Two main drawbacks of radiation therapy are the frequency and length of the treatment. Treatment is usually given once a day, five days a week, for three to seven weeks. Techniques that shorten the course of treatment continue to be studied in clinical trials. The results of these trials will decide whether these therapies become part of standard care.
After talking with your health care provider, we encourage you to consider joining a clinical trial of radiation therapy for breast cancer.
BreastCancerTrials.org in collaboration with Susan G. Komen® offers a custom matching service that can help you find a clinical trial that fits your health needs. Learn more about this program.
Learn more about clinical trials.
Learn about emerging areas in radiation treatment for metastatic breast cancer.
Accelerated, hypofractionated whole-breast irradiation
Accelerated, hypofractionated whole-breast irradiation is like standard radiation therapy except it uses a slightly higher dose of radiation per session (hypofractionation). This reduces the number of treatment sessions (making this an accelerated therapy).
Several randomized clinical trials have been done comparing this technique to standard radiation therapy and the results have been promising [17-19]. For example, a Canadian trial found women who got an accelerated three-week course of therapy had the same low of rates of breast cancer recurrence as those who got the standard five-week course of therapy . The long-term side effects (10 years after treatment) of increasing the dose of radiation per session appeared similar to those with standard radiation . Given these findings, some older women with small tumors may get a shortened course of radiation therapy. However, the use of accelerated, hypofractionated whole-breast irradiation for other women with breast cancer is still under study.
Accelerated partial breast irradiation
Accelerated partial breast irradiation delivers radiation only to the area around the tumor bed (the tissue in and around the space where the tumor was removed during lumpectomy). This reduces the number of treatment sessions (accelerated therapy). While standard radiation therapy is given five days a week for five to seven weeks, accelerated partial breast irradiation is usually given twice a day for one week. Not everyone can have this type of radiation therapy.
Accelerated partial breast irradiation can be done by brachytherapy, three-dimensional conformal external beam or by intraoperative radiation therapy. These techniques are still under study.
Brachytherapy uses targeted radiation therapy placed inside the tumor bed. Implanted radiation "seeds" (interstitial radiation therapy) or a single small balloon device (intracavitary radiation therapy, MammoSite®) can be used to deliver the radiation.
Some early findings suggest accelerated partial breast irradiation with brachytherapy may be as effective as standard radiation therapy in reducing rates of recurrence [20-23]. However, follow-up time on these studies is short and the long-term effects of brachytherapy are not yet known. It is also not clear which women are the best candidates for brachytherapy and whether the cosmetic look of the breast is worse with brachytherapy than with standard radiation therapy .
Although brachytherapy is available at some medical centers, it is still under study and is not considered part of standard care at this time.
Three-dimensional (3D) conformal external beam radiation therapy
Three-dimensional (3D) conformal external beam radiation therapy uses standard external beam radiation to target only the tumor bed.
Studies on 3D conformal external beam radiation therapy are limited at this time.
Intra-operative radiation therapy
With intra-operative radiation therapy, a single dose of radiation is given to the tumor bed during breast surgery (lumpectomy). This dose of radiation is higher than in a standard radiation session.
Intra-operative radiation therapy needs further study before its risks and benefits are known. At this time, it is being studied mainly in Europe.
Our commitment to research
At Susan G. Komen®, we are committed to ending breast cancer forever by energizing science to find the cures and ensuring quality care for all people, everywhere. Our global research grants and scientific programs are essential driving forces for achieving this mission. Many of the world’s leaders in breast cancer research have been supported by Komen’s Research and Scientific Programs – including three Nobel Laureates. Komen’s funding has supported research that has resulted in a better understanding of breast cancer; earlier detection; personalized, less invasive treatments for what was once a “one-treatment-fits-all” disease; and improved survival rates. Learn more about the exciting research we are funding.
*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.