Brachytherapy and breast cancer.

Brachytherapy has been an important component of radiation therapy for breast cancer. It played a historical role in the development of breast-conserving techniques for early-stage breast cancer. The primary use for brachytherapy in this setting has been to deliver a localized boost dose of radiation to the lumpectomy bed after whole breast radiation therapy. In recent years, there has been less utilization of brachytherapy as a boost technique. This is predominantly related to wider availability of electrons for delivering a boost dose. Another significant factor for the decline is the controversy of whether routine boosting of the tumor bed is necessary for all early-stage breast cancer patients after conservative surgery and whole breast radiation therapy. Despite this, brachytherapy is still the preferred boost technique in certain subsets of patients. Newer applications of brachytherapy for the treatment of breast cancer have emerged and have shown promise. For early-stage breast cancer, these include brachytherapy as the sole radiation modality after lumpectomy and in combination with local excision as an alternative to mastectomy for treatment of local recurrences after conservative surgery and radiation therapy. In selected locally advanced cases of breast cancer, brachytherapy has been used as part of a technique that attempts breast conservation. At this time, these newer uses of brachytherapy for the treatment of breast cancer remain investigational.