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Types of radiotherapy used to treat breast cancer

Thanks to advances in radiotherapy technology and techniques, radiation oncologists are able to choose from among several approaches when deciding how best to treat a patient following a lumpectomy or mastectomy. This breadth of options allows the physicians to tailor their treatment plan to a patient’s specific needs, weighing factors such as the location and extent of the area to be treated and the patient’s overall health. Board-certified radiation oncologist Priti Patel, MD, who practices with Regional Cancer Care Associates (RCCA), explains that those options include:

  • Whole-breast radiation. As its name indicates, this form of radiation targets the entire breast. Dr. Patel explains that it is the most common form of radiation therapy delivered by an external beam (external-beam radiotherapy, or EBRT).
    While whole-breast radiation is unlikely to cause serious long-term side effects, patients can experience fatigue and skin redness, she says, noting that neither effect is debilitating and that both are treatable. Whole breast radiation can typically be done in anywhere from 15 to 33 treatments.
  • Accelerated partial-breast irradiation (APBI) is another external-beam modality. Unlike whole-breast radiation, however, this approach targets a small area. APBI is employed in early-stage breast cancer, and typically involves fewer doses and shorter treatment intervals than whole-breast radiation, making treatment more convenient to the patient. APBI, however, also can cause fatigue and skin changes, Dr. Patel explains.
  • Chest wall radiation is administered after mastectomy to kill cancer cells that may remain along the chest wall. If the cancer has spread to the lymph nodes, they, too, are radiated. Skin changes, including redness and a sunburn-like tanning effect, can occur immediately after chest wall radiation, Patel notes. A sensation of tightness or pulling of the breast also can result, she adds.
  • Brachytherapy is an approach in which a sealed radiation source is inserted in or near the affected area. Some radiation oncologists and patients choose brachytherapy over external-beam radiation because a brachytherapy course lasts 5 days, while external-beam radiation therapy regimens sometimes require several weeks, Dr. Patel says. However, she notes that unlike EBRT, brachytherapy is an invasive treatment. A catheter is used to place the sealed radiation into the lumpectomy cavity. This heightens the risk of adverse effects, which can range from skin redness to infection and fibrosis.
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Regional Cancer Care Associates is one of fewer than 200 medical practices in the country selected to participate in the Oncology Care Model (OCM); a recent Medicare initiative aimed at improving care coordination and access to and quality of care for Medicare beneficiaries undergoing chemotherapy treatment.