Breast Brachytherapy Using Ultrasound in Radiation Oncology
Breast brachytherapy is a radiation treatment used in early stages of breast cancer. A radioactive substance is instilled into the lumpectomy cavity through multiple catheters.
If you need to stay overnight in Madison during your treatments and would like help finding a local hotel at a discount rate, please contact our housing coordinator at 608-263-0315. Some local hotels offer shuttle service to and from the hospital.
You will be asked to sign several consent forms. We will take a picture of your face. It will be placed in your chart for identification purposes. We will also take pictures of your breasts for planning the catheter placement. All photos remain in your clinic chart and will be kept private and confidential.
Before Catheter Placement
The catheter placement is scheduled for ___________________________.
This procedure will take 2-3 hours.
Please inform the nurse of your current medicines. Your nurse will give you instructions on which prescription medicines can be taken the morning of the procedure.
You will be given prescriptions. You will need to have these filled and follow the instructions listed below. If you do not take them as prescribed, you must tell your doctor before the catheter placement. Tell your doctor or nurse if you have allergies to any of these medicines.
- EMLA® cream. This is an anesthetic cream that you will put on the skin. Apply to your breast 1-2 hours before the catheter placement. Cover the cream with a clear plastic dressing (Tegaderm® ) or Saran® wrap and tape. The dressing will keep the cream on your skin. Apply at _____________.
- Valium® 5mg. This is a sedative and anti-anxiety medicine. Take 1 or 2 tablets 45 minutes before the catheters are placed. Keep on taking it only if needed. Don’t drive if you take this medicine. Take at ______________________.
- Percocet® or Roxicet® (acetaminophen and oxycodone) 5mg/325mg or Vicodin® (acetaminophen and hydrocodone) 5mg/500mg may be prescribed. This is a narcotic pain medicine. Take 1 tablet 45 minutes before the catheters are placed. Keep on taking it if needed. Don’t drive if you take this medicine. This medicine can cause constipation. Take at ________________________.
- Naproxen sodium 220 mg (Aleve®, for example). This is an anti-inflammatory medicine. It will reduce the pain and swelling. Take 1 tablet 45 minutes before the catheters are placed. Keep on taking this medicine twice daily through your treatments. You may drive if you take this medicine. Take at __________.
Check with your doctor if you take any blood thinning medicines. These may need to be stopped at least one week ahead of time. See the list below.
- Aspirin or products that contain aspirin, Ectotrin®, Excedrin®
- Heparin
- Coumadin®
- Non-steroidal anti-inflammatory drugs Advil®, Motrin®. Aleve®. Nuprin®
- Some herbal medicines
If you are allergic to Lidocaine, epinephrine, or latex, please let us know.
Day of Catheter Placement
The date of catheter placement ____________________________.
You will be receiving sedation for your procedure. Please arrange for someone to drive you home after the procedure. Do not drive or make important decisions until the next day. Depending on the time of your procedure, you may be able to eat a light meal in the morning. Please check with your nurse or doctor. You may not eat or drink anything SIX hours before the catheter placement. Do not eat or drink past ________________am/pm.
Apply the EMLA® cream and take the prescribed medicines at the given times.
Wear comfortable clothing. A button-down shirt will be easy to take off and put on.
Report to Radiation Oncology (K4B100) at _____________.
The catheter placement is a sterile procedure. You will be lying on your back for about 2 hours. First, you will have a breast ultrasound to locate the correct site of the lumpectomy. This will help us place the catheters. Second, your breast will be cleaned. Sterile towels and drapes will be placed around the site.
Your doctor will use a pen to draw on the skin. The inner circle is the lumpectomy site and the outer circle is about one and a half inches beyond this space. We want the radiation given to this area, too.
Your doctor will inject Lidocaine®, epinephrine and sodium bicarbonate to numb your breast. If you have an allergy or a reason why one of these medicines cannot be used, please tell us.
After your breast is numbed, brachytherapy needles are placed into the skin. This will be repeated until all of the needles are in place.
After all needles have been placed, plastic catheters will be slid through each needle. The needles will then be removed. A plastic tab (button) will hold each catheter in place.
Your skin and breast will be washed, an antibiotic ointment will be applied, and the catheters covered with a sterile dressing. A special support bra will hold the catheters in place.
Evening after Catheter Placement
Because of the medicine you took before the procedure, you may feel tired. Plan to take it easy the rest of the evening.
You may have some pain when the numbing medicine wears off. This is normal. Take the naproxen as scheduled and the pain medicine if you need it.
An ice pack on top of the dressings may help relieve the pain.
Do not get the dressings or catheters wet.
Do not remove the support bra. Sometimes, the dressings may shift. Wash your hands before you adjust the dressings.
Take your temperature before bedtime. Call your doctor if you have a temperature of 100.0° F or more.
Day after Catheter Placement
Report to Radiation Oncology (K4B100) on ________________________ at _______ for a CT scan. A CT scan is a computerized x-ray that will be used for treatment planning. When this is done, each catheter will be trimmed. This will take about an hour and a half.
You may eat and drink liquids before the CT scan.
When the CT scan is over, a nurse will look at the catheter sites and clean the skin around them. Antibiotic ointment will be put around each button. A new dressing will be put on and secured by the support bra. You will be given a schedule for your treatment times.
Week-end
Take your temperature 3 times a day. Call your doctor if your temperature is 100.0°F or higher.
Your arm motion might be slightly limited because of the catheters. Avoid lifting more than 10 pounds with the arm on the treatment side.
The support bra and dressing are only removed during your treatments. Keep this area dry.
Radiation Treatment Appointments
Every day, once in the morning, check in at Patient Registration at Main Street in the hospital. You will also check in at the Radiation Oncology Clinic (K4/B100), twice a day, before each treatment. You will have two treatments a day, with 6 hours between each treatment. Each treatment will last about one hour. You will see a doctor at each treatment. The total number of treatments is determined by your doctor. Most patients receive 10 treatments.
Each catheter will be connected to the radiation treatment machine by a tube. The radioactive source travels into each catheter, one by one, until the treatment is complete. Most people do not feel pain during the treatment. You will hear a sound from the treatment machine. You will be alone in the room during the treatment, but the staff will see you on a TV monitor and be able to talk with you.
After the treatment is over the cables will be removed. A nurse will clean the catheters and apply a new dressing before you leave.
Neither you nor the catheters are radioactive. You are not a risk to your family and friends.
Completion of Treatment
After the last treatment, a nurse will remove the catheters. Most often there is little or no pain or bleeding.
The nurse will clean your breast and put antibiotic ointment on the catheter sites. You will be given all the skin care supplies that you will need to care for yourself.
Take your temperature twice a day for 1 week, then daily for 1 week. Call if your temperature is 100.0°F or higher. Check your breast daily for signs of infection: redness, swelling, non-clear drainage.
If you have any questions or concerns, please call us.
Radiation Oncology Clinic (608) 263-8500
If you live out of the area: 1-800-323-8942. Ask for the Radiotherapy Clinic.
If the clinic is closed, the phone will be transferred to the paging operator. Ask for the radiotherapy doctor on call. Leave your name and phone number with the area code. The doctor will call you back.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 12/10/2012
Copyright © 01/12/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5929
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