Review of MammoSite brachytherapy: Advantages, disadvantages and clinical outcomes

Figures & data

Figure 1.  The MammoSite ® Radiation Therapy System, courtesy of Cytyc Corporation and affiliates.

Table I.  Average volume and dose parameters for IB and MSB patients [17].

Variables	MSB	IB
VPTV (cc)	109.6	63.4
V90 (%)	96	92
V100 (%)	88	87
V150 (%)	27	55
V200 (%)	3	32
D90 (%)	99	94
Dmin (%)	67	58
Dlung (%)max	66	55
Dheart (%)max	27	29

Table II.  Patient characteristics including total dose, volume of lumpectomy cavity, volume of ipsilateral breast, volume of ipsilateral lung and heart volume [24].

Variables	IB	MSB	3D-CRT
Number of patients	10	10	10
Total dose (cGy)	3200	3400	3850
Average lumpectomy cavity (cc)	38	53	24
Range (cc)	5-101	37-70	8-44
Average PTV volume (cc)	192	107	237
Range (cc)	97-357	83-125	104-380
PTV expansion (cm)	1.5	1	1 + CTV (1.5)
Average breast volume (cc)	1920	1628	1568
Range (cc)	1059-2654	1147-2729	633-2569
Average lung volume (cc)	1116	1404	1355
Average heart volume (cc)	563	568	584

Table III.  Dosimetric comparison of 3 different APBI techniques [25].

Variables	MSB	3DCRT	IMRT
PTV volume (cc)	94.3	184.3	184.3
V110 (%)	84.2	0.99	0.8
V100 (%)	94.9	92.3	93.7
V95 (%)	97.9	99.9	99.9
V90 (%)	99.3	99.9	100.0
Ipsilateral breast V50 (%)	29.2	55.8	46.2
Ipsilateral lung V30 (%)	5.4	6.7	1.9
Heart V5 (%)	11.6	4.1	1.2

Table IV.  Dose perturbation factors using MC calculations at 1 cm from the balloon surface for various balloon radii and contrast concentration percentages [19,20].

Contrast concentration (%)	Dose reduction factor	Balloon radius (cm)
	2	3
0	1	1
5	0.992-0.995	0.986-0.989
10	0.984-0.990	0.971-0.982
25	0.960-0.978	0.943-0.959
50	0.954	0.925
75	0.937	0.898
100	0.919	0.875

Table V.  Clinical results of cosmetic outcomes and tumour recurrence using the MSB.

Author	# of patients	Average follow-up (months)	Good/ excellent cosmetic results (%)	Skin distance (mm)	Skin dose/ fraction (cGy)	Tumour recurrence (%)
Dragun et al. [32]	100	24	21-69	7-8		0
Keisch et al. [33]	43	21	88	> 7		0
Keisch et al. [34]	43	29	84	> 7		0
Shah et al. [36]	28	19	93	≥ 5		0
Dickler et al. [37]	30	13	93	7-15	354-422	0
DiFronz et al. [38]	40	13	97	> 7		0
Harperet al. [39]	30	7	20-73	4-14	130-558	0
Vicin et al. [40]	248	12	92	≥ 7		0.1
Benitez et al. [41]	100	9.5	98	7-13		2
Jeruss et al. [42]	158	12	88	> 7		0
Sadeghi et al. [43]	67	13	96	7-15	56-488	0

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