Can One Radiation Dose After Breast Cancer Surgery Be as Effective as Six Weeks’ Worth?

Tuesday, October 1, 2013 - 7:33am
Assistant Professor, Radiation Medicine

Following breast cancer removal by lumpectomy, whole breast irradiation is commonly required. We know that when breast cancer cells return after surgical removal, they often recur in the area where the tumor was removed. (In other words, these recurrences rarely start growing in other parts of the breast or body far away from the surgical site.)

External Beam Radiation Therapy EBRT (EBRT) is the most common type of radiotherapy used to treat breast cancer. While it can be used to deliver partial breast radiation treatments, it is most often used to treat the whole breast after the cancer is removed. This can take six to seven weeks of a patient’s time in most cases.

There are currently four major partial breast radiation treatment options following surgery for women with breast cancer. These include Intra-operative Radiation (IORT), which delivers a single dose of radiation to the surgical site during the actual surgical procedure; Interstitial Radiation Therapy, administered by placing catheters throughout the area where the tumor was removed, and sliding a radiation seed through them to treat the site of the tumor; Intracavitary Therapy, where a set of catheters is placed into the surgical cavity and is used to deliver radiation to the patient over a week’s worth of treatments; and EBRT as described above but using smaller fields than those used to treat the whole breast.

Because of our understanding of how breast cancer returns, and knowing how the various radiation treatments I described above each have positive unique attributes, I began to hypothesize: Could we create a new and better way to deliver post-operative radiation for breast cancer patients?

We soon went to work and now are undertaking a clinical trial studying Partial Breast Irradiation. Our treatment approach combines what I believe are the best aspects of each of the four partial breast therapies above into one, simple and improved technique.

As with Intra-operative Radiation Therapy, we are giving the complete dose in just one treatment. Like Interstitial Therapies we are using a device that has many catheters which allows us to maximally target the dose. From External Beam Radiation Therapy, we have added the use of CT scans to most accurately plan where in the breast to target. And from Intracavitary Therapy, we have borrowed the idea of using a device that is simple to use and doesn’t require extensive training to administer.

Our hope is that by delivering a single dose of radiation therapy in a highly targeted way, we can shave weeks off of a patient’s treatment plan, decrease radiation side effects and decrease the costs of administering treatment dramatically. All this with the same great clinical outcome we see with whole breast irradiation is our goal.

If successful, this treatment could become a national best practice. It also would need little advanced training or capital investment for new equipment, because this equipment is already in most radiation oncology departments in the United States. It is yet another step in Roswell Park’s ongoing mission to ensure that cancer can’t win.

We’ll keep you posted on our progress, and are excited about the potential of this innovative study. To learn more about our breast cancer diagnosis and treatment programs, visit our website at https://www.roswellpark.org/cancer/breast.