Radiation Oncology

back to Disease Sites

Radiation Therapy for Breast Cancer

Women with breast cancer are often treated with a combination of surgery, chemotherapy or hormone therapy, and radiation therapy. The decision to use chemotherapy or hormone therapy is made with a medical oncologist, and addresses the risk of systemic (whole body) spread, or even involvement of the other breast, in addition to the tumor diagnosed. The decision to use surgery and potentially radiation therapy addresses the risk of local recurrence, in the breast or adjacent lymph nodes only.

Choice of Local Therapy

Many women who present with early stage breast cancer have a choice of either breast conservation or mastectomy. Breast conservation involves the removal of the cancerous lump followed by external beam radiation to the breast. The most appropriate choice is a complex and personal decision which should be discussed with your doctor. Click to find further information regarding the use of breast conserving therapy 

What is External Beam Radiation Therapy?

What is 3-D conformal therapy and why is it Better?  

Conformal therapy allows for the customized treatment of each individual. Every woman has a unique size and shape of breast, and this therapy allows the minimum amount of heart and or lung to be irradiated.

Potential Side Effects

Most patients do very well during and after radiotherapy. There is some mild fatigue that occurs during the treatment, and resolves. Skin redness and irritation of the breast is expected, and usually occurs halfway through a typical 6 week course of radiotherapy, resolving completely a few weeks after finishing. The only common long-term side effect is a mild difference in the cosmetic appearance of the breast ( firmness, swelling). There a few rare side effects that are minimized further by three dimensional conformal therapy. More info

Radiation Therapy After Mastectomy

Despite having had a mastectomy, some patients benefit from radiation to the chest wall region. The patients most likely to benefit are those with original tumors >4 cm in size, or with >3 axillary lymph nodes involved by tumor . However, newer data is implying that any women with positive lymph nodes after mastectomy should be considered for radiotherapy to prevent local/regional recurrence or even improve survival.

Locally Advanced Breast Cancer

Most patients with locally advanced breast cancer are not candidates for breast conservation therapy.  They usually are treated with a combined approach with chemotherapy, mastectomy and radiation to the chest wall. Some patients may be treated with chemotherapy first, to shrink the tumor, and possibly avoid mastectomy.  There are early results to suggest this may be appropriate for certain women.  Treatment is therefore highly tailored to each specific case and the sequence of how each modality is applied can vary. 

Tamoxifen - Hormonal Therapy 

This is a selective estrogen receptor modulator that can be used to prevent recurrence of breast cancer as well as prevention of formation of new breast cancers in many patients. A patient's  age, tumor size, and estrogen receptor status all determine whether or not a patient  might benefit from the use of tamoxifen.  The benefits and risks of tamoxifen are usually  discussed with a Medical Oncologist. More about Tamoxifen

Chemotherapy

Chemotherapy is delivered by a medical oncologist as is a systemic treatment - meaning it is designed to treat cancer cells throughout the body.  Recommendations regarding which women should receive chemotherapy, the specific agents and their duration of use are constantly being modified when new information becomes available.  

A patient's age, tumor size, and cell characteristics determine whether she should receive chemotherapy.  Side effects vary by which chemotherapy drugs are utilized. The role of chemotherapy and the potential side effects should therefore be discussed with a medical oncologist. More info