Breast cancer is very common in women. About one in nine women will get breast cancer. Chances are quite high that almost every woman has a relative with breast cancer or has a friend or acquaintance with breast cancer. Thanks largely to the use of screening mammograms (Yes, it works!) most breast cancer is caught at an early stage. This is good news, because there are excellent treatment options available. For most women with early stage breast cancer, the first decision is whether to have a mastectomy to remove the breast and check the lymph nodes or to keep her breast (breast conservation therapy). Both of these approaches offer excellent and essentially identical chances of curing the breast cancer, but are very different. After early stage breast cancer has been diagnosed, thorough research and obtaining opinions from a breast surgeon and a radiation oncologist are highly encouraged BEFORE beginning treatment.

When researching on the internet, patients should stick to “name brand” sources of information such as well-known hospitals or university medical centers. Some women with breast cancer also require chemotherapy or hormone blocking therapy. This can be incorporated with either mastectomy or breast conservation therapy and the sequencing of therapy is individualized for each unique patient.

In the “real world”, over 90% of women choose to keep the breast, that is they choose breast conservation therapy. This involves a “package deal” of surgery to remove the breast tumor, surgery (usually at the same time) to check if cancer is in the lymph nodes under the arm, and radiation treatments to the breast. The lymph nodes do not need radiation of they do not contain cancer cells. In addition, chemotherapy, “targeted therapy” and/or hormone blocking therapy may be necessary as well. The decision as to how best to combine and sequence the treatments a woman needs for her individual breast cancer is as individual as each woman! This decision is best made as part of a team approach including the breast surgeon, radiation oncologist, medical oncologist and, of course, the patient. The details of surgery and chemotherapy are best discussed with the breast surgeon and medical oncologist who will be performing those treatments. Our discussion here will focus on the radiation treatments.

The most common breast radiotherapy treatment is external beam radiation to the whole breast. This is done once a day, five days a week for a period of either 33 or 16 treatments. In the United States, the treatment approach using 33 fractions is most common. Of these 33 treatments, 28 are delivered to the entire breast and the final 5 treatments are targeted specifically to the area from which the tumor was removed. Each treatment is delivered quickly, over a period of less than 5 minutes. The patient feels nothing and there are no immediate effects during each individual treatment. Like any type of cancer therapy, radiation has both short and long term effects, and those are best discussed in detail with the radiation oncologist who will be directing the treatment.

Breast cancer therapy is one area where Radixact TomoTherapy really shines! Radixact Tomotherapy is excellent about wrapping the radiation dose around the chest to treat only the breast and greatly reduce the radiation dose to the lung and heart! This is especially true of left breast cancers since the heart is located on the left side of the chest. This greatly reduces the risk of long term radiation effects such as scarring of the lung or damage to the heart. When the lymph nodes contain cancer cells, the lymph nodes which drain lymph fluid from the breast are usually treated as well. This results in more radiation reaching the normal tissues such as the lung and the heart. However, the “collateral damage” to the lung and heart is much less with Radixact Tomotherapy than with older conventional radiation techniques such as 3D conformal radiation therapy. The cosmetic appearance of the breast after external beam radiation is excellent in most women.

Overall, external beam radiation treatment used as a part of breast conservation therapy for early stage breast cancer has a less than 5% chance of the cancer returning in the treated breast and has cure rates equal to mastectomy. These excellent results allow most women with early stage breast cancer to keep their breast with excellent cosmetic results and avoid the need for breast reconstruction or the use of breast prostheses in their bra.
A diagnosis of breast cancer is almost always life-changing. As such, many patients perform a “lifestyle reassessment” in which they re-evaluate the roles of maintaining healthy nutrition and exercise habits and well as adopting stress reducing techniques.

Many also seek out the help and advice of friends as well as to broaden their social connections with others, especially with other women who have been through the breast cancer treatment process. Some nationally recognized support groups include the Susan G Komen Foundation which specializes in breast cancer support services and its fund raising event Race for the Cure. Other national organizations which offer support for breast cancer patients as well as support to people with many other types of cancer include the American Cancer Association, Relay for Life and many many others. A Google search will quickly identify the cancer support organizations in your local area which may be able to help you during your journey.