Metastatic cancer is, unfortunately, still a fact of life for a small number of breast cancer patients. However, recent surgical developments - notably the Gamma Knife procedure - have vastly increased the safety and efficacy of treatment for metastatic cancer.

The Gamma Knife is a refinement of stereotactic radiosurgery, which has been used in research for almost 100 years. Doctors have used this form of surgery to treat patients since 1958, when Lars Leksell created a unit using multiple sources of Cobalt 60, a radioactive material that produces beams that converge in an intracranial target. The device that precisely delivers the single high dose of radiation is called the Gamma Knife.

Radiosurgery protects normal tissue from radiation injury. It operates through precise targeting of cross-fired radiation beams focusing in abnormal tissue, without touching the surrounding normal tissue. It divides doses into tiny fragments of time, spaced to allow recovery or normal tissue and aimed by sophisticated computer software. Typically, radiosurgery involves the active participation of a surgeon, a radiation oncologist, a medical physicist, and a neuroradiologist. Together, the team defines and prescribes the appropriate dose of radiation.

Because the Gamma Knife procedure does not involve a surgical incision, patients avoid most risks of conventional surgery, such as hemorrhage, infection, and side effects of general anesthesia. In general, patients experience little discomfort and tolerate the procedure extremely well.

Another advantage of this approach is its speed. All treatments are done in a single day, on an outpatient basis. The referring physician, in close communication with the radiosurgery team, conducts all follow-up monitoring and care.

In our practice, we have found radiosurgery to be a powerful tool in the palliative management of advanced metastatic disease, even in cases presenting with large numbers of brain metastases. Most of our patients required two outpatient treatments, which them to undergo other therapeutic treatments with relative ease. Most radiosurgery patients, we have found, enjoy a quality of life that they find acceptable.