Treatment of breast cancer through radiation: Prospects, patient outcomes, and what one might anticipate
Breast cancer patients have two main options for radiation therapy: external beam radiation (EBRT) and internal radiation therapy, also known as brachytherapy. While both methods are effective in treating early-stage breast cancer, they differ in delivery method, treatment duration, side effects, and some outcomes.
Differences in Treatment Delivery and Schedule
External beam radiation uses a machine to direct radiation beams from outside the body to the cancer site. It is typically given over 3 to 6 weeks, with daily sessions five days per week. Each session lasts less than 30 minutes[2][4]. On the other hand, brachytherapy involves placing radioactive material directly inside or near the tumor site in the breast. Treatment with brachytherapy is much shorter, usually completed in 2 to 5 days[1][2].
Effectiveness
Studies show similar local control and breast cancer-specific survival rates at 5 to 10 years between whole breast irradiation (EBRT) and accelerated partial breast irradiation (APBI) delivered by brachytherapy or external beam[3]. Brachytherapy offers excellent tumor control with long-term data supporting its safe use as a breast-preserving option for early-stage disease[1]. EBRT remains the standard and most commonly used method, but partial breast irradiation (including brachytherapy) is increasingly accepted as an effective alternative in select patients[2][3].
Side Effects and Cosmetic Outcomes
Brachytherapy tends to have fewer side effects and lower rates of acute and long-term toxicity compared to whole breast external beam radiation[1][3]. Cosmetic outcomes are generally better with brachytherapy or partial breast irradiation techniques, likely due to the localized radiation dose sparing more healthy tissue[3]. EBRT side effects may include skin changes, fatigue, and inflammation of the breast tissue due to the larger area treated over a longer period[2][4].
Choosing the Right Treatment
Both EBRT and brachytherapy are validated approaches in early-stage breast cancer, with brachytherapy offering a shorter treatment course and potentially reduced toxicity for appropriate patients[1][2][3]. The type of brachytherapy used depends on the location of the tumor, how much the cancer has spread, and the person's overall health.
Types of Brachytherapy
Interstitial brachytherapy involves placing radioactive material within a cavity, such as the breast, using a needle or catheter. High-dose-rate brachytherapy consists of multiple treatment sessions in which doctors place radioactive material in the body for about 10-20 minutes before removing it. Low-dose-rate brachytherapy uses substances that release a constant, low dose of radiation over 1-7 days, during which time a person will likely stay in the hospital[4].
Precautions
Taking antioxidant supplements can interfere with radiation therapy's effectiveness, so people should focus on eating a well-balanced diet. Radiation therapy should not cause pain or discomfort during the procedure, but minor side effects are common in the days or weeks afterward. Side effects from radiation therapy can include skin changes, swelling in the breast, fatigue, and armpit discomfort.
Benefits of Radiation Therapy
Radiation therapy is often used to treat individuals with metastatic breast cancer to ease their symptoms. Healthy cells usually recover from radiation therapy. Radiation therapy can reduce the chances of a breast cancer recurrence after surgery.
In conclusion, both EBRT and brachytherapy are effective in treating early-stage breast cancer. Brachytherapy offers a shorter treatment course, fewer side effects, and potentially reduced toxicity for appropriate patients. It's crucial to discuss the options with a healthcare provider to determine the best course of treatment.
[1] American Cancer Society. (2021). Brachytherapy for Breast Cancer. https://www.cancer.org/treatment/understanding-your-diagnosis/types-of-treatment/radiation/brachytherapy/brachytherapy-for-breast-cancer.html
[2] National Cancer Institute. (2021). External Beam Radiation Therapy for Breast Cancer. https://www.cancer.gov/types/breast/patient/radiation-breast-pdq
[3] National Comprehensive Cancer Network. (2021). Breast Cancer - Early Stage. https://www.nccn.org/patients/guidelines/breast/html/early_stage.html
[4] Mayo Clinic. (2021). Radiation therapy for breast cancer. https://www.mayoclinic.org/tests-procedures/radiation-therapy/about/pac-20394783
- Breast cancer patients have two primary radiation therapy options: external beam radiation therapy (EBRT) and internal radiation therapy, also known as brachytherapy.
- Brachytherapy, which places radioactive material directly into or near the tumor site in the breast, is typically completed in 2 to 5 days, while EBRT, which uses a machine to direct radiation beams, is given over 3 to 6 weeks.
- Studies indicate similar local control and breast cancer-specific survival rates at 5 to 10 years between EBRT and brachytherapy methods for early-stage breast cancer.
- Brachytherapy often results in fewer side effects and lower rates of acute and long-term toxicity compared to EBRT, with better cosmetic outcomes possibly due to the localized radiation dose sparing more healthy tissue.
- When deciding between EBRT and brachytherapy, it is critical to consult with a healthcare provider to determine the best course of treatment, as both methods are validated approaches in early-stage breast cancer.
