Imaging for early stage breast cancer

Multi-catheter interstitial brachytherapy

The technique used the longest (most extensive follow up) 14-20 catheters inserted in several planes with 1-1.5 cm intervals

• ensures adequate coverage of the lumpectomy cavity plus margins

avoids hot and cold spots

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• number of catheters depends on size and shape of the target Technique for insertion: • Free-hand or template-guided technique Better QA with CT based 3D planning and image guidance – virtual planning Delivery of RT:

• LDR, sources of Ir-192 sources are implanted for 2-5 days, inpatient

• HDR, fractionated with each fr varying sec-min, often 34 Gy/10 fr/5 days (BED equal to 45 Gy in 4.5 days of the LDR regimen used in many APBI trials), outpatient