Radiation therapy for breast cancer

Some patients with breast cancer need radiation therapy. Let's take a closer look at how this treatment works.

How it works?

The main treatment regimen that modern international protocols recommend to use for irradiation of breast cancer, is hypofractionated irradiation. These are doses of 40-42.5 Gy given to the patients in 15-16 fractions (treatments). Recommended additionally may be the radiation of the boost (bed of the removed tumor). In Ukraine, healthcare institutions just started transit to such fractionation regimen, although it has been a priority according to the international NCCN protocols since 2016.

It has been few years now that LISOD is using the hypofractionated radiation regimen as a routine, treatment according to classical fractionation is only in some cases.

It is noteworthy to mention that according to the international protocols of breast cancer treatment successfully used is the APBI regimen, an accelerated partial breast irradiation. The indications for the treatment are strict such as, small tumor, patient is above 50 years of age (using APBI approach for somewhat younger patients may be an option, if there are no negative criteria), no oncoplastic surgery has been made, other. LISOD pioneered using this approach of irradiation in Ukraine and, we remain to be the only ones who does it in Ukraine. It significantly reduces the load on the adjacent healthy organs, on the breast tissue in its entirety, and healthy breast,  treatment is over in 10 sessions, the shortest possible time.

It should be emphasized that in LISOD, it is tumorboard that chooses an irradiation regimen in each clinical case and also decides if the boost (tumor bed) needs to be irradiated. Recommendations are personalized and regard is given to all nuances of the illness.

Irradiation after surgery

Radiation therapy(adjuvant) follows after the surgery  to prevent recurrence of illness.

Treatment begins as soon as stitches heal. The best is in 4-8 weeks after the surgery.

If recommended after the surgery is also a chemotherapy,  irradiation can start in 3-4 weeks after last chemotherapy treatment.

Radiation therapy following breast conserving surgery is a standard of care. It significantly reduces the likehood of recurrence. Irradiation is given to the whole breast and the lymphatic drainage channels, if indicated. Need to irradiate the boost is decided individually.

After a mastectomy (total removal of breast), radiation therapy is sometimes recommended to the chest wall and lymph drainage channels (again, according to indications).

Equipment

Radiation Therapy in LISOD is performed on modern VARIAN linear accelerators. This makes the treatment very precise and safe.

The RT technique is individual and depends on the scope of treatment, irradiation regimen chosen, single and accumulative doses, etc.

For each clinical case, experts prepare few therapy plans using IMRT, VMAT, and 3D-CRT techniques. The best plan is then chosen based on all factors to ensure the highest protection of the surrounding organs and tissues, achieve the best outcome of treatment and enable a high quality of the patient's life in future.

The team

Radiation therapy in LISOD is handled by a team of experts, that encompasses radiation therapists, medical physicists, X-ray technicians, and experienced nurses. RT department is led by Zvi Bernstein, a clinical oncologist and radiotherapist from Israel with over 40 years of experience. Our powerful team is a pledge to the high-quality and safe treatment.