Table of ContentsView AllTable of ContentsHow It WorksTypes of RadiationFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
How It Works
Types of Radiation
Frequently Asked Questions
Radiation therapy, also known as radiotherapy, is one of the treatment tools that can be used to treat breast cancer. It involves the use of ionizing radiation to kill cancer cells. It can also be used inpalliative careto improve comfort and quality of life for incurable cancer. Radiation therapy is not used for everyone, and youroncologistcan discuss with you whether it is appropriate for your course of treatment.
Not everyone with breast cancer needs radiation therapy. It is generally used in the following circumstances:
Broadly speaking, there are three types of radiation therapy used to treat breast cancer: external beam radiation,brachytherapy(also known as internal radiation therapy), and proton beam therapy.Each has its specific purpose and indications.
This article discusses the different types of radiation therapy for breast cancer and what to know about them.
Verywell / Brianna Gilmartin
Radiation is used against cancer cells to slow their growth and to kill them.Cancer cells are different from normal cells in several ways. Rather than undergoingapoptosis(programmed cell death) so that old cells can be replaced with new ones, cancer cells survive much longer than healthy cells. Moreover, they multiply at an accelerated rate, allowing them to infiltrate normal tissues.
Once mapped, the tumor site can be irradiated from different angles either externally (with ionizing radiation beams) or internally (with encapsulated radioactive materials).
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Types of Radiation for Breast Cancer
There are different types of radiation for breast cancer, including external beam radiation, brachytherapy, and proton beam therapy. Knowing more about each one can help ease concerns and reduce stress.
External Beam Radiation
Radiation can also be used withchemotherapyif a tumor cannot be surgically removed.
External beam radiation treatments would start after you heal from breast surgery or complete chemotherapy. The entire schedule of radiation therapy (called the course) is divided into daily treatments referred to as fractions.
Before radiation therapy begins, a radiation oncologist and aradiation therapistwill map the treatment area to determine the correct dose and angles of irradiation.The oncologist may apply small ink marks or tattoos to your skin to focus the radiation correctly.
Speak with your oncologist in advance of the procedure to determine if any ink marks will be permanent.
The traditional schedule of whole breast radiation is five days a week, Monday through Friday, for five to six weeks. Each session lasts between 15 and 30 minutes.
In some cases, accelerated breast irradiation (ABI) or accelerated partial breast irradiation (APBI) may be used. With this treatment, stronger radiation doses are given over a shorter period of time.
There are several types of ABI used when appropriate, including:
External beam radiation can spill over and affect other tissues, including the lungs, ribcage, and surrounding muscles. It can cause both short- and long-term side effects, depending on the size of the dose, the duration of therapy, the location of the tumor, and your general health.
Common short-term side effects include:
These side effects typically resolve once the therapy is completed, but some may take longer to improve than others. Skin changes, in particular, can take up to a year to normalize and may not fully return to their pretreatment state.
Long-term side effects may also occur due to the cumulative exposure to radiation.
These include:
Brachytherapy
Brachytherapy, also known as internal radiation therapy, is used after a lumpectomy to irradiate the surgical cavity from within.The radiation is delivered through one or several small tubes, called catheters, that are inserted through the skin of the breast. Radioactive seeds, pellets, tapes, or ribbons are then fed into the catheters and left for several minutes or days before being removed.
Brachytherapy can be used with whole breast radiation or on its own as a form of accelerated partial breast irradiation (APBI).
The two types of brachytherapy commonly used in breast cancer are:
Another type of brachytherapy, known as permanent breast seed implant (PBSI), may be used in early-stage cancer.It involves the permanent implantation of low-dose radioactive seeds to prevent cancer recurrence. After several months, the seeds will lose their radioactivity.
As with external beam radiation, brachytherapy requires careful mapping of the surgical cavity. Prior to the delivery of radiation, one or more catheters would be inserted into the breast, either during the lumpectomy or with a separate procedure.The catheters are kept in place for the duration of therapy, with a short length of tubing extending outside of the breast.
Once the correct dose and coordinates have been established, the external catheter is connected to a machine called an afterloader. This feeds the radioactive source through the catheters and removes them once the fraction is complete.
Compared to the five to six weeks needed for external beam radiation, breast brachytherapy can be completed in three or seven days.
Intracavity brachytherapy is typically performed over five days and involves two 10- to 20-minute sessions delivered six hours apart.Interstitial brachytherapy, which is less commonly used, may be performed as an in-hospital procedure over one or two days.
Brachytherapy can cause many of the same side effects as external beam radiation, although they tend to be less severe.
Because brachytherapy involves one or more small incisions, there is an added risk of infection, particularly if the catheter site gets wet or is not cleaned. In some cases, a pocket of fluid, called aseroma, may develop beneath the skin. This requires drainage with a needle.
Long-Term Side Effects of Radiation Therapy
Proton Beam Therapy
Proton beam therapy, also known as proton therapy, is an advanced method of radiation that poses less harm to surrounding tissues.The radiation emitted in proton therapy does not travel beyond the tumor.
The charged particles, called protons, only release their energy as they reach their target. This reduces the amount of radiation that can harm other tissues. Side effects are similar to other types of radiation therapy, but are generally less severe.
Proton therapy has been around since 1989 and is used to treat certain cancers (includingprostate cancerandlymphoma). Research is ongoing to determine whether it would be effective for treating breast cancer.
The cost and availability of proton therapy remain significant barriers to its use.
Summary
There are different kinds of radiation used to treat breast cancer: external beam radiation, brachytherapy, and proton beam therapy. If you need radiation as part of your treatment plan, the type of radiation can vary depending on the stage of your cancer and other factors.
A Word From VeryWell
Treatment for breast cancer can seem overwhelming or confusing at times. There are many different types of treatment, and different ways of administering each treatment. Your healthcare provider will go over the treatment options that are most appropriate for your diagnosis.
Don’t be afraid to ask questions—that’s what they’re there for. Knowing more about each option can help you discuss the choices and make informed decisions about your care, as well as knowing what to expect.
Frequently Asked QuestionsThe length of treatment depends on what kind of radiation you are getting. The schedules can vary widely depending on your stage of cancer, the type of radiation you are getting, and the dosage. Your oncologist will let you know your schedule once the specific type of radiation therapy is determined.The radiation treatment itself is painless. The side effects that it may cause can be uncomfortable for some people, although this is often temporary. But the radiation itself is not painful.Radiation does cause hair loss, but only in the area being treated. You may lose underarm hair or hair on your chest, but not the hair on your head. If you have radiation to the brain for metastases (areas where the cancer has spread), then you may experience hair loss on your head.Avoid tight-fitting clothing over the treated area. This can irritate sensitive skin. Talk with your treatment team about a skin care routine and what products to use to help soothe the affected skin. The radiated area should also be kept out of the sun to avoid further irritation. You may experience fatigue, so be gentle with yourself and don’t overdo it. Talk with your treatment team about do’s and don’ts with your radiation treatment.
The length of treatment depends on what kind of radiation you are getting. The schedules can vary widely depending on your stage of cancer, the type of radiation you are getting, and the dosage. Your oncologist will let you know your schedule once the specific type of radiation therapy is determined.
The radiation treatment itself is painless. The side effects that it may cause can be uncomfortable for some people, although this is often temporary. But the radiation itself is not painful.
Radiation does cause hair loss, but only in the area being treated. You may lose underarm hair or hair on your chest, but not the hair on your head. If you have radiation to the brain for metastases (areas where the cancer has spread), then you may experience hair loss on your head.
Avoid tight-fitting clothing over the treated area. This can irritate sensitive skin. Talk with your treatment team about a skin care routine and what products to use to help soothe the affected skin. The radiated area should also be kept out of the sun to avoid further irritation. You may experience fatigue, so be gentle with yourself and don’t overdo it. Talk with your treatment team about do’s and don’ts with your radiation treatment.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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