%0 Journal Article
%T Inherent change in MammoSite applicator three-dimensional geometry over time
%A Subhakar Mutyala
%A Walter Choi
%A Atif J Khan
%A Ravi Yaparpalvi
%A Alexandra J Stewart
%A Phillip M Devlin
%J Radiation Oncology
%D 2007
%I BioMed Central
%R 10.1186/1748-717x-2-37
%X Accelerated partial breast irradiation (APBI) with the MammoSite catheter is a new brachytherapy concept in breast conserving therapy for a subset of patients with early stage breast cancer [1,2]. The catheter consists of an inflatable balloon and a central channel for HDR brachytherapy. The initial experience [3] describes the ideal technique for the initial placement of the catheter, either at the time of lumpectomy or percutaneously under ultrasound guidance. As the initial Phase I trial describes, in order to deliver a homogenous dose to the tumor cavity, the balloon on the catheter should be inflated with saline to achieve a uniform spherical shape. Asymmetry of the applicator, poor placement, and intrinsic applicator abnormalities are all grounds for removal of the applicator. In this trial, a number of applicators were removed, with poor balloon conformance the most common reason for removal. We describe three separate cases where asymmetric applicators corrected themselves over time without any intervention, allowing for subsequent treatment.The first patient is a 72 year-old female with an abnormality noted on a screening mammogram. A stereotactic core biopsy showed invasive ductal carcinoma. The patient subsequently had a lumpectomy and axillary node dissection, with pathology revealing a well-differentiated 9 mm invasive ductal carcinoma with no lympho-vascular space invasion. Surgical margins were negative and all lymph nodes removed on axillary dissection were negative for tumor. The patient was seen in our department and had a full history, physical, and pathology review. Based on her history and pathology, she was deemed a candidate for APBI with the MammoSite applicator and was placed in our institutional protocol.The patient returned for MammoSite placement by ultrasound guided percutaneous method approximately 6 weeks after her surgery. The MammoSite was placed successfully and inflated with 45 cc of contrast diluted with sterile water (1:10). Imme
%U http://www.ro-journal.com/content/2/1/37