Is Radiation the Next Step?

Radiation therapy can reduce the risk of cancer coming back by as much as 30%.

What is radiation?

Radiation therapy is a common follow-up treatment for people with breast cancer. It uses specific amounts of high-energy radiation to shrink tumors and kill off remaining cancer cells.

If you have a lumpectomy…

Chances are good your healthcare team will recommend that you follow up with radiation. The goal of this treatment is to kill off any cancer cells that might have been left behind during surgery or any mutated cells that could potentially progress into cancer at a later time.

If you have a mastectomy…

Your doctors may still recommend radiation—especially if your tumor was large, cancer cells were found in your lymph nodes or the tumor was close to your rib cage or chest-wall muscles. In these cases, radiation therapy is aimed at reducing the risk of a recurrence near the surgical site. This is referred to as a local recurrence.

What type of radiation are you getting?

Standard External Radiation Therapy

This type of radiation is delivered in the form of high-powered energy beams, such as X-rays, to your entire breast from a machine outside your body. This is the most common type of radiation therapy used for breast cancer.

Time commitment: Treatments are usually done each weekday for six to seven weeks. Treatments generally begin three to six weeks after surgery (unless chemo is required in between). The sessions are short, so you should be able to keep to your normal routine.

What happens: First, the area to be treated will be carefully "mapped," then radiation beams will be directed at it from a machine. After a lumpectomy, the target area is the entire breast. Sometimes the lymph nodes above and below the collarbone and near the chest wall are also included in what is referred to as the radiation field. After a mastectomy, for locally advanced cancer, radiation is directed at the area of the surgery and the lymph nodes.

Who it's best for: This is the gold standard in breast cancer care, and it's used unless there are clear indications that another treatment might be preferable.

Accelerated Partial Breast Radiation Therapy (brachytherapy)

In this treatment, radiation is delivered using a small tube or tubes placed inside the breast—either near the tumor site or right inside the pocket left after a lumpectomy. Accelerated partial breast radiation can also be delivered externally.

Time commitment: Brachytherapy is generally done twice a day for five days, and it starts shortly after surgery.

What happens: One to three days before the treatments start, a physician will place one or more tubes inside your breast through a small incision. For treatments, he or she will load a radioactive substance into the tubes. The treatment session lasts a few minutes, and then the radioactive substance is removed.

Who it's best for: Generally, this option is offered only to women over age 50 who had small tumors removed by lumpectomy and no positive lymph nodes. The pocket left after the lumpectomy also needs to be the right size and shape.

Planning for Radiation Side Effects

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