Clinical opinions / 20 Aug, 2020

The latest in radiation therapy treatment for breast cancer

Prof John Boyages AM

Radiation therapy for breast cancer has been used as a treatment technique for many years. While there are many different types of treatments for breast cancer, radiation therapy in addition to conventional treatments such as surgery or hormonal treatments can improve the success of your treatment.

Radiation therapy has evolved dramatically over the last 10 years, with treatment now offering greater precision, shorter treatment times and a more convenient and comfortable experience for patients. One of the most important benefits has been the ability to reduce the number of treatment sessions (or ‘fractions’) required during radiation therapy for breast cancer. For many patients, radiation therapy treatment is just as effective when given over three to four weeks compared to five to six weeks.

The UK Fast-Forward trial, which was published in The Lancet Journal, recently investigated whether radiation therapy for breast cancer can safely be shortened from four weeks to one week with five consecutive treatments.1 Preliminary findings of the trial have shown that although the risk of cancer returning seems to be just as low when treatment is delivered in one week compared with four weeks, some women who were treated in one week experienced additional side effects such as breast thickening and breast pain. The trial also only studied women who were managed in a specific manner and may not be applicable for all patients. Most patients were older and did not have a mastectomy. In addition, the follow-up remains short (most patients had four to five years of follow-up or less) and many radiation oncologists in the US and Australia remain cautious about this approach.

Reducing the amount of time spent in the centre for treatment can make a big difference for patients, from saving you the stress of travel and time spent away from loved ones to reducing costs without further complications. However, it’s important that radiation therapy treatment is personalised to you and your cancer, which will help determine how long your treatment will take and the number of sessions you require. Usually your treatment can be given in as short as 15 treatments (three weeks). Our team at Icon Cancer Centre are now offering five fraction whole breast irradiation for highly selected patients (e.g. > 75 years of age, no chemotherapy, breast conservation only) in the first instance.

With the availability of sophisticated volumetric modulated arc therapy (VMAT), a novel technique that delivers radiation continuously as the treatment machine rotates, radiation can be delivered in multiple directions to directly target the cancer while protecting surrounding healthy tissue. Radiation therapy using VMAT delivers treatment quickly, reducing the overall amount of radiation to healthy tissue while ensuring the right amount is delivered to your breast (and often a little extra through a “boost” to target where the cancer started in your breast).

At Icon Cancer Centre, we are proud to offer the latest in radiation therapy including VMAT and provide faster and more comfortable treatment for men and women with breast cancer.

Professor John Boyages AM is a Radiation Oncologist at Icon Wahroonga and Icon Gosford.

References

For a full list of references, click here.
  1. Brunt, Adrian Murray, et al. “Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial.” The Lancet (2020).

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