What Type of Radiation Therapy is Right for My Breast Cancer?

Woman lying down on linear accelerator.

If you’ve been diagnosed with breast cancer, your physician may have recommended radiation therapy as a part of your treatment plan. Radiation therapy uses high energy rays or particles to destroy cancer cells.

Radiation therapy is often used after breast cancer surgery. Its purpose is to eliminate any cancer cells that remain or to reduce the risk of cancer recurrence. It can be included in a treatment plan with chemotherapy. It can also be used to reduce side effects if the cancer has spread to other parts of the body.

Understanding External and Internal Radiation

There are two main types of radiation therapy used to treat breast cancer: external radiation therapy and internal radiation therapy.

EXTERNAL RADIATION THERAPY

There are two main types of radiation therapy used to treat breast cancer: external radiation therapy and internal radiation therapy.

External radiation therapy is the most common form of radiation used to treat breast cancer. A machine is used to concentrate rays of energy from outside of the body into the area affected by the cancer. The radiation is aimed directly at the targeted area. The machine moves around the body to direct the beams of energy at the site from different angles.

External radiation therapy may be recommended:

  • After a mastectomy—if no cancer cells are found in nearby lymph nodes, radiation will be focused on the chest wall, the mastectomy scar, and anywhere drains were placed following the surgery. This is usually given five days a week for six weeks.

  • After breast-conserving surgery—radiation may be given to the whole breast to eliminate any remaining cancer cells or to lower the chance of recurrence. Whole breast radiation is often given five days a week for six to seven weeks.

  • If cancer has spread to the lymph nodes—radiation may be given to the lymph nodes under the arms, above the collarbone, and/or beneath the breastbone. This is typically given five days a week for six weeks at the same time any radiation to the chest wall or breast is given.

Radiation therapy often starts one or two months after surgery. This allows the surgery site to heal first. If you are receiving chemotherapy alongside radiation therapy, treatment will usually begin after chemotherapy has finished.

Before starting radiation therapy, your radiation oncologist and radiation therapists will take images of the area receiving radiation. This helps them to determine the boundaries of the treatment area and target the radiation beams more accurately. The area will be marked with tattoos before treatment starts. These tattoos are very small, and you will likely only have a couple. 

The actual treatment will last no more than a few minutes, and the procedure will be painless.

INTERNAL RADIATION THERAPY

Internal radiation therapy, also called brachytherapy, delivers radiation therapy from inside of the body. A device containing radioactive seeds or pellets is temporarily placed into the breast directly into the affect area. Small tubes or catheters are often used to administer this kind of radiation therapy for breast cancer.

Internal radiation therapy can deliver a large dose of radiation directly to where the cancer is or was. It does this over a shorter period of time. The goal of this form of radiation is to reduce the risk of breast cancer recurrence. It also limits the dose of radiation to surrounding normal tissue.

While internal radiation therapy is an effective way to deliver treatment to an exact area, it may not be appropriate for all breast cancer patients. Factors including tumor location and size may limit whether you are able to receive this treatment.

Guidelines from the American Brachytherapy Society recommend internal radiation therapy to women over the age of 45 following a lumpectomy if:

  • The removed tumor is three centimeters or smaller in size.

  • The cancer has not spread to the lymph nodes.

  • No cancer cells were found in the rim of healthy tissue removed with the cancer.

Internal radiation therapy is usually given over a period of five days. A catheter with an inflatable device on the end will be surgically placed into the tumor site. During treatment, the radiation pellets or seeds will be placed into the inflatable device through the tube and left there for 10 to 20 minutes. The length of the treatment will depend on your type of cancer, your other cancer treatments, and overall health. After the entire course of treatments is done, the catheter and device will be removed.

ASK YOUR PHYSICIAN ABOUT RADIATION THERAPY FOR BREAST CANCER

Patients with breast cancer often worry about radiation treatment. It is a painless process, although there may be some side effects. Most patients can attend work and maintain their normal lives during treatment. Many patients are surprised to find they have a better experience with radiation treatment than expected.

Your cancer care team can answer any questions or concerns you may have about radiation therapy. If you’ve recently been diagnosed with breast cancer and would like more information about radiation therapy, visit https://www.siliconvalleyoncology.com/breast-cancer.

Lindsey Matech