Breast cancer: Lumpectomy cavity movement

Oct 20, 2009 at 1:42 p.m. ET

The National Cancer Institute estimates one in eight women may develop breast cancer over the course of their lifetime. Some may even develop a condition called lumpectomy cavity movement. Not only can this condition lead to under-treatment, it can also cause unnecessary exposure of healthy breast tissue to radiation. So what exactly is lumpectomy cavity movement and how can you deal with it? consulted leading radiation oncologist Dr Joseph Imperato, the medical director of radiation oncology at Lake Forest Hospital in Lake Forest, Illinois, to find out.

Woman holding chest

What is lumpectomy cavity movement? Can you please explain the issue of tumor cavity movement? What is it and why is it important for breast cancer patients to understand it?

Dr Joseph Imperato: Lumpectomy cavity movement refers to the natural changes in size, shape and location of the lumpectomy cavity [the cavity from which the tumor was removed] in the patient's body due to tissue healing and scarring, as well as simple physical movement. For patients undergoing radiation therapy, this movement forces the physician to [treat] a larger area surrounding the cavity to avoid missing it, exposing normal tissue to [more] radiation than necessary.

Technology to the rescue How have newer technologies helped address the challenge of tumor cavity movement?

Dr Joseph Imperato: To address this challenge, physicians are using a new FDA-cleared application of 3D ultrasound technology called the Clarity System that visualizes the precise location and size of the tumor cavity in "real time" during treatment planning and then daily with each consecutive radiation treatment during the boost portion of their treatment. Clarity is radiation-free and uses the same gentle, non-invasive ultrasound technology most often associated with pregnancy and providing images of babies. Patients gain the peace of mind that their radiation treatment is being delivered directly to the area where it is needed most while minimizing exposure to healthy tissue.

Breast conservation therapy How should someone newly diagnosed with breast cancer deal with the issue of tumor cavity movement?

Dr Joseph Imperato: Precise delivery of radiation to the target area is especially critical for women who opt for breast conservation therapy—lumpectomy followed by radiation therapy. Women should talk with their doctor about what methods they are using to monitor changes in the lumpectomy cavity to ensure that radiation is being delivered accurately and precisely.

Future advances in tumor cavity management What does the future of science hold for dealing with tumor cavity movement? Do you foresee any advances in the medical field that make it easier to deal with?

Dr Joseph Imperato: In the future, other mechanisms may be used such as placing fiduciary markers to monitor intra treatment motion similar to what is being researched in prostate cancer treatment.

Do your research on breast cancer treatments What advice would you give to someone newly diagnosed with breast cancer?

Dr Joseph Imperato: My first piece of advice is to try to remain calm. Breast cancer is one of the most treatable and curable cancers. Take the time to research all of your options before embarking on any treatment program. Make sure you feel comfortable with the team of doctors you will be working with and above all, don't be afraid to ask questions.

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