Partial Breast Radiation
A type of radiation therapy
called partial breast radiation was developed to address the side effects of whole breast radiation therapy, which can include too much radiation to healthy tissue and to the skin, ribs, heart and lungs. The 3 to 6 week daily treatment schedule is also tough for many people.
Partial breast radiation focuses mainly on the area where the cancer was first found. It can be given by external beam or internally using brachytherapy. In this procedure, a surgeon places a tiny balloon or hollow, flexible tubes called catheters in the area of the tumor. In general, radiation is given twice a day for a week, with each treatment taking up to half an hour. When you complete treatment, the surgeon removes the catheters or balloon.
Doctors are still studying the effectiveness and side effects of partial breast radiation. If you want this treatment, explore the risks and benefits with your doctor.
External Beam Partial Breast Radiation
Partial breast radiation can be delivered into the breast from outside the body by external beam using intensity-modulated radiation therapy (IMRT). It is being studied for use after lumpectomy.
IMRT uses computer-controlled x-rays to focus radiation to the exact shape of the tumor area while protecting normal cells as much as possible. The shape of the radiation beams can be changed to match the shape of the tumor.
IMRT is planned by using a computed tomography (CT) scan or magnetic resonance (MRI) images. A computer helps calculate the way radiation is directed across the tumor. These results help your doctor figure out the radiation intensity, or dose, and beam direction that will best match the tumor shape.
All radiation therapy is directed at the tumor, but IMRT directs it more so. IMRT increases the low dose of radiation to healthy tissue but can do a better job of concentrating the radiation in the high dose area. But IMRT also requires longer daily treatment times and more planning and safety checks before you can start therapy.
Internal Partial Breast Radiation
Occasionally, partial breast radiation can be given by temporarily placing radioactive substances inside the breast. This is called brachytherapy, and is being studied for use after lumpectomy.
During treatment, a doctor puts a source of radiation directly inside your body using seeds, wires or a catheter. The radiation targets the area where the tumor was found and the surrounding tissue to kill any remaining cancer cells.
Researchers are still working to find out how these new technologies compare to standard external radiation in preventing recurrence. Your providers can help you decide which treatment is right for you.
Brachytherapy
Brachytherapy is a procedure that involves placing radioactive material inside your body. It is one type of radiation therapy that’s used to treat breast cancer.
External beam radiation is the standard form of radiation therapy. With brachytherapy, or radiation given from inside the body, doctors deliver higher doses of radiation to more specific areas. This is done by placing a radioactive implant in or near the tumor. Brachytherapy treatment is usually shorter than external beam radiation and may cause fewer side effects.
There are two types of brachytherapy: intracavitary and interstitial. Both these methods use radioactive implants such as seeds, wires, capsules, balloons or tubes.
Who Gets Brachytherapy?People with early-stage breast cancers who have had or will have a lumpectomy, a breast-sparing surgery, are sometimes eligible for brachytherapy. This method is still being studied in large randomized clinical trials.
Sometimes a boost can be given to the site of your surgery after a mastectomy, but this is rarely done with brachytherapy. If it is, your doctor will use a surface applicator, not an implant.
How Is Brachytherapy Used?Brachytherapy can be used on its own as a radiation treatment.
Many studies are comparing brachytherapy to standard whole breast radiation to see whether they work equally well at preventing the cancer from returning to the breast. This question is still being studied. If you want this treatment, explore the risks and benefits with your doctor.
How Is Brachytherapy Given?
- Intracavitary radiation therapy is a form of brachytherapy where a balloon is inserted in the cavity, or space, where the tumor is found. The balloon is filled with fluid to hold it in place.
Twice a day over about 1 week, a radiation oncologist places a small radioactive seed into a catheter that runs from outside of the breast to the balloon. The seeds stay inside the body just long enough to give the prescribed dose of radiation. You will feel nothing during the procedure, which usually takes 5 to 10 minutes. After all treatments are complete, the balloon and catheter are removed. Your doctor may offer you pain medicine for the removal to make you more comfortable.
- Interstitial radiation therapy is a form of brachytherapy similar to intracavitary brachytherapy but many catheters are used. The radioactive pellets are put in the tubes for short periods over several days and then taken out.