Breast Cancer Treatment
Radiation therapy is one of several types of treatments for breast cancer that is often given to patients as part of an overall plan that typically includes surgery and may also include chemotherapy, hormone therapy, and/or targeted therapy.
Breast cancer is treated by a team of cancer specialists including a surgeon, a medical oncologist, and a radiation oncologist. These specialists are supported by many nurses and technicians who are there to help the patient throughout the breast cancer treatment journey.
Patients are often referred to receive radiation therapy at some point during their care. You have a choice as to where you go. Talk to your doctor about where you’d like to receive state of the art radiation therapy that’s also conveniently located near your home.
Types of Radiation Therapy Used for Breast Cancer
Radiation therapy, also known as radiotherapy, uses high-energy x-rays to kill cancer cells. It is targeted to the cancer site and only affects that part of the body. Radiation is typically used after surgery to decrease the chances of the cancer returning in the breast.
Doctors use two types of radiation therapy to treat breast cancer:
External Beam Breast Cancer Radiation
With external beam radiation, the radiation comes from an x-ray machine called a linear accelerator. To begin the treatment process, you will go through a planning session called a CT simulation. Those CT images are used to identify areas where treatment is needed and also areas that need to be protected, like the heart and lung. Your radiation oncologist will design and calculate a treatment plan tailored to your anatomy and the specifics of your breast cancer. The radiation oncologist may use various planning techniques including IMRT (Intensity Modulated Radiation Therapy), 3D (three dimensional) or DIBH (Deep Inspiratory Breath Hold) to protect your organs. Once the plan is ready, you will undergo a practice session called a verification simulation to confirm your daily treatment setup.
Once the treatment begins your setup will be verified daily to ensure that the radiation is delivered precisely every time. IGRT (image-guided radiotherapy) may be utilized for the daily verification process. Treatments are delivered 5 days a week for 4 to 6 weeks. The treated area typically includes the whole breast and possibly the draining lymph nodes followed by treatment targeted to the lumpectomy cavity or mastectomy scar.
Possible Side Effects of External Beam Radiation Therapy
Side effects from radiation treatment can vary, but there are some common side effects to watch for and talk to your oncologist and radiation technician who you will see often. They can often help you with treating the side effects and minimizing their effects.
Common side effects of external radiation for breast cancer include:
- Tenderness to the touch, especially in the area where the radiation beam is pointed
- Red, dry, tender, or itchy skin similar to a sunburn
- Swelling, which may feel like breast “heaviness”
- General fatigue
Internal Breast Cancer Radiation Therapy
Accelerated partial breast irradiation (APBI) is an internal radiation therapy which may be an option for patients with early-stage breast cancer.
How APBI Works
APBI involves the surgeon implanting a thin, hollow tube called a catheter into the breast. This surgery is typically the second one, scheduled after the lumpectomy and confirming that the margins around the lumpectomy are clear of cancer cells.
At the end of the catheter, a balloon or multiple smaller catheters are expanded to fill the lumpectomy cavity. Once the catheter has been placed, there is a treatment planning session called a CT simulation. The CT images collected during the planning process are used to identify where the treatment is needed and areas that will need to be protected, like your chest wall and skin. Your radiation oncologist will design and calculate a treatment plan tailored to your anatomy and the catheter placement.
Treatments are given twice a day for five days for a total of ten treatments. The catheter treatment device remains in place for the duration of the treatment course requiring daily dressing changes by your care team. During treatment, a radioactive seed is inserted into the catheter tube so that it can deliver radiation to the lumpectomy cavity. It’s only left in place for about 5-10 minutes each time the treatment is administered. Once complete the radiation oncologist will deflate the catheter and remove the device in the office.