Treatment of breast cancer with embolization or chemoembolization (program ID: 689046)
HELIOS University Hospital Wuppertal
Thorsten SchmidtSpecialized in: neuroradiology
Department of Neuroradiology
- Initial presentation in the hospital
- Clinical history taking
- Review of available medical records
- Physical examination
- Laboratory tests:
- Complete blood count
- General urine analysis
- Biochemical analysis of blood
- Tumor markers
- Inflammation indicators (CRP, ESR)
- Ultrasound scan
- CT scan / MRI
- Preoperative care
- Embolization or chemoembolization, 2 procedures
- Symptomatic treatment
- Cost of essential medicines
- Nursing services
- Elaboration of further recommendations
How program is carried out
During the first visit, the doctor will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.
Chemoembolization begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.
When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.
Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.
After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.
After the first procedure, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. After that, you will receive recommendations for further follow-up and treatment.
- Medical records
- MRI/CT scan (not older than 3 months)
- Biopsy results (if available)
You may also book
About the department
The Department of Neuroradiology at the HELIOS University Hospital Wuppertal provides the full range of diagnostic and therapeutic services in the areas of its specialization. The team of the department's doctors deals with the diagnostics and treatment of brain and spinal cord pathologies. The department has at its disposal state-of-the-art medical equipment, including systems for CT, MRI and myelography, thanks to which specialists can comprehensively assess the state of the nervous system, detect pathological processes at the initial stages and provide effective treatment. Among the department's therapeutic options, a special focus is on the interventional treatment of acute stroke – thrombectomy. Another important focus of the specialists' work is the treatment of cerebral vascular malformations, stenosis of the arteries of the brain and spinal cord, and cerebral aneurysms. In addition, the department provides CT-guided interventional pain management to relieve chronic back pain. The department's neuroradiologists cooperate closely with doctors from the related medical specialties: neurologists, neurosurgeons, ophthalmologists, otolaryngologists and radiation therapists. The specialists strive to provide each patient with high quality medical care meeting his needs and wishes. The department is headed by Dr. med. Thorsten Schmidt.
The key area of the department's competence is the urgent treatment of acute stroke with thrombectomy – an interventional procedure to remove a blood clot from a vessel. The purpose of the therapeutic procedure is to restore the patency of the affected area of the artery and normalize blood flow in the brain. Thrombectomy is performed in advanced medical centers with special equipment and qualified doctors. The department's specialists resort to this procedure only in cases when it is impossible to carry out lysis therapy (the procedure of blood clot "dissolution" with medicines) or when it is ineffective. The interventional manipulation is performed under general anesthesia and involves the introduction of a catheter through a puncture of the femoral artery. With the help of imaging devices, the surgeon can clearly see the route of catheter advancement. After the catheter reaches the thrombosed artery in the brain, the surgeon captures the thrombus and mechanically removes it. After the procedure, the patient is constantly monitored by medical personnel and receives the necessary treatment.
The department's doctors also have vast experience in the endovascular treatment of cerebral aneurysms. Previously, the only treatment method for aneurysms was considered open surgery that required craniotomy, but today there is a sparing endovascular method for aneurysm removal. The department's doctors treat cerebral aneurysms using microcoil embolization. This does not require craniotomy, since access to the pathological focus is provided by puncturing the femoral artery. The surgeon inserts a microcatheter into the groin, and then advances it along the bloodstream to the aneurysm. With the microcatheter, platinum microcoils are delivered to the aneurysm, using which the surgeon blocks the blood flow to the aneurysm and eliminates the risk of aneurysm rupture. The intervention involves the use of constant X-ray guidance, and special contrast agents are injected into the human body immediately before the procedure to visualize the vessels. Microcoil embolization practically does not injure healthy tissues, therefore, the patient does not suffer from severe pain and can leave the hospital 2-3 days (with satisfactory results of follow-up examinations) after the surgical intervention.
In its clinical practice, the department often deals with cases of severe back pain that does not respond to classical pharmacotherapy. In such cases, interventional pain management is indicated to the patient, namely periradicular therapy or facet joint infiltration (depending on the cause of chronic back pain). Both procedures are performed under local anesthesia and X-ray guidance to exclude damage to vital spinal structures. During the manipulations, the doctor injects anti-inflammatory and analgesic drugs. Periradicular therapy and facet joint infiltration ensure good results and can be repeated.
The department's range of medical services includes:
- Computed tomography
- Magnetic resonance imaging
- CT-guided sampling of brain and spinal cord tissue (biopsy)
- Thrombectomy for the treatment of acute stroke
- Endovascular embolization for cerebral aneurysms
- Interventional repair of arteriovenous malformations
- Interventional treatment of dural arteriovenous fistulas
- Interventional treatment of vertebral and cerebral artery stenosis
- Interventional treatment of intracranial artery stenosis
- Removal of vascular neoplasms in the head and neck: glomus tumors and hemangiomas
- Interventional CT-guided pain management: periradicular therapy and facet joint infiltration
- Other diagnostic and therapeutic options
Higher Education and Professional Career
- Since June 2013 Head Physician of the Department of Neuroradiology at the HELIOS University Hospital Wuppertal.
- May 2012 - April 2013 Acting Head of the Department of Neuroradiology at the University Hospital Giessen and Marburg.
- July 2010 - April 2012 Managing Senior Physician, Department of Neuroradiology at the University Hospital Giessen.
- July 2010 - August 2011 Senior Physician, Department of Neuroradiology, University Hospital Giessen.
- July 2009 - May 2010 Senior Physician, Institute of Diagnostic and Interventional Radiology, HELIOS Clinic Krefeld.
- November 2007 - June 2009 Senior Physician, Department of Neuroradiology, University Hospital RWTH Aachen.
- April 2006 - October 2007 Medical Specialist in Diagnostic Radiology, Neuroradiology, Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen.
- January 2000 - March 2006 Physician, Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen.
- 1991 - 1999 Study of Human Medicine and graduation thesis defense, University of Bonn.
- 1998 One-year clinical training, University of Cape Town.
- 1993 - 1994 Study of Medicine (4th year), University of Bristol.
Photo of the doctor: (c) Helios Universitätsklinikum Wuppertal
Accommodation in hospital
- Program [Description]
Treatment of breast cancer with embolization or chemoembolization
- Hospital: HELIOS University Hospital Wuppertal
There are 25 breast cancer treatment hospitals on Booking Health websiteShow all clinics