Day One
The patient is a 69-year-old female diagnosed with right lower-outer quadrant
breast cancer, post lumpectomy. After initial consultation, the decision was made
to treat via mammosite application BID for duration of 5 days and a total of 10
treatments. Due to the complexity of brachytherapy delivery, the physician will
spend additional time planning treatment. The patient was brought to the CT simulator
and was placed in the supine position. After appropriate set up position was determined,
marks were made on the skin to define the superior and inferior border of the treatment
field. Immobilization device included a breast board. The brachytherapy ribbon with
dummy seeds was inserted in the catheter.
CT scan was obtained to acquire anatomic information regarding the location of the
lumpectomy site, patient contour, and critical structures. The procedure was completed
without complications and the patient was scheduled for treatment starting tomorrow.
Day Two
Patient presented for first treatment this morning. A simulation of mammosite
treatment of the right breast was performed. Dummy seeds were inserted into the
catheter and CT guidance was utilized to confirm size and balloon configuration.
A complex brachytherapy isodose plan was generated and checked by physics staff.
A confirmatory calculation was completed. The patient was transported to the high
dose rate (HDR) brachytherapy suite. The catheter was attached and the first application
was completed.
Patient presented for second treatment this afternoon, six hours after completion
of morning application. A simulation of the right breast was performed. Dummy seeds
were inserted into the catheter and CT guidance was utilized to confirm size and
balloon configuration. A confirmatory calculation was performed. The patient was
transported to the HDR suite. The catheter was attached and the second application
was completed.
Day Three
Patient presented for third treatment this morning. A simulation of the
right breast was performed. Dummy seeds were inserted into the catheter and CT guidance
was utilized to confirm size and balloon configuration. A confirmatory calculation
was completed. The patient was transported to the HDR suite. The catheter was attached
and the third application was completed.
Patient presented for fourth treatment this afternoon, six hours after completion
of morning application. A simulation of the right breast was performed. Dummy seeds
were inserted into the catheter and CT guidance was utilized to confirm size and
balloon configuration. A confirmatory calculation was performed. The patient was
transported to the HDR suite. The catheter was attached and the fourth application
was completed.
Day Four
Patient presented for fifth treatment this morning. A simulation of the
right breast was performed. Dummy seeds were inserted into the catheter and CT guidance
was utilized to confirm size and balloon configuration. A confirmatory calculation
was completed. The patient was transported to the HDR suite. The catheter was attached
and the fifth application was completed.
Patient presented for sixth treatment this afternoon, six hours after completion
of morning application. A simulation of the right breast was performed. Dummy seeds
were inserted into the catheter and CT guidance was utilized to confirm size and
balloon configuration. A confirmatory calculation was performed. The patient was
transported to the HDR suite. The catheter was attached and the sixth application
was completed.
Day Five
Patient presented for seventh treatment this morning. A simulation of the
right breast was performed. Dummy seeds were inserted into the catheter and CT guidance
was utilized to confirm size and balloon configuration. A confirmatory calculation
was completed. The patient was transported to the HDR suite. The catheter was attached
and the seventh application was completed.
Patient presented for eighth treatment this afternoon, six hours after completion
of morning application. A simulation of the right breast was performed. Dummy seeds
were inserted into the catheter and CT guidance was utilized to confirm size and
balloon configuration. A confirmatory calculation was performed. The patient was
transported to the HDR suite. The catheter was attached and the eighth application
was completed.
Day Six
Patient presented for ninth treatment this morning. A simulation of the
right breast was performed. Dummy seeds were inserted into the catheter and CT guidance
was utilized to confirm size and balloon configuration. A confirmatory calculation
was completed. The patient was transported to the HDR suite. The catheter was attached
and the ninth application was completed.
Patient presented for tenth treatment this afternoon, six hours after completion
of morning application. A simulation of the right breast was performed. Dummy seeds
were inserted into the catheter and CT guidance was utilized to confirm size and
balloon configuration. A confirmatory calculation was performed. The patient was
transported to the HDR suite. The catheter was attached and the tenth application
was completed.
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