Reducing Radiation During Breast Cancer Treatment


PITTSBURGH, Pa. (Ivanhoe Newswire)— Radiation treatment after breast cancer surgery used to be a prescribed one-size-fits-all. Now, clinicians in the U.S. are considering reducing radiation for one group of breast cancer patients following the results of a European study.

This is one serious side effect of breast cancer radiation treatment designed to destroy any lingering cancer cells can damage the skin. For many patients, doctors prescribe radiation five days a week for five or six weeks. But what if they could get the same outcome with fewer visits?

“When the patients get breast cancer treatment, they come daily for treatment. So, each visit is counted as a fraction. So, in this five-fraction, they come five times instead of like 20 or 30 times,” explained Sushil Beriwal, MD, a radiation oncologist, at UPMC Hillman Cancer Center

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The results of the APBI clinical trial from Florence, Italy studied patients diagnosed with early stage breast cancer that had not spread to the lymph nodes. Results suggested a shorter course of focused radiation is just as effective in preventing cancer from recurring.

“So, it’s a win-win situation. If you are a suitable candidate, it causes less physical discomfort, less financial discomfort, and less visits to the hospital,” shared Dr. Beriwal.

Experts say reducing the amount of time a woman spends in radiation treatment may encourage more women to undergo lumpectomy and radiation rather than mastectomy. Some women choose mastectomy because of the inability to get to a radiation facility every day for several weeks.

Contributors to this news report include: Cyndy McGrath, Executive Producer & Field Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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BACKGROUND: The standard for treatment for early stage breast cancer is typically mastectomy or lumpectomy. Lumpectomy, also referred to as a breast-conserving surgery, only removes part of the breast tissue and is used in conjunction with radiation treatment due to its higher rate of recurrence. Radiation is typically delivered via external beam radiation therapy, where the whole breast is exposed to radiation from an external machine. This treatment is typically a daily practice for up to five to seven weeks. Radiation therapy uses high-energy X-rays among other radiation techniques to kill the cancerous cells in the breast tissue. Internal radiation therapy is also an option and involves utilizing radioactive substances placed within needles, seeds, or thin tubes that are delivered directly into or near the cancerous cells. Internal radiation therapy commonly requires less time than external radiation therapy. Radiation for patients that choose breast-conserving therapy reduced local regional recurrence by 19 percent. Fifteen-year mortality from breast cancer was reduced from 60 percent to 54 percent for patients who underwent radiation following mastectomy when compared to patients who only underwent mastectomy and not radiation therapy.


SIDE EFFECTS: Radiation therapy can come with painful side effects. This most commonly includes skin changes such as dryness itching, blistering, or peeling. Therapy can also result in radiation burns. Another common symptom is chronic fatigue or exhaustion. Otherwise, side effects are a wide range of anomalies such as dry mouth, mouth and gum sores, difficulty swallowing, jaw stiffness, nausea, hair loss, lymphedema, tooth decay, shortness of breath, breast soreness, shoulder stiffness, cough, fever, radiation pneumonitis, radiation fibrosis or permanent lung scarring, loss of appetite, vomiting, bowel cramping, diarrhea, rectal bleeding, incontinence, bladder irritation, erectile dysfunction, lowered sperm counts, changes or stop in menstruation, symptoms of menopause, and possible infertility.


NEW TECHNOLOGY: The most current research suggests that a shorter, more focused course of radiation could yield the same benefits of therapy with fewer side effects. The therapy is called accelerated partial breast irradiation, also called APBI, and it is radiation delivered at a more concentrated, higher dose, over a shorter period of time, typically within one week. APBI can be delivered using intensity modulated radiation which can deliver fractioned radiation, meaning that the total dose is of radiation is given in several small, daily, or twice daily, doses internally using brachytherapy. This therapy limits exposure of healthy tissue to the radiation and has a much shorter total treatment time f a week or less because of the high doses. Additionally, because of the targeted nature of the approach, there is less exposure of radiation to vital organs like the lings and heart.






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Doctor Q and A

Read the entire Doctor Q&A for Sushil Beriwal, MD, Radiation Oncologist

Read the entire Q&A