Radiation Therapy

Radiation therapy as a primary treatment is a promising technique for women who have early stage breast cancer. This procedure allows a woman to keep her breast and involves lumpectomy followed by radiation (x-ray) treatment.

Once a biopsy has been done and breast cancer has been diagnosed, radiation treatment usually involves the following steps:

• Surgery to evaluate underarm lymph nodes to see if the cancer has spread beyond the breast, (i.e. sentinel lymph node biopsy or axillary lymph node dissection).

• External radiation therapy to the breast and the surrounding area (involving approximately 5 weeks of treatment).

• "Boost" radiation therapy to the biopsy site which is usually marked with surgical clips to mark the tumor bed (one additional week of radiation therapy).

For external radiation therapy, a machine beams x-rays to the breast and possibly the underarm lymph nodes. The usual schedule for radiation therapy is 5 days a week for about 5 to 7 weeks. In some instances, a "boost" or concentrated dose of radiation may be given to the area where the cancer was located. This can be done with an electron beam. Less frequently used is a boost done internally with an implant of radioactive materials.

If you are having radiation therapy as primary treatment for early stage breast cancer, a qualified, board-certified radiation therapist who is experienced in this form of treatment should do it.

ADVANTAGES:
• The breast is not removed.
• Lumpectomy with radiation therapy as a primary treatment for breast cancer appears is as effective as mastectomy for treating early stage breast cancer.
• The skin usually regains a normal appearance.

DISADVANTAGES:
• A full course of treatment requires short daily outpatient hospital visits for approximately 5 weeks.
• Treatment may produce a skin reaction like sunburn and may cause fatigue.
• Itching or peeling of the skin may occur.
• Radiation therapy can sometimes cause a temporary decrease in white blood cell count, which may increase the risk of infection.
• You maintain your breast and therefore have a variable risk of local recurrence which may require a mastectomy should cancer return.
• Post-mastectomy reconstruction options are limited after radiation therapy to the breast.