Breast Brachytherapy (Using Multi catheters)
With 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
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
Important Items to review before
The catheter placement is scheduled for:
This procedure will take 2-3 hours.
Please tell the nurse about your current
medicines. Your nurse will tell you which
medicines can be taken the morning of the
You will get the prescriptions mentioned
below. You need to fill them and follow the
directions. If you do not take them as
prescribed, you must tell your doctor before
the procedure. Tell your doctor or nurse if
you have allergies to any of these
1. EMLA cream. This is a numbing
cream for your skin. Put it on your
breast 2 hours before the procedure.
Cover the cream with a clear plastic
dressing (Tegaderm ) or Saran
wrap and tape. The dressing will
keep the cream on your skin. Apply
2. Valium 5mg. This is a relaxant
medicine. Take 1or 2 pills 1 hour
before the procedure. Keep taking it
only if needed. Don’t drive if you
take this medicine. Take at
3. Percocet or Roxicet (oxycodone
and acetaminophen) 5mg/325mg or
Norco® (hydrocodone and
acetaminophen) 5mg/325 mg may be
prescribed. These are narcotic pain
medicines. Take 1 tablet 1 hour
before the procedure. Keep taking it
only if needed. Don’t drive if you
take this medicine. This medicine
can cause constipation. Take at
4. Naproxen sodium 220 mg (Aleve ,
for example). This is an anti-
inflammatory medicine. It will
reduce pain and swelling. Take 1
tablet 1 hour before the procedure.
Keep taking this medicine 2 times
a day 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 1 week ahead of time.
See the list below.
ξ Aspirin or products that
contain aspirin, Ectotrin®,
ξ Non-steroidal anti-
inflammatory drugs Advil®,
Motrin®. Aleve®. Nuprin®
ξ Some herbal medicines
If you are allergic to Lidocaine®,
epinephrine, contrast dye, or latex, please
let us know.
Day of Catheter Placement
The date of catheter placement
You will receive 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. Do not eat or drink anything 6
hours before the catheter placement. Do not
eat or drink past
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 on and off.
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 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. The outer circle is about 1 ½ 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
After all the needles are placed, plastic
catheters are slid through each needle. The
needles will 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. The
catheters are covered with a sterile dressing.
A special support bra will hold the catheters
Afternoon of Catheter Placement
You will recover from the sedation for about
1 hour after the procedure. You may leave
the department and have lunch or stay and
rest until your Planning CT scan in the
afternoon. 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 1 ½ hours.
You may eat and drink liquids before the CT
You may want to take at least one pain pill
before you arrive. During the planning
session, the catheters will be touched. They
might be slightly sore and tender.
When the CT scan is over, a nurse will look
at the catheter sites and clean 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.
Evening after Catheter Placement
Because of the medicines 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 θ F or more.
Weekend (Applies if your catheters
are placed on Friday)
Take your temperature 2 times a day. Call
your doctor if your temperature is 100.0 θF
Your arm motion might be slightly limited
because of the catheters. Do not lift more
than 10 pounds with the arm on the
The support bra and dressing are only
removed during your treatments. Keep this
Radiation Treatment Appointments
Every morning, check in at Patient
Registration at Main Street in the hospital.
You will also check in at the Radiation
Oncology Clinic (K4/B100) before each
treatment. This will let the nurse know you
are here. You will have 2 treatments each
day. There will be 8 hours between each
treatment. Each treatment will last about 45
minutes to 1 hour. You will see a doctor at
each treatment. The total number of
treatments is determined by your doctor.
Most patients receive 10 treatments, 2 times
a day for 5 business days.
Each catheter will be connected to the
radiation treatment machine by a tube. The
radioactive source travels into each catheter
until the treatment is done. 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 staff will see you on a TV
monitor and can talk with you.
After the treatment is over, the cables will
be removed. A nurse will clean the
catheters. A new dressing is put on before
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 the skin care supplies to
care for yourself.
Take your temperature 2 times a day for 1
week, then daily for 1 week. Check your
breast daily for signs of infection.
ξ Temperature of 100.0 θF or higher.
ξ 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 Radiation Oncology
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.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©10/2017. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5929.