Partial Breast Irradiation (PBI)

What is PBI?

Partial Breast Irradiation (PBI), a five-day targeted therapy, is a treatment option for patients with early-stage breast cancer that involves treating only the lumpectomy cavity plus the neighboring tissue. Traditional radiation therapies for breast cancer patients treat the entire breast over a six to seven week period. Because a higher dose of radiation is delivered to the lumpectomy cavity, PBI is able to accomplish treatment in five days with good local tumor control and excellent cosmetic results in well-selected patients. Accelerated treatment makes it easier for patients who may find traditional, daily radiation treatments logistically challenging. There are many methods of administering PBI. The most current method is a technique known as intracavitary brachytherapy.

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Who is a candidate for PBI?

Not every patient with breast cancer is a candidate for PBI. Patient selection is critically important for achieving effective local control with cosmetic results. Candidacy for the procedure will be determined based on the patient’s menopausal status, size of the tumor, involvement of lymph nodes and clearance of the surgical margins among other factors.

How is PBI performed?

PBI is a simple, outpatient procedure. During the breast conservation surgery or sometime after, a brachytherapy device called a catheter will be placed into the lumpectomy cavity through a small incision in the breast. A portion of the catheter will remain outside of the breast. Following the placement of the brachytherapy device, CT images will be acquired, and a detailed plan will be developed to further define the treatment for that individual patient. During treatment sessions, the catheter that remains outside of the breast will be connected to a computer-driven device that will push the radioactive source through the catheter to the target site. The radioactive source will be left in place for a predetermined amount of time before it is withdrawn. Each treatment will last no longer than 15 minutes. After completion of all of the treatments, the catheter will be carefully removed from the breast.

What are the side effects associated with PBI?

Side effects with PBI are generally mild. The most commonly reported side effects associated with PBI are redness, bruising and breast pain. There may also be leakage at the incision site where the catheter was placed. This should go away after a short time.