Targit information

Operation information

After standard wide local excision (WLE) of the primary tumour, the remaining breast tissue is mobilised by dissecting the breast tissue from the overlying skin and subcutaneous tissue. Gentle mobilisation of the breast tissue avoids application of tension to the tissue during pulling of the purse-string suture. It will also ensure that after application of the purse-string suture, the skin is not drawn in close to the applicator, thereby avoiding the risk of radiation-induced skin necrosis. One needs to ensure that the skin is kept at a minimum distance of 5 mm from the applicator surface, otherwise skin necrosis may result.

After removal of the primary tumour, the WLE specimen and the resultant cavity are measured in three dimensions to guide the choice of applicator size. The applicator should not be too tight, since for radiotherapy to be effective, adequate tissue oxygenation is required. On the other hand, the applicator should not be too loose as the breast tissue needs to be in direct contact with the applicator without any dead space to ensure that an adequate radiation dose is delivered to the tumour bed. Careful attention to haemostasis is extremely important. The INTRABEAM and the hydraulic arm need to be covered by a sterile plastic drape, which is specifically designed for this purpose. The applicator, which is connected to the INTRABEAM, is then inserted into the tumour bed and the purse-string suture is pulled and tied snugly at the neck of the applicator. In this way the breast tissue (the target) is conformed around the applicator (the source) and therefore this type of radiotherapy can be referred to as conformal radiotherapy.