Breast cancer is the most prevalent cancer among American women, with approximately 300,000 new cases diagnosed annually, including both women and men. About 20% of these cases are noninvasive, known as ductal carcinoma in situ (DCIS). Early detection and treatment have significantly improved the prognosis for breast cancer patients.
Upon a breast cancer diagnosis, it’s essential to discuss treatment strategies with your healthcare team. Treatment plans are personalized based on the cancer’s stage, location, and individual patient factors. Common treatment modalities include:
Radiation Therapy: This treatment uses high-energy rays to target and destroy cancer cells that may remain after surgery, thereby reducing the likelihood of recurrence. Radiation can be directed at the breast, chest wall, and sometimes the lymph nodes.
Surgery: Often the initial approach for localized breast cancer, surgery aims to remove the tumor. In certain cases, preoperative chemotherapy is administered to shrink the tumor, allowing for less extensive surgery. Post-surgical treatments may include chemotherapy or radiation therapy to reduce the risk of recurrence in the breast, chest wall, or lymph nodes.
Lumpectomy (Partial Mastectomy): This breast-conserving surgery involves removing the cancerous tissue along with a margin of healthy tissue. It’s typically followed by radiation therapy to eliminate any remaining cancer cells.
Mastectomy: This procedure entails the removal of the entire breast. Breast reconstruction can often be performed concurrently or at a later time. In specific situations, radiation therapy may be recommended post-mastectomy.
Lymph Node Biopsy: Depending on individual risk factors, a biopsy of nearby lymph nodes may be conducted during surgery to assess for the presence of cancer cells. If cancer is detected in the lymph nodes, further removal may be advised.
Both mastectomy and breast-conserving therapy (lumpectomy followed by radiation) are effective in treating breast cancer. Consult with your radiation oncologist to understand the benefits and risks associated with each option.
Medical Therapy: Medications, including chemotherapy, hormone therapy, or targeted therapies, are often prescribed to enhance cure rates and prevent new breast cancers from developing. A medical oncologist will determine the most appropriate medications based on your specific case.
After a lumpectomy, radiation therapy is commonly administered to the entire breast and, if necessary, adjacent lymph node areas. Treatments are delivered using a linear accelerator, which emits specialized, painless X-rays. Each session is brief, but precise setup may require 15–30 minutes. Typically, treatments occur five days a week, Monday through Friday, over a period ranging from one to seven weeks, depending on surgical findings.
Prior to starting treatment, a planning session (CT simulation) is conducted to map the treatment area. This may involve a CT scan and the placement of small skin marks or tattoos to ensure accurate positioning during each session. While high-energy X-rays (photons) are commonly used, electrons or protons may be utilized in certain cases.
Recent studies have indicated that, for early-stage breast cancer, shorter courses of whole breast radiation therapy with slightly higher daily doses can be as effective as traditional longer courses. Discuss with your radiation oncologist whether a shorter treatment duration is suitable for you.
For left-sided breast cancers, specific breathing techniques may be employed during treatment to minimize radiation exposure to the heart.
Research suggests that, for select patients, targeting only the portion of the breast where the tumor was located, rather than the entire breast, over a shorter timeframe may be effective. PBI can be administered in two ways:
Consult your radiation oncologist to determine if PBI is appropriate for your situation.
Following a mastectomy, radiation therapy may be recommended for the chest wall and nearby lymph nodes, regardless of whether reconstruction has been performed. Factors influencing this decision include tumor size, lymph node involvement, and the presence of cancer cells near the surgical margins. If you’re considering reconstruction, discuss with your surgeon and radiation oncologist how post-mastectomy radiation may impact the process.
For left-sided breast cancers, breathing techniques may be utilized during treatment to reduce heart exposure.
Maintaining your well-being during radiation therapy is crucial. Consider the following:
Coping with the stress of a cancer diagnosis and treatment can be challenging. Engaging with support groups and leaning on friends and family can provide valuable assistance. Consult your healthcare team for information on available support resources.
Radiation therapy for breast cancer may lead to side effects, which are generally temporary and subside after treatment concludes. Common side effects during treatment include:
Many of these side effects can be managed with appropriate medications. It’s important to inform your healthcare provider about any discomfort so they can offer suitable interventions.
In some cases, side effects may emerge months or years after treatment. These can include:
Various factors influence the likelihood of these side effects. Discuss with your radiation oncologist to understand your specific risks and to develop strategies for managing any potential side effects.
If you have questions about your diagnosis, treatment options, or side effects, please contact our office to schedule a consultation with one of our radiation oncologists.
Dr. O’Connor and Dr. Montes are radiation oncologists specializing in cancer treatment through radiation therapy. Our multidisciplinary team includes radiation therapists, physicists, dosimetrists, radiation oncology nurses, medical assistants, an oncology nurse navigator, and certified nutrition specialists, all dedicated to providing comprehensive care.
