verify that the tissue margins are clear of cancer to optimize removal of the entire tumor,” says Dr. Sebastian. Then, Dr. Sebastian places the radiation catheter into the lumpectomy bed. A portable O-arm CT scanner then takes a 3-D image of the catheter in relation to the cavity, the skin and the chest wall. “This helps us confirm our calculations to ensure the radiation is delivered for optimal effect and safety,” says Dr. Nasr. “Once we’ve confirmed we’re in the right position, a full course of radiation is delivered through the catheter in about 10 minutes.” Then, Dr. Sebastian completes the surgery.
3-dimensional reconstruction of IORT treatment plan
3-dimensional reconstruction of IORT treatment plan.

*The patient’s name was changed for privacy.

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