Radiation therapy is used to stop the growth and division of cancer cells. External beam radiation may be given after breast surgery, or to shrink a tumor before surgery is done. If you're having surgery first, your surgeon will remove as much of the breast cancer as possible. Then radiation is done to kill off any straggling cancer cells that may remain. Whole breast radiation (WBI) is given after a mastectomy or lumpectomy to prevent breast cancer recurrence. It is a painless form of external beam radiation therapy.
Also Known As: Whole Breast Irradiation, WBI, WB-EBRT, Whole Breast Radiotherapy
Standard and Accelerated Whole Breast Radiation
Standard whole breast radiation usually requires 25 treatments, given daily Monday through Friday for five or six weeks. Each treatment gives your breast a low dose of radiation that kills cancer cells and affects healthy cells as well. In fact, breast cancer cells will continue to die for a couple of weeks after you finish radiation treatments.
If you don't live near a clinic or hospital, ask your radiation oncologist about your options for accelerated treatments. Accelerated whole breast radiation (also called hypofractioned whole breast irradiation) can be completed in three weeks.
The American Society for Therapeutic Radiology and Oncology (ASTRO) reported that two studies comparing standard and accelerated whole breast radiation showed that the methods had similar rates of risk of recurrence and most patients had good cosmetic results.
Whole Breast Radiation May Target More Than Breast Area
Because breast tumors may shed cells into your blood and lymph systems, your radiation treatments may cover more than your breast. Whole breast radiation will include your breast tissue, but may also be expanded to cover your chest wall and underarm area. These are the areas in which recurrence is most likely to happen. Your treatments will be carefully planned to avoid or limit radiation to your heart and lungs.
What to Expect During a Radiation Treatment Session
Your radiation oncologist will carefully plan your treatments to hone in on the best positions and dosage. There will be a special appointment for a simulation session where you will lay down while images of the target area are taken. Tattoos or ink marks may be used to help locate the target's position. A molded pillow might be created to help you stay in position during treatments.
When actual treatments begin, wear loose clothing that is easy to remove. For each treatment session, you will change into a hospital gown and go into a special treatment room. While lying on a table with your molded pillow, your radiation therapists will help you get into position. During the treatment, your therapist will stand in a separate shielded room and operate the radiation machine.
Radiation will take from one to five minutes. You will change back into your clothing and go back to normal activities when all is said and done.
Side Effects of Whole Breast Radiation
Whole breast radiation will affect cancerous as well as healthy tissues, and side effects may occur. You might not experience all of these side effects, and if you do, they may vary in intensity from patient to patient. From most to least common, you may have these radiation side effects:
- Fatigue
- Appetite might decrease
- Breast skin becomes sunburned and sensitive
- Breast changes (swelling, tenderness or heaviness)
- Neutropenia (low white blood count)
If your radiation include your underarm area for treatment of lymph nodes, you may develop lymphedema (arm swelling). Gentle exercise can help reduce arm lymphedema.
Coping And Recovery from Whole Breast Radiation
As you go through treatment, keep in mind that your side effects are temporary and will taper off over time. Allow yourself time to rest and recover from fatigue, especially near the end of your treatments.
Wear loose layers of soft clothing to prevent skin irritation. Ask your doctor about skin treatments that you can use between treatments to promote healing. Take warm (not hot) showers and baths and use cool (not cold) compresses on your skin, to avoid blistering and skin peeling. Be gentle with yourself and pamper your skin during and after treatment. Most of your side effects should disappear in six months to a year after you have completed radiation treatment.
Sources:
Accelerated Breast Radiation: Cheaper, Faster, and Just As Effective? American Cancer Society. Last Updated 2008/10/03.
External Beam Radiation Therapy. American Cancer Society. Last Updated 04/20/2007.
