Advanced precision in breast cancer radiation treatment reduces side effects
This is a commentary by Dr. Stephen Ramey, a radiation oncologist at the Nancy N. and J.C. Lewis Cancer & Research Pavilion at St. Joseph’s/Candler.
Radiation treatments for breast cancer patients have changed dramatically over the past 15 years.
Radiation is now more convenient, more precise, and generally has much fewer side effects for patients.
Convenience has improved, particularly in women receiving whole breast radiation without treatment of the lymph nodes. Most of the time we are delivering those treatments in 3 to 4 weeks as opposed to 5 to 6 weeks, previously. Multiple research trials have indicated that by shortening radiation courses, cure rates remain the same, and side effects, like skin reaction are actually less common.
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Technology has also made great strides resulting in improved precision of treatments. One technique delivers radiation only while the patient is taking a deep breath (called deep inspiratory breath hold). This technique is often used for left-sided breast cancers or when the lymph nodes are being treated to deliver less radiation to nearby tissues including the heart and lungs.
For women with larger breasts, we know that skin side effects are often increased and that it can be more difficult to avoid radiation to nearby structures. To reduce these effects, we can use a prone breast technique, meaning the patient lays on their stomach allowing breast tissue to fall away from the rest of the body. This leads to less radiation to areas outside of the breast and fewer side effects.
Particularly for patients with more advanced breast cancer that requires lymph node radiation, we can deliver treatment with VMAT (volumetric modulated arc therapy) or IMRT (intensity-modulated radiation therapy). Both techniques utilize computer programs to help deliver highly customized treatments which deliver high doses to the target areas but reduces exposure to nearby tissues.
Another technique that is dramatically improving both convenience and precision for patients with breast cancer is accelerated partial breast irradiation, also known as APBI. APBI can be utilized for women with early stage, favorable breast cancer who meet certain criteria. This method can reduce the treatment time from once a day for 3-4 weeks (15 to 20 treatments) to 1-1.5 weeks (5 treatments). Multiple studies have shown this technique results in extremely high rates of cure with less side effects.
While research and improved technology have led to dramatic advances in breast cancer over the years, one basic concept has not changed: the earlier that breast cancer is detected, the better the ultimate outcome. In addition to higher survival rates, patients with breast cancer that is caught early may benefit from less involved treatment techniques (for instance, partial breast radiation instead of whole breast radiation) and avoid some of the side effects.
That’s why early detection through mammography remains the best way to beat the disease.
It has been exciting to see the improved awareness of this disease and importance of screening. We’ve seen breast cancer awareness permeate the collective consciousness internationally, nationally, and through successful regional campaigns such as PAINT THE TOWN PINK.
These concerted efforts highlight the ability women have to improve their own health outcomes by having an annual mammogram.
Paint the Town Pink’s annual Mammography Day will be on Monday, Oct. 31 at six convenient locations throughout the region. Register by calling 912-819-PINK, or visit sjchs.org/PINK for more information.
This article originally appeared on Savannah Morning News: Breast cancer advances in radiation treatment reduce side effects
