Brachytherapy averts capsular contraction.(NEWS)

CHICAGO -- Image-guided multicatheter brachytherapy produces excellent cosmesis and a low complication rate--including a minimal risk of capsular contracture--in women with early-stage breast carcinoma who have undergone mammoplasty augmentation, according to data presented at the annual meeting of the Radiological Society of North America.

The zero incidence of capsular contracture among patients in this trial compares quite favorably to the 55% risk of implant hardening with whole breast irradiation (WBI), reported Dr. Robert R. Kuske, who is in private practice in Scottsdale, Ariz.

"The markedly improved cosmetic outcomes and reduced capsular contracture rates, compared with results from WBI, are due to the lack of circumferential dose to the foreign body in the breast, the augmentation implant," Dr. Kuske said.

The currently accepted treatment for early-stage breast cancer in women with breast implants--skin-sparing mastectomy with axillary dissection and implant exchange followed by WBI--carries the 55% risk of capsular contracture due to the formation of collagenous scar tissue around the implant, Dr. Kuske said.

Another treatment option for women with breast implants and early stage breast cancer is lumpectomy followed by WBI. But this option also carries the substantial risk of capsular contracture.

The fact that capsular contracture was not found in any of the 70 patients in this trial could have important implications for many of the estimated 49,000 women who undergo mammoplasty augmentation each year and who will develop breast cancer at some point in their lives, he said.

The need for an effective alternative to WBI is becoming increasingly important because "women who had implants 10, 15, or 20 years ago are growing into the age where they are developing breast cancer," said Dr. Kuske, noting that one-third of his patients have had breast augmentation.