Radiation therapy for breast cancer uses high-energy rays to destroy cancer cells and prevent them from returning after surgery. This localized treatment targets the breast area or chest wall, aiming to eliminate any remaining microscopic cancer cells. Its primary purpose is to reduce the risk of cancer recurrence in the treated area.
Factors Determining Treatment Regimen
The number and type of radiation treatments patients receive depend on several individual factors. These include the cancer’s stage, size, and specific type (e.g., invasive ductal carcinoma or ductal carcinoma in situ). Lymph node involvement, overall health, age, and prior treatments like lumpectomy, mastectomy, or chemotherapy also influence the plan. Specific tumor characteristics, such as molecular subtype and genetic markers, also help oncologists tailor the radiation regimen.
Standard Radiation Treatment Schedules
The most common radiation schedule, conventional fractionation, involves daily treatments over 5 to 7 weeks. Patients receive a single dose each weekday, totaling 25 to 35 sessions. This schedule delivers radiation in smaller doses, allowing normal tissues time to repair between sessions. It is a longstanding standard, effective in reducing recurrence risks.
Hypofractionated radiation offers a shorter course, lasting 3 to 4 weeks. This approach delivers higher daily doses over 15 to 20 sessions. It is often used for early-stage breast cancer patients after a lumpectomy, providing comparable effectiveness to conventional schedules. The increased daily dose achieves the same total biological effect in a shorter timeframe.
Accelerated Partial Breast Irradiation (APBI) is a targeted approach, delivering radiation to only the portion of the breast where the tumor was located. This method can shorten treatment duration, often completed in just 5 days. APBI can be delivered through techniques like brachytherapy (placing radioactive sources directly into the tumor bed) or external beam APBI. These treatments are generally reserved for carefully selected patients with very early-stage, low-risk breast cancers.
After the main radiation course, some patients may receive additional “boost” doses to the area where the tumor was removed. This extra radiation targets the tumor bed to further reduce local recurrence risk. A boost typically involves 5 to 8 additional daily treatments, delivered after the standard or hypofractionated course. This treatment is considered for younger patients or those with tumor characteristics suggesting a higher recurrence risk.
Managing Side Effects During Treatment
Patients undergoing radiation therapy for breast cancer commonly experience skin reactions in the treated area. This can manifest as redness, dryness, itching, or even peeling, similar to a sunburn. Applying gentle, non-irritating moisturizers and avoiding harsh soaps can help manage these symptoms. Protecting the irradiated skin from sun exposure is also important during and after treatment.
Fatigue is a frequent side effect, often accumulating as treatment progresses. This tiredness can range from mild to severe, affecting daily activities. Resting, maintaining a balanced diet, and light exercise (if tolerated) can help mitigate fatigue. Listen to your body and conserve energy.
Breast swelling or tenderness in the treated breast is also common due to inflammation from the radiation. This can cause discomfort and a feeling of fullness. Wearing supportive, comfortable bras without underwires can provide relief. Over-the-counter pain relievers may be used as directed by a healthcare provider to manage any associated pain.
Less common side effects include lung irritation (cough or shortness of breath) or heart issues, particularly if the left breast is treated. Arm swelling, known as lymphedema, can also occur, especially if lymph nodes were removed. Patients should communicate any new or worsening symptoms to their care team promptly. The medical team can offer strategies to manage these side effects.