Know the Types of Radiation Therapy for Breast Cancer

Radiation therapy can be used for women with metastatic breast cancer to help with symptoms in the affected area, in approximately 80 percent of cases. 

Radiation Therapy is an effective therapy to treat breast cancer in various ways. It not only destroys the cancer cells that may remain in the margin after surgery and prevents cancer recurrence but also helps to eradicate cancer even from the affected lymph nodes. 

The type of radiation therapy depends on the extent of the spread of cancerous tissue and may involve the whole breast or partial radiation only on the affected region. 

Let us know in detail about the types of breast cancer radiotherapy and its success.

What is Radiation Therapy?

Radiation therapy is a treatment method that uses high-energy rays or particles to eliminate cancer cells. It is commonly used in combination with other treatments for breast cancer in certain cases. The use of radiation therapy depends on the stage of breast cancer and other factors.

Situations where radiation therapy may be used

Radiation Therapy can be used to treat breast cancer patients during different surgical procedures including breast-conserving surgery or mastectomy. 

a. After breast-conserving surgery 

Radiation therapy is used to reduce the risk of cancer recurrence in the same breast or nearby lymph nodes.

c. After a mastectomy

If the cancer is larger than 5 cm if cancer is found in multiple lymph nodes, or if certain surgical margins have cancer cells (such as the skin or muscle), radiation therapy may be recommended.

Types of radiation therapy for breast cancer

There are different types of radiation therapy for breast cancer patients. But depending on the location of the radiation source, it can be broadly categorized into External beam radiation therapy and brachytherapy. 

1. External beam radiation therapy (EBRT) 

This is the most common type of radiation therapy for breast cancer. It involves using a machine outside the body to focus radiation on the affected area.

EBRT is used for women with breast cancer. The specific areas that require radiation depend on whether a mastectomy or breast-conserving surgery was performed, as well as the presence of cancer in nearby lymph nodes.

If you have breast cancer without affecting the lymph nodes, radiation is focused on the chest wall, mastectomy scar, and areas where surgical drains were placed. 

For breast-conserving surgery patients, radiation is usually given to the entire breast. An additional boost of radiation may be given to the area where the cancer was removed if there is a high risk of recurrence.

If cancer is found in the lymph nodes under the arm, radiation may be given to this area. In some cases, radiation may also be administered to the lymph nodes above the collarbone and beneath the breastbone.

Timing of external beam radiation therapy

External beam radiation therapy is typically delayed until the surgical site has healed, which can take a month or longer. If chemotherapy is also being administered, radiation treatments are usually postponed until chemotherapy is completed. Hormone therapy or targeted therapy may be given concurrently with radiation.

Types and schedules of external beam radiation for breast cancer

External beam radiation therapy can be either given to the whole breast or may be partially applied. 

Whole breast radiation 

The standard schedule for whole breast radiation is 5 days a week for approximately 6 to 7 weeks. Alternatively, hypofractionated radiation therapy may be used, which involves larger daily doses over a shorter period (3 to 4 weeks).

Accelerated partial breast irradiation (APBI) 

This approach delivers larger radiation doses over a shorter time to only one part of the breast (the tumor bed) compared to whole breast radiation. Different techniques, such as intraoperative radiation therapy, 3D-conformal radiotherapy, and intensity-modulated radiotherapy, can be used for APBI.

2. Brachytherapy for breast cancer 

Brachytherapy is a type of radiation therapy that involves placing radioactive sources directly into the body near the cancerous tissue.

Intracavitary Brachytherapy

It is a widely employed method of treating breast cancer in women. This particular type of brachytherapy involves the placement of a specialized device into the void left behind after breast-conserving surgery. This device remains in position throughout the duration of the treatment until it is deemed complete. To ensure proper placement, surgical expertise is required as various devices are available for use.

The device is initially inserted into the breast as a small catheter or tube. Once inside, the end of the breast expands, resembling a balloon, to securely hold its position during treatment. The other end of the catheter extends outward from the breast. During each treatment session, one or more sources of radiation, often in the form of pellets, are carefully inserted through the tube and into the device for a brief period. These sources of radiation are then removed.

Typically, treatments are administered twice a day for a span of 5 days, allowing patients to receive treatment on an outpatient basis. 

Interstitial Brachytherapy

Interstitial brachytherapy is an alternative method used for treating breast cancer. Instead of placing a single device, multiple small, hollow tubes known as catheters are inserted around the area from which the cancer was removed. These catheters are left in place for several days to facilitate treatment.

During treatment, radioactive pellets are inserted into the catheters for short periods each day. These pellets deliver the necessary radiation and are subsequently removed.

Short-term and long-term side effects of breast radiation therapy 

During radiation therapy to the breast, the following short-term side effects may occur:

• Skin irritation, dryness, and alterations in pigmentation
• Breast tenderness or discomfort
• Fluid accumulation leading to breast swelling (lymphedema)

Radiation therapy can have lasting effects on the breast, manifesting in various ways, including:

1. Mild darkening of the skin
2. Increased visibility and enlargement of pores
3. Alterations in skin sensitivity, potentially leading to thickening and firmness
4. Changes in breast size due to the accumulation of fluid or the formation of scar tissue

Success Rate of Breast Cancer RadiationTherapy 

In simple terms, a study found that radiotherapy reduced the risk of breast cancer recurrence and breast cancer-related death. 

Specifically, it decreased the chance of any type of recurrence (locoregional or distant) over 10 years from 35.0% to 19.3%. 

Additionally, it lowered the risk of breast cancer death over 15 years from 25.2% to 21.4%. For women with pN0 disease (no clinical lymph node metastasis), radiotherapy reduced these risks from 31.0% to 15.6% for recurrence and from 20.5% to 17.2% for breast cancer death. 

The study also found that the reduction in recurrence risk varied based on factors such as age, grade, hormone receptor status, and type of surgery. Overall, the research suggests that radiotherapy can significantly reduce the risk of breast cancer recurrence and death.

Cost of Breast Cancer Radiation Therapy In India

Specifically, the cost of radiation therapy for breast cancer in India can range from around INR 1.5 lakhs to INR 3 lakhs (approximately US$2,000 to US$4,000).  It’s important to note that the cost can vary based on the number of sessions required and the specific radiation technique recommended by the consulting radiation oncologist

Role of MedicoExperts in Conducting Breast Radiation Therapy 

MedicoExperts plays a significant role in the administration of breast radiation therapy. They are a team of medical professionals, including radiation oncologists, who specialize in the treatment of breast cancer using radiation therapy techniques. Their role involves

Treatment Planning: MedicoExperts works closely with the patient’s healthcare team to develop an individualized treatment plan for breast radiation therapy. This plan takes into account the specific characteristics of the tumor and the stage of cancer. 

Throughout treatment, MedicoExperts closely monitors the patient’s response to radiation therapy. They may make adjustments to the treatment plan if necessary to optimize its effectiveness and minimize side effects.

After the completion of radiation therapy, MedicoExperts continue to play a role in the patient’s follow-up care. They monitor the patient’s progress, conduct regular check-ups, and collaborate with other healthcare professionals to ensure comprehensive post-treatment care.

Conclusion 

Radiation therapy for breast cancer is of various types and the surgeon makes the decision depending on the type of surgery performed and the condition of the patient. 

While there is radiation therapy where the source of radiation is kept away from the cancerous tissue, there are types where a radiation device is placed inside the tissue. 

The success of radiation therapy in the last 10 years is quite commendable with numerous patients getting survival and non-recurrence benefits as a result of the treatment.

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