Radiation Therapy for Breast Cancer
Accelerated Partial Breast Irradiation
External beam radiation therapy to the whole breast for several weeks after a lumpectomy is the standard of care for early-stage breast cancer. In national clinical trials, doctors are studying if accelerated partial breast irradiation (also called APBI) — where radiation is delivered to only part of the breast over one to five days — works as well. Many of these techniques are only available in a few clinics and then only to a select group of patients.
- Breast brachytherapy involves placing flexible plastic tubes called catheters or a balloon into the breast. Twice a day for five days, the catheters or the balloon are connected to a brachytherapy machine, also called a high-dose-rate (HDR) afterloader. Your radiation oncologist then directs a special computer to guide a small, radioactive seed into the breast tissue near where the tumor was removed. The radiation is left in place for several minutes. After the end of the five days, the catheters or balloon are removed.
- 3-D conformal partial breast irradiation is a type of external beam radiation therapy where only part of the breast receives external beam radiation. The long-term results of these techniques are still being studied. Talk with your radiation oncologist for more information. This is the most widely used APBI technique in the ongoing Radiation Therapy Oncology Group/National Surgical Adjuvant Breast and Bowel trial.
- For intraoperative radiation therapy (IORT), radiation oncologists deliver radiation to the place where the tumor was removed while the patient is in surgery. In some cases, doctors insert a small device to where the cancer was removed. Radiation is then applied through the tip of the device for 20 to 40 minutes. In other centers with shielded operating rooms, electron beam or HDR IORT is used. The advantage of this technique is the radiation can be given all at once instead of over several days or weeks.
In 2009, a panel of radiation oncology breast experts published a consensus statement on APBI in ASTRO's official journal, the International Journal of Radiation Oncology*Biology*Physics.
