Understanding Radiotherapy in the Treatment of Breast Cancer: A Comprehensive Insight

Radiotherapy targets cancer cells in breast tissue. Dr. Wilson explains how it works and what to expect.

Introduction

The decision often depends on the stage and characteristics of the disease, as well as the type of surgery performed (such as after breast-conserving surgery). This article delves into the intricacies of radiotherapy as an option for treating breast cancer, providing an understanding of how it works and what to expect during treatment.

Background and Significance

After a breast cancer diagnosis, patients face various treatment options tailored to the stage and type of their cancer. Radiotherapy, which utilizes high-dose radiation beams to target and destroy cancer cells, has evolved significantly thanks to technological advancements like our state-of-the-art Halcyon machine. This modality has become indispensable in contemporary cancer management paradigms.

Pre-Treatment Diagnostic Assessments

Treatment protocols are individualized, and diagnostic assessments are crucial for tailoring the most effective treatment regimen. “Prior to commencing radiotherapy or any other treatment, a comprehensive diagnostic work-up is conducted, including mammograms and imaging to assist with the staging of the disease. Computed tomography (CT) scans, positron emission tomography (PET) scans, and magnetic resonance imaging (MRI) can all be used for diagnostic purposes,” explains Dr. Wilson.

Breast Cancer Staging: An Overview

Breast cancer staging ranges from stage 0 (carcinoma in situ) to stage IV, with lower stages indicating limited spread and stage IV indicating metastasis or spread to other organs. Dr. Wilson notes that surgery followed by radiotherapy often serves as the treatment for early-stage disease.

“In hormone receptor-positive patients, we may also introduce hormonal therapies that modulate estrogen levels or inhibit estrogen receptors. In more advanced stages, chemotherapy or targeted therapeutic agents may be added to the treatment strategy,” Dr. Wilson adds. “As technology advances, cancer treatment is increasingly becoming personalized. Researchers can now identify a multitude of markers on cancer cells, allowing treatment options to evolve to the point where treatment plans are highly individualized.”

“Advancements in genomic technologies have increasingly personalized cancer treatment. Genetic screening can particularly inform treatment strategies for patients with BRCA1 and BRCA2 mutations or those with cancer caused by genetic factors,” he adds.

Indications for Radiotherapy in Breast Cancer

Dr. Rob Wilson, an oncologist with a strong interest in breast cancer treatment, emphasizes that radiotherapy is most often advised for patients diagnosed with node-positive disease, indicating that cancer cells have metastasized from the primary tumor in the breast to the nearby lymph nodes. It is also recommended after breast-conserving surgery.

Summary

• Breast-Conserving Surgery: Patients usually receive radiation post-surgery for extra protection.
• Lymph Nodes: Regional nodal RT is advised for women with more than 3 affected lymph nodes and is also suggested for those with 1-3 involved nodes or high-risk tumors.
• Pre-Surgery Chemotherapy: Radiation still occurs after chemotherapy, with regional nodal treatment depending on disease stage and response.
• Post-Mastectomy: Radiation is often used, especially when high-risk features or residual disease are present.

“In such instances, radiotherapy serves as a pivotal part of the treatment strategy,” adds Dr. Wilson.

For personalized treatment plans, consult with your healthcare provider, as RT is a critical component in combating breast cancer.

Types of Radiotherapy for Breast Cancer

• Conformal Radiotherapy (3DCRT): This treatment allows doctors to direct radiation beams to conform to tumor shapes, reducing exposure to healthy tissue.
• Intensity-Modulated Radiotherapy (IMRT): An advanced form of 3DCRT, IMRT allows for varying the intensity of radiation, thus providing a tailored approach to treat complex tumors.
• Volumetric Arc Radiotherapy (VMAT): In VMAT, the radiation machine rotates around the patient, delivering a continuous but varying dose of radiation from multiple angles. “This optimizes the dose delivery to the tumor while reducing exposure to adjacent healthy organs,” Dr. Wilson remarks.

The Halcyon™ Radiation Therapy System

The Halcyon™ radiation therapy system is designed to deliver precise image-guided, volumetric, intensity-modulated radiation therapy up to four times faster than standard technology. It captures either two-dimensional or cone-beam CT images for guidance in less than 15 seconds and also delivers varying intensities of radiation for cancer treatments that last a few minutes per session.

The Importance of Early Detection

Dr. Wilson underscores that early detection through regular self-examinations and routine mammograms is the most effective preventative measure.

Risk Factors and Demographics

Dr. Wilson says that risk factors for breast cancer commonly include age, gender, ethnicity, and lifestyle choices. “The typical profile of a breast cancer patient in South Africa mirrors that of the rest of the world. Risk factors include age, with incidence increasing after 40 and peaking around 70. Women are at higher risk than men. Ethnicity also plays a role; for instance, Caucasian women seem to be at higher risk. Socioeconomic factors can also influence diagnosis stages, possibly due to better healthcare access,” he notes.

Lifestyle factors like obesity, smoking, alcohol consumption, and lack of exercise also contribute to risk, as do hormonal replacement therapy during menopause. Certain reproductive factors such as late age at first pregnancy (>35 years), Nulliparity, ‘Longer estrogen window’ (Early menarche and late menopause) along with decreased breast feeding also contribute to increased incidences.

Conclusion

For those contending with a breast cancer diagnosis, understanding the role of radiotherapy can demystify part of the treatment journey. As with any medical condition, early detection and personalized treatment plans offer the best prognosis.

Read more about Busamed Hillcrest Private Hospital’s Halcyon Machine, which is a state of the art and sophisticated radiotherapy machine.