Contura Brachytherapy for Breast Cancer

The Good and Bad and What to Expect

Contura Multi-Lumen Brachytherapy Balloon
Contura Multi-Lumen Brachytherapy Balloon Detailed View. Photo © SenoRx, Inc.

After breast-conserving surgery and for some women after a mastectomy, radiation is needed to prevent cancer recurrence. While standard external beam radiation is delivered to the body from a machine outside your body, Contura is a form of intracavity brachytherapy, delivering radiation from inside your breast. 

Let's learn more about Contura, including its advantages, disadvantages, and what to expect during placement and therapy.

 

What is Contura?

Contura® is a multi-lumen balloon breast brachytherapy device, used after a lumpectomy for early-stage breast cancer. Using a Contura allows your doctor to treat your breast cancer right at the source, with radiation from inside your breast. You will have two treatments a day for only five days, and the treatment will be customized for your body. Contura has special features that will spare your skin and internal organs from radiation exposure.

Breast tumors are seldom perfectly round, so lumpectomy cavities are often irregularly shaped. Contura has a vacuum feature that gently pulls breast tissue into contact with the balloon surface, improving radiation dose to the surgery area and preventing the formation of seromas. The Contura balloon catheter is available in two sizes, each of which encases five lumens, or channels for radiation seeds. If your tumor was close to your breast skin or your breast was too small for balloon brachytherapy, the Contura may be configured for your brachytherapy treatments.

How Contura Compares To Other Devices:

In a 2009 study in Brachytherapy, Contura was compared to a single-lumen MammoSite to see which balloon catheter can best deliver the radiation dose to breast tissue, while doing the least harm to your skin. The Contura fit patients better and seldom needed to be removed.

 

In a 2015 article in Radiation Oncology, the Contura device was comparable to the Mammosite multi-lumen balloon device.

Advantages of Contura Brachytherapy

Contura is a type of accelerated partial breast irradiation (APBI) that treats just the tissue around your tumor - keeping radiation away from skin, chest wall and ribs. You have just ten outpatient treatments, twice a day for five days, after which the catheter is removed.

Contura can fit the shape and size of most tumor cavities. That tight fit between the balloon and tissue also helps prevent fluid accumulation. The shape of your radiation dose can be customized through five catheter lumens.

Disadvantages of Balloon Catheter Radiation:

You will have a catheter line sticking out of your breast during the week of treatment.  Infections might occur, so keep the insertion point clean and dry. You'll have to skip showers while Contura is in place, and take sponge or tub baths instead. Wear a soft, stretchy bra to accommodate the catheter line.

If the catheter line interferes with your sleep, adjust your sleeping position and use pillows to maintain a restful night's sleep.

Placement of a Contura Multi-Lumen Balloon:

The Contura can be implanted either during your lumpectomy or up to 10 weeks later. Your doctor will insert a Contura catheter into your breast until the balloon rests in your lumpectomy cavity. Saline will be added through one channel, to inflate the balloon and hold it in place until the device is removed. Contrast agent will be added so the balloon will show up well on imaging. The insertion site will be cleaned and dressed, then the catheter that extends outside your breast will be taped into place.

What To Expect During Treatments:

Treatments with Contura are done as outpatient visits - right in your clinic. You should plan on a morning and an afternoon appointment daily for five days. The actual treatment may take about seven minutes. As you sit in a recliner, your radiation dose is inserted through one or more of the catheter lines. A tiny radioactive seed attached by a wire to a radiation machine emits energy through the balloon into your lumpectomy area. Once the proper dose has been given, the seed is removed and your catheter is cleaned, closed, and taped into place. You'll be able to drive yourself to and from each appointment.

Recovery And Mild Side Effects:

When your five days of treatments are done, the Contura will be deflated and removed.  A sterile dressing will cover the insertion site.  You may have some mild side effects after radiation treatment – drainage from the wound, breast pain, some skin redness and bruising. 

What Should I Do?

Give your skin good care, keep the area clean and dry, and it should clear up in a short while.  Wear soft, extra-comfy bras until you feel recovered from radiation.  See your doctor if you suspect an infection at the insertion site.

Sources:

Rana Z et al. Comparative dosimetric findings using accelerated partial breast irradiation across five catheter subtypes. Radiat Oncol. 2015;10:160.

Wilder RB et al. A Contura catheter offers dosimetric advantages over a MammoSite catheter that increase the applicability of accelerated partial breast irradiation. Brachytherapy, 2009 Oct-Dec;8(4):373-8. 

 

 

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