The breast is made up of ducts and lobules surrounded by fatty tissue.
Cancer confined within a duct is called ductal carcinoma in situ (DCIS). Lobular carcinoma in situ (LCIS) is cells confined to a lobule.
Tumors that break through the wall of the duct or lobule are called infiltrating ductal or infiltrating lobular carcinomas.
Inflammatory breast cancer may involve the entire breast with specific skin changes and swelling.
BREAST-CONSERVING SURGERY
Studies have shown that women with early-stage breast cancer who have a lumpectomy to remove the cancer followed by radiation live just as long as women who have a mastectomy and may be preferred by many women. The standard of care after breast-conserving surgery is external beam radiation therapy. Often, this follows chemotherapy or antiestrogen therapy.
•Your surgeon will perform an operation called a lumpectomy, also called a partial mastectomy, to remove the tumor.
•In some cases, a second operation called a re-excision may be needed if microscopic examination finds tumor cells at or near the edge of the tissue that was removed (called a positive or close margin).
•To see if your cancer has spread, your doctor may remove several lymph nodes from under your arm (axilla). If any of these nodes contain cancer cells, more nodes may be removed.
• Breast-conserving surgery is not suitable for all breast cancer patients. Talk with your surgeon to see if this is the best procedure for you
EXTERNAL BEAM RADIATION THERAPY
External beam radiation therapy involves a series of daily outpatient treatments to accurately deliver radiation to the breast.
Painless radiation treatments are delivered in a series of daily sessions. Each treatment will last less than 30 minutes, Monday through Friday, for five to seven weeks. The usual course of radiation treats only the breast, although treatment of the lymph nodes around the collarbone or the underarm area is sometimes needed.
3-dimensional conformal radiotherapy uses images of the body aquired with a specialized CT to deliver very precise doses of radiation to the breast and spare surrounding normal tissue.
Intensity modulated radiation therapy (IMRT) is a form of 3D-CRT that further modifies the radiation by varying the intensity of the radiation beams. It may decrease the dose to the heart and lungs in selected patients.
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Intensty Modulated Radiation Therapy allows to encompass the breast uniformly limiting the dose to the lung and heart. Side effects might include skin irritation, like a mild to moderate sunburn, mild to moderate breast swelling and fatigue |
| PARTIAL BREAST IRRADIATION | |
Doctors are studying ways to deliver radiation to only part of the breast over shorter period of time. These techniques, available for a very select group of patients, are used after a lumpectomy to deliver radiation to the tumor site rather than the entire breast.
Breast brachytherapy involves placing flexible plastic tubes called catheters or a balloon into the breast. Over one to five days, the catheters or the balloon are connected to a brachytherapy machine so high doses of radiation can treat the nearby breast tissue.
An applicator delivers high dose of radiation to the surgical cavity site
The other techniques is 3-D conformal partial breast irradiation
An example of four external radiation beam which are focused on the surgical site area.
The picture shows four external radiation beam which are focused on the surgical site area.
The long-term results of these techniques are still being studied. Talk with your radiation oncologist if you would like more information and see if you are a candidate for an investigational study.
AFTER MASTECTOMY RADIATION
In cases where the breast is surgically removed, your doctor may suggest radiation therapy for the chest wall and nearby lymph node areas.
Whether or not radiation therapy should be used after removal of the breast depends on several factors, including the number of lymph nodes involved, tumor size and surgical margins.
OTHER TREATMENTS
Chemotherapy and/or hormonal therapy are often suggested.
In some cases, chemotherapy may be advised to help keep the cancer from coming back; chemotherapy usually is given before radiation therapy course.
Sometimes, treatment with a drug to block the effects of estrogen and progesterone may be recommended i.e. Tamoxifen, Femara, Arimidex etc.
These decisions are usually made after talking with a medical oncologist, another important member of your treatment team.
