Diane Best was walking through a Walmart parking lot when her doctor called to tell her she had breast cancer.
“I just cried and cried,” the 52-year-old Best said, but there was a silver lining. “The doctor told me that if I had to have breast cancer, I had the best kind - ductal carcinoma in situ.”
DCIS is highly treatable because the cancer is located solely within the milk ducts of a woman’s breast. Once the cancer is removed, the rate of recurrence is under 30 percent.
Best’s coworkers at Bayhealth Milford Memorial Hospital buoyed her spirits with their confidence that treatment would be successful and she’d be able to continue living a normal life.
There was more good news: chemotherapy is not necessary when treating DCIS, only radiation. On top of that, Bayhealth Kent General Hospital, where Best was to receive treatment, is one of just two facilities in the state using an innovative new technology called high dose rate brachytherapy.
HDR brachytherapy uses a radioactive source about the size of a single piece of rice to deliver radiation to a targeted area in the body through a catheter, according to Bayhealth Radiation Oncology’s Dr. John Lahaniatis, who treated Best.
She had a lumpectomy, or a portion of her breast removed, in July, just weeks after being diagnosed. Though the cancerous cells in her breast measured just five millimeters, “they took out a lump the size of a hacky sack,” Best said, removing all matter within a certain distance of the cancer. The cavity the lumpectomy left in her breast made her a perfect candidate for HDR brachytherapy, allowing her to forego outer radiation to her entire breast and the burns that come with it.
Doctors placed a balloon spacer in the cavity, which kept her body from healing the area naturally until radiation could be delivered. About a week later, after giving the rest of her body some time to recover, the balloon was removed and the radiation catheter placed.
Best went to Kent General to receive HDR brachytherapy twice a day for five days, as opposed to daily for six weeks as with traditional radiation treatment. It was in place for about two and a half weeks, during which time she couldn’t shower, as the device entered and exited her body through an open wound that was constantly draining; her devoted husband gave her sponge baths and changed the bandages twice a day.
“It was very painful - sticking out of my side. Even after they took the catheter out, the doctor left the wound open for another couple weeks to let it finish draining,” Best said.
It’s been about a month since the catheter was finally removed from her breast, and the only sign it was ever there is a bit of bruising and a scar barely an inch wide. Her body is 100 percent cancer-free. Best is on medication to prevent it from returning, as well as anti-hormone therapy, since her cancer fed off estrogen. She'll visit with her oncologists every three months for the next three years.
The more doctors can personalize cancer treatments to fit each patient’s specific needs, the more likely it is they’ll succeed in beating the cancer. According to Dr. Lahaniatis, HDR brachytherapy is a valuable new personalization tool.