The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on brachytherapy as the sole method of adjuvant radiotherapy for breast cancer after local excision.


Treatment for breast cancer usually involves surgery to remove part or all of the breast. This is sometimes followed by radiotherapy, particularly if only part of the breast has been removed. Brachytherapy is a type of radiotherapy in which a radiation source is placed inside the body area to be treated. It typically involves the insertion of radioactive implants into the space in the breast where tissue has been removed. The implants are usually in place for one to five days. The aim of the procedure is to minimise the chance of the cancer recurring.

Coding recommendations

X65.3 Delivery of a fraction of interstitial radiotherapy

Y35.4 Introduction of radioactive substance into organ for brachytherapy NOC

Y89.- Brachytherapy (if applicable)

Z15.- Breast

Z94.- Laterality of operation

In addition an ICD-10 code from category C53.- Malignant neoplasm of cervix uteri is assigned.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.