Radiation oncology for breast cancer: What is it and what are your options?

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Radiation therapy can help reduce the risk of breast cancer from coming back.


By Philip Gilbo, MD, Chief of Radiation Oncology at Norwalk Hospital, Nuvance Health


If you have breast cancer, you probably want to know all your options before making treatment decisions. Radiation therapy is one of the main treatments for breast cancer following surgery.


But what exactly is it, why would someone with breast cancer need it, and what are the different types?


Learn more about radiation therapy at the Nuvance Health Cancer Institute.


What is radiation therapy for breast cancer?


Radiation is precisely focused beams of energy used to eliminate cancer cells. It is a fundamental part of modern breast-conserving treatment. The main purpose of radiation for breast cancer is to reduce the chance the cancer comes back in the same area after surgery.


When should you have radiation therapy for breast cancer?


Radiation is an especially important component of breast conservation therapy, which consists of a partial mastectomy or lumpectomy, lymph node removal and radiation therapy. Your care team may recommend this approach if you have a small tumor relative to breast size.


Your care team may also recommend radiation therapy following a mastectomy if there is a high risk of the cancer coming back depending on the type and your genetics.


Learn more about types of breast cancer surgery.


What should you consider before radiation therapy for breast cancer?


You and your care team should consider the following factors when making a decision about your treatment plan:


Generally, most individuals who have a lumpectomy will also have radiation therapy. However, these factors may impact treatment decisions about the size of the radiation field, length of treatment and if radiation is indicated at all.


Is there more than one type of radiation?


There are different types of radiation therapy for breast cancer. For many years, individuals would typically receive a type of treatment called whole breast radiation. A newer treatment called partial breast radiation therapy is also now available. Some Nuvance Health cancer centers offer this treatment.


Partial breast radiation therapy for breast cancer


Partial breast accelerated radiation therapy is for people with ductal carcinoma in situ (DCIS) or early-stage invasive breast cancer after lumpectomy. Partial breast accelerated radiation therapy is also called accelerated partial breast irradiation (APBI). Treatments are usually completed over five to ten days.


In addition to fewer treatments, partial breast radiation may preserve more healthy tissue when compared to whole breast radiation therapy. This technique may also speed your recovery and improve your quality of life. There are multiple studies with over a decade of follow-up demonstrating equivalence to whole breast radiation therapy.


Whole breast radiation therapy for breast cancer


Whole breast radiation treats the entire breast. Whole breast radiation treatments are usually five days a week for three to four weeks. This has long been considered a standard for breast cancer radiation.


Is radiation therapy safe?


Radiation has been in use for over 125 years and we have accumulated many decades of data and experience based on clinical trials showing that radiation therapy is safe and effective.


New technology allows us to deliver very concentrated and focused beam radiation that protects nearby organs by keeping the radiation away from them.


Is radiation for breast cancer worth it?


Nationally, almost 50% of cancer patients will receive radiation at some point in their journey. Radiation therapy allows people the option of preserving their breasts. Ample data compares mastectomy to breast preservation therapy with radiation therapy. These studies show that there is no difference between the two treatments in terms of treating cancer.


For people who have cancer that has spread elsewhere in the body, radiation can also be used to help relieve pain related to cancer. This may reduce or even eliminate the need for narcotics.


How long is radiation therapy for breast cancer?


In general, most radiation treatments are daily, Monday through Friday. Total treatments range from as little as five to up to thirty treatments depending on the type of breast cancer. Most treatments take around 20 minutes, though often the total experience within the department may take up to an hour.


Does radiation therapy hurt?


You will neither see nor feel the radiation. It is like getting an X-ray. The radiation is painless and non-invasive.


Does radiation therapy have side effects?


The most common side effects of radiation therapy are fatigue and skin reactions. Your radiation oncologist will help you manage side effects.


Usually, fatigue is not all day long and only at certain times of the day. Skin reactions vary; it could be as little as some redness of the skin or more bothersome like a sunburn. Side effects do not start right away, and in fact are more common at the end of the treatment.


Some people are concerned about their loved ones — especially their kids and grandkids — receiving radiation from their treatment. It is important to note that people are not radioactive when they receive external beam radiation for breast cancer. There are no safety concerns for other people that you live with or come into contact with.


What should you look for in a radiation oncology program?


If you have breast cancer and need to make decisions about your care, look for an accredited cancer center with a multispecialty approach to cancer care. The cancer center should include board-certified doctors, licensed physicists and therapists, registered nurses, dietitians and other roles.


You should have confidence in your doctors and feel like they take time to answer your questions. Look for a cancer center that has established programs and close relationships between specialists.


Also, look for a cancer center that offers supportive services such as nutritional support, lymphedema therapy and survivorship programs, because they play an important role in recovery from breast cancer and help patients achieve optimal outcomes.


Learn more about what to look for in a breast cancer center.


The bottom line: Radiation is one of the main pillars of cancer treatment. Your care team should develop an individualized treatment plan based on the type and stage of cancer, location, previous treatments and your preferences.