External beam radiation therapy (EBRT) uses one or more beams to deliver high energy x-rays from outside the body to the cancerous area. Treatment is usually given over four to six weeks; each treatment is about 15 minutes.
Types of EBRT which can be used for the treatment of breast cancer include:
- Intensity modulated radiation therapy (IMRT) – a high precision type of radiation therapy that uses computer controlled linear accelerators to deliver precise radiation to your breast or chest area after surgery, whilst minimising the dose to the underlying organs such as the heart and lungs.
- Volumetric modulated arc therapy (VMAT) – a novel radiation therapy technique that delivers the radiation dose continuously as the treatment machine rotates. This technique accurately shapes the radiation dose to the tumour while minimising the dose to surrounding organs.
- Surface guided radiation therapy (SGRT) – also known as tattoo-free radiation therapy, uses advanced camera technology to facilitate 3D tracking of the skin’s surface during set-up and treatment. SGRT is available at Icon Cancer Centre Windsor Gardens and Icon Cancer Centre Mulgrave.
Image guided radiation therapy (IGRT) is used to ensure EBRT is delivered as accurately as possible. This involves advanced imaging equipment and computer software such as MRI, CT and x-ray to increase the radiation therapist’s ability to precisely target a tumour with radiation beams. A low-dose CT scan is done before treatment to ensure your radiation plan is delivered precisely every day with sub-millimetre accuracy.
If you have had a lumpectomy, sometimes an extra dose of radiation is given to the region where your tumour has been removed. This can be done using an integrated “boost” as part of a VMAT or IMRT plan or following treatment to the whole breast.
Reducing the risk of damage to your heart
Deep Inspiration Breath Hold (DIBH) is a technique for left-sided breast cancer patients that reduces the potential impact of radiation on the heart. The process involves holding a certain number of breaths for short bursts during treatment which allows the heart to move backwards into the chest while the breast is exposed to radiation.
Delivering reduced treatment sessions for selected patients
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 While preliminary findings of the trial have shown that the risk of cancer returning seems to be just as low when treatment is delivered in one week compared with four weeks, 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). Icon Cancer Centre now offer five fraction whole breast irradiation for highly selected patients (e.g. > 75 years of age, no chemotherapy, breast conservation only) in the first instance. For more information, click here.
Delivering reduced treatment volumes for selected patients
For men and women who are aged 60 to 65 with small grade 1 or 2, oestrogen receptor-positive tumours and no family history of breast cancer, partial breast irradiation (PBI) may be suitable in some instances. PBI for selected patients is available at Icon Cancer Centre Wahroonga.