Breast Brachytherapy (Multicatheters)
Using CT Guidance in Radiation Oncology
Breast brachytherapy is a radiation treatment used in early stages of breast cancer. Small
plastic catheters (tubes) are placed into the breast at the site of the cancer. A radioactive
seed travels into the catheters to deliver radiation directly to the cancer site. This
decreases the amount of radiation that goes to healthy tissues.
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 patient housing coordinator at
608-263-0315. Some local hotels offer shuttle service to and from the hospital.
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 let you know 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.
1. 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 _____________.
2. 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 ______________________.
3. 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 ________________________.
4. 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.
ξ Aspirin or products that contain aspirin, Ectotrin®, Excedrin®
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
Day of Catheter Placement
The date of catheter placement ___________________________________.
You will be receiving sedation for your procedure. Please arrange for someone to drive
you to the hospital and walk you down to the Radiation Oncology Clinic. Also, you will
need a driver to take you home after the procedure. You should not drive or make
important decisions until the next day.
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, your
breast will be cleaned with an Iodine cleaning solution. Second,
sterile towels and drapes will be placed around the site. A
template or plastic grid will be placed on either side of your
breast. This will guide the placement of the catheters. The
doctor will numb your breast and then will place 3 brachytherapy
needles into the template through your breast to secure the
template. A CT scan will be done right after this to show your doctor the best place to
put the rest of the catheters.
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 the CT scan, the doctor will continue to numb your
breast and the remaining brachytherapy needles are
placed into the skin. This will be repeated until all of the
needles are in place. The template is then removed.
After all the 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.
Afternoon of Catheter Placement
You will recover from the sedation for about an hour after the catheters are placed. You
may leave the department and have lunch or stay and rest until your planned 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 a half
hour to an hour.
You may eat and drink liquids before the CT scan.
You may want to take at least one pain pill before your CT scan. 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 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.
Evening after Catheter Placement
Because of the medicine you took before the procedure and the IV sedation, 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.
Your arm motion might be slightly limited because of the catheters. Avoid lifting more
than 10 pounds with the arm on the treatment side.
If your catheters will be in over a weekend, the nurse will teach you how to take care of
yourself during that time.
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 at least 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 8-10 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 clicking 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
Completion of Treatment
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 teach you how to care for yourself after treatment and give you all the skin
care supplies that you will need.
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 Clinic.
If the clinic is closed, the phone will be transferred to the paging operator. Ask for the
Radiation Oncology 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.
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