Beryl McCormick and Simon Powell lead efforts to improve radiation therapy options for women with breast cancer.
Radiation therapy uses high-energy x-rays to destroy cancer cells. At Memorial Sloan Kettering, we use radiation therapy in many different situations for women with breast cancer.
Following a lumpectomy, for example, we can focus radiation on the breast and, in some cases, the surrounding lymph node area to destroy any stray cancer cells. This approach lessens the chance that cancer will come back. Most frequently we target the entire breast after this surgery, but for women with very early-stage breast cancer, our treatment program targets only the affected part of the breast. This is called partial-breast radiation.
Sometimes we give radiation therapy after a mastectomy, but only if there’s a high risk of cancer coming back in that area. Our plastic surgeons and medical oncologists work together to offer postmastectomy radiation to women who’ve had an immediate reconstruction and need radiation treatment.
Our approach has resulted in both excellent control of the cancer in the area treated (local control) and a low rate of major radiation-related problems with reconstruction. Women who need systemic therapy, such as chemotherapy, may receive radiation after chemotherapy is completed.
Your treatment team will work with you to identify the best sequence of radiation treatments. A course of standard radiation therapy for breast cancer typically includes five days of treatment each week for three to six weeks.
Types of Radiation Used for Breast Cancer
We offer several types of radiation therapy for breast cancer.
In IMRT, a special computer program is used to deliver a consistent dose of radiation to the breast. This technology prevents so-called hot spots (areas that receive more radiation than others due to the shape of the breast). It also minimizes acute (immediate) and late (delayed) side effects. In special situations, IMRT is also used to limit the radiation dose to organs close to the breast or lymph nodes being treated.
In this method, you lie on your stomach (instead of your back) and radiation is directed to the affected breast as it hangs through an opening in the treatment table. This approach reduces radiation exposure to nearby vital organs, such as the heart and lungs. It’s been found to be especially useful for women with large breasts.
In IGRT, doctors and radiation therapists use imaging technologies such as x-ray and MRI to locate the tumor just before giving the radiation dose, while you are in the treatment position. This results in a more accurate delivery of radiation directly to the tumor.
Some women can benefit from an advanced form of radiation therapy called proton therapy. It delivers high doses of radiation to tumors that may be resistant to other forms. Proton therapy directs its cancer-fighting energy to precise locations within the body. This allows our doctors to deliver the necessary dose to the tumor — maximizing the chance of destroying it — while also lowering the dose to normal tissue, thereby reducing the risk of treatment-related side effects. This cutting-edge technology is available at a limited number of locations in the United States.
Radiation treatments today are very precise, resulting in little harm to surrounding skin or healthy tissues. They’re generally very well tolerated. But after a few weeks, you may notice some side effects, such as a sunburn-like condition on the skin, fatigue, discoloration of the skin, or swelling and heaviness in the breast.
Your radiation oncologist will explain in detail what to expect and when side effects are likely to appear. He or she can also prescribe a topical skin cream to minimize the side effects.