[962859]
The patient had a left axillary sentinel node biopsy and left wire-localized partial mastectomy with complex closure greater than 3mm. Before the cavity was closed, the mammosite cavity evaluation device was placed into the cavity, instilled with 35ml of saline and us was performed. The ultrasound demonstrated a balloon to skin thickness medial to the incision of 65mm, inferolateral to the incision 50mm and superolateral to the incision 75mm. The balloon was deflated and removed. Subsequently, approximately three weeks post-mastectomy, the patient had placement of a contura brachytherapy balloon in the left breast at the 2 - o'clock position with no complications. A simulation note, four days later, states that the balloon had been filled with 30ml of saline and 1ml of contrast to help with imaging. 3mm axial slices were taken of the breast. The images were sent to the treatment planning system and evaluated. It was apparent that the seroma in the superior position of the breast superior to the contura balloon remained intact with very little resolution. Evaluation of the lumpectomy cavity was that it was too far distant from the surface of the contura balloon due to the seroma. It was determined that she was not a candidate for partial breast radiation using that balloon. The balloon was pulled 5 days after initial placement, and the fluid extracted from the balloon was bloody and cloudy. The catheter was found to not be appropriate for the intended therapy and therefore was discontinued. The fluid in the balloon was found to be bloody and cloudy. Documentation indicates that 1 ml of contrast had been added to the 30 ml of saline which accounts for the cloudiness but not the bloody appearance.
Patient Sequence No: 1, Text Type: D, B5