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Home Treatment Options Radiation Radiation Therapy and its Role in Treating Breast Cancer

Radiation Therapy and its Role in Treating Breast Cancer

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Radiation therapy is one of many treatment options available to patients diagnosed with breast cancer. It uses a high-energy radiation beam, or x-ray, to kill cancer cells. Radiation is delivered to the breast affected by cancer and often to nearby lymph nodes. It can be delivered in one of three ways: external-beam radiation therapy, internal radiation therapy or brachytherapy, or systemic radiation therapy. A machine outside of the body delivers external-beam radiation, while internal radiation therapy uses cancer-killing medication placed near cancer cells within the body. Systemic radiation therapy uses medication that travels through the bloodstream to kill cancer cells.

Radiation therapy works by damaging the DNA and cellular structure of cancer cells through the creation of particles known as free radicals. Altering the DNA, or genetic information, of cancer cells prevents them from dividing and effectively causes cancer cell death. The body can naturally break down and eliminate these dead cells. While radiation therapy is planned in a way to minimize damage to surrounding normal tissue, it can damage the normal cells in your body as well. Your team of physicians knows the amount of radiation normal tissue can safely tolerate, and takes possible damage to normal cells into account when planning your radiation therapy.

Radiation therapy can be used as either curative or palliative treatment, and can reduce the risk of local recurrence by up to seventy-five percent. This means that patients with Stage 0 to Stage IV cancer can benefit from radiation. Most commonly, radiation therapy is recommended to patients after lumpectomy or mastectomy to kill any cancer cells left behind after tumor removal. After lumpectomy, your physician may recommend whole breast radiation therapy if the cancer is early stage, smaller than four centimeters, located in one site or removed with clear margins. Radiation is recommended after mastectomy if the tumor is larger than five centimeters, four or more lymph nodes were involved, the removed tissue had positive margins, or if the cancer has invaded the skin. The two most common ways of delivering radiation therapy in beast cancer are external-beam radiation therapy and partial breast irradiation. Radiation can be used in combination with surgery, chemotherapy and hormonal therapy, and the timing and sequence depends on your unique situation.

Radiation therapy is not an option for everyone. Full dose radiation therapy can only be given once to a particular part of the body; if you have received prior radiation to the same body part, radiation therapy is no longer a treatment option. If you have connective tissue disease, such as scleroderma or certain types of vasculitis, your body is extra-sensitive to the side effects of radiation and may not be able to tolerate therapy. Radiation therapy is not an option for pregnant patients who wish to carry their pregnancy to term.

The most common side effects of radiation therapy include fatigue, breast pain, swelling, skin changes, persistent breast swelling and fibrosis. Staying active and healthy during radiation therapy is important to minimize these side effects, promote tissue healing and prevent infection. Proper skin care, which your physician will discuss with you, will also help minimize skin reactions at the site of therapy.

Shreya Sengupta, Shikha Jain MD

References:

Radiation therapy for breast cancer. http://my.clevelandclinic.org/services/radiation_therapy/hic_radiation_therapy_for_breast_cancer.aspx. 2009

When is radiation appropriate. http://www.breastcancer.org/treatment/radiation/when_appropriate.jsp. 2008.

Radiation therapy for cancer. http://www.cancer.gov/cancertopics/factsheet/Therapy/radiation.

Role of radiation therapy in breast conservation therapy. http://www.uptodate.com/