Radiation Therapy for Breast Cancer

At NYU Langone, doctors may use radiation therapy, which uses high-energy beams that kill cancer cells, to treat women with breast cancer.

This treatment is most often used to prevent cancer from returning after breast-conserving surgery, also called lumpectomy. Radiation therapy usually follows chemotherapy in women who have had a lumpectomy.

NYU Langone doctors most frequently use external beam radiation therapy to manage breast cancer. This type of radiation therapy is delivered outside of the body by a machine called a linear accelerator. The machine rotates around a woman during therapy to treat the entire breast. Treatment sessions take several weeks to complete.

Some women may require treatment only to the area where the tumor was removed, an approached called partial breast irradiation. This approach allows treatment to be completed in one week and is available in a clinical trial setting. 

Radiation therapy may also be recommended after a mastectomy if a woman has also had her sentinel or axillary lymph nodes surgically removed. Radiation therapy is directed at the reconstructed breast or the chest wall and the lymph node basins—the area where the nodes were surgically removed.

NYU Langone experts ensure that the radiation therapy is delivered as precisely as possible. A woman receiving external beam radiation therapy is not radioactive in any way and does not need to limit contact with children or pregnant women.

Treatment Planning

NYU Langone radiation oncologists use CT scans of the target area and surrounding tissue and organs in conjunction with computer software to develop a customized treatment plan for you. This software creates a three-dimensional image of the target tissue and surrounding organs, and allows our doctors to determine how best to target the cancer while sparing as much nearby healthy tissue as possible.

Dr. Carmen Perez Reviews Radiology Images

Dr. Carmen Perez reviews radiology images.

NYU Langone physicians may perform frequent CT scans during treatments to ensure that the radiation therapy is targeting the breast cancer and avoiding healthy tissue. This approach, called image-guided radiation therapy, helps compensate for organs moving during treatments, which may require an adjustment in radiation targeting. The technique also enables doctors to track the size and shape of the tumor over the course of treatment.

Prone Position External Beam Radiation Therapy

NYU Langone radiation oncologists helped pioneer prone external beam radiation therapy, an approach that allows for better distribution of the treatment dose. During this approach, doctors ask the woman to lie face down, known as the prone position, instead of lying on her back, called the supine position.   

This positioning uses gravity to displace the breast tissue away from the body, allowing radiation oncologists to better target the breast tissue while avoiding the heart and lungs.

The prone position also has the advantage of markedly decreasing the skin reaction commonly referred to as a radiation burn. Radiation beams are evenly distributed throughout the breast and are less concentrated in the skin folds, as compared to radiation therapy given to women when they lie on their backs during treatment.

Radiation Therapy After Breast-Conserving Surgery

External beam radiation therapy is given five days a week over the course of three to six weeks to women who have had breast-conserving surgery, depending on their doctor’s recommendation. Women’s preferences are also taken into consideration. 

Radiation is delivered to the entire breast. In addition, the area where the tumor was located may receive an additional dose called a “radiation boost.”

Women who have an early cancer with no lymph node involvement who have had breast-conserving surgery may be able to receive higher daily doses of radiation therapy, which shortens the overall treatment course. They can receive 15 or 16 treatment sessions over 3 weeks. This treatment schedule may or may not include a radiation boost.

Radiation Therapy After Mastectomy

For women who have had a mastectomy, radiation therapy is delivered to the chest wall, muscle behind the removed breast tissue, the reconstructed breast, and the draining lymph node basins.

Treatment can be given after reconstruction for five days a week for five to six weeks.

Managing Side Effects

NYU Langone doctors are able to avoid serious side effects of radiation therapy, such as heart or lung damage, with the use of the prone technique and highly targeted treatments. Women who have radiation therapy may experience breast swelling and skin irritation, similar to a sunburn.

Doctors can prescribe topical skin creams to help manage these effects. They can also refer you to our support services and to NYU Langone’s integrative health services.

Clinical Trials

NYU Langone researchers are evaluating a 15-day radiation therapy regimen, which includes a boost of radiation applied to the area where the tumor was located, in women who have had breast-conserving therapy. 

Our doctors are also studying partial breast radiation therapy, which is given after surgery and is applied to the area where the tumor was located. Treatment is complete in one week. Postmenopausal women may be eligible for partial breast radiation therapy in a clinical trial setting. 

Researchers are evaluating using radiation therapy in women with breast cancer that has spread in conjunction with immunotherapy. This may encourage the body’s immune system to fight the cancer. 

Your doctor can advise you on whether participating in a clinical trial may be beneficial to your treatment plan and, if so, assist you in the enrollment process.

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