Radiation Therapy
For Breast Cancers
Facts
About Breast Cancer
Breast cancer is the most
common type of cancer in American women, according to the American
Cancer Society.
- Each year, nearly 216,000 women and 1,500 men learn they have
breast cancer.
- Another 59,000 women learn they have in situ or noninvasive
breast cancer.
- Nearly 40,000 women will die from breast cancer each year.
Risk
Factors for Breast Cancer
Most women who develop
breast cancer do not have known risk factors, but some factors may
increase the chance of developing this disease. One of these risk
factors is age — more than 75 percent of women diagnosed with breast
cancer are over age 50. Other factors include:
- Early onset of menstruation.
- Family history of breast cancer in your mother or sister.
- Hormone replacement therapy with estrogen and progesterone.
- Alcohol consumption.
- A personal history of breast cancer or prior breast biopsy for
benign disease.
Diagnosing
Breast Cancer
Breast tumors are typically,
but not always, painless, so it is important to have any breast
or underarm lump checked. Swelling, discoloration, thickening of
the skin or nipple discharge also should be checked immediately.
- In some cases, a biopsy to determine if you have breast cancer
will be done in an office setting using a needle to remove cells
from the lump.
- A stereotactic biopsy uses mammography targeting to pinpoint
smaller tumors and permit a small amount of tissue to be removed
by a needle for diagnosis.
- Your surgeon may suggest removing the lump to see if you have
cancer.
Types
of Breast Cancer
The breast is made up of
ducts and lobules surrounded by fatty tissue.
- Cancer confined within a duct is called ductal carcinoma in
situ (DCIS). Lobular carcinoma in situ (LCIS) is cells confined
to a lobule.
- Tumors that break through the wall of the duct or lobule are
called infiltrating ductal or infiltrating lobular carcinomas.
- Inflammatory breast cancer may involve the entire breast with
specific skin changes and swelling.
Breast-conserving
Surgery
Studies have shown that women
with early-stage breast cancer who have a lumpectomy to remove the
cancer followed by radiation live just as long as women who have
a mastectomy and may be preferred by many women. The standard of
care after breast-conserving surgery is external beam radiation
therapy. Often, this follows chemotherapy.
- Your surgeon will perform an operation called a lumpectomy,
also called a partial mastectomy, excisional biopsy or tylectomy,
to remove the tumor. In some cases, a second operation called
a re-excision may be needed if microscopic examination finds tumor
cells at or near the edge of the tissue that was removed (called
a positive or close margin).
- To see if your cancer has spread, your doctor may remove several
lymph nodes from under your arm (axilla). If any of these nodes
contain cancer cells, more nodes may be removed.
- Breast-conserving surgery is not suitable for all breast cancer
patients. Talk with your surgeon to see if this is the best procedure
for you.
External
Beam Radiation Therapy
External beam radiation therapy
involves a series of daily outpatient treatments to accurately deliver
radiation to the breast.
- Painless radiation treatments are delivered in a series of daily
sessions. Each treatment will last less than 30 minutes, Monday
through Friday, for five to seven weeks.
- The usual course of radiation treats only the breast, although
treatment of the lymph nodes around the collarbone or the underarm
area is sometimes needed.
- 3-dimensional conformal radiotherapy (3D-CRT) combines multiple
radiation treatment fields to deliver very precise doses of radiation
to the breast and spare surrounding normal tissue.
- Intensity modulated radiation therapy (IMRT) is a form of 3D-CRT
that further modifies the radiation by varying the intensity of
the radiation beams. It is currently being studied for treating
breast cancer.
- Side effects might include skin irritation, like a mild to moderate
sunburn, mild to moderate breast swelling and fatigue.
Partial
Breast Irradiation
Doctors are studying ways
to deliver radiation to only part of the breast.
- Available in a few clinics for a very select group of patients,
these techniques are used after a lumpectomy to deliver radiation
to the tumor site rather than the entire breast.
- Breast brachytherapy involves placing flexible plastic tubes
called catheters or a balloon into the breast. Over one to five
days, the catheters or the balloon are connected to a brachytherapy
machine so high doses of radiation can treat the nearby breast
tissue.
- Other techniques include 3-D conformal partial breast irradiation
and intra-operative radiation therapy (IORT).
- The long-term results of these techniques are still being studied.
Talk with your radiation oncologist if you would like more information.
After
Mastectomy Radiation
In cases where the breast
is surgically removed, your doctor may suggest radiation therapy
for the chest wall and nearby lymph node areas.
- Whether or not radiation therapy should be used after removal
of the breast depends on several factors, including the number
of lymph nodes involved, tumor size and surgical margins.
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