Early-stage breast cancer is often treated with a lumpectomy or mastectomy and radiation. Even though the tumor may have been small and no metastasis was found, women and their doctors still look for ways to prevent a recurrence. The technique of giving a radiation boost at the end of treatment has been very effective in keeping breast cancer from coming back.
A Little Extra At The End of Radiation
A radiation boost is one or more extra treatments, given at a higher dose than routine treatments, and targeted at the tumor bed. This extra dose covers a small area and affects the tissue where cancer is most likely to return. Radiation boost treatments are given after the regular sessions of radiation are complete. Women who are 40 years old or younger at time of treatment get the most benefit from a radiation boost, but patients of all ages will have a lower risk of recurrence if they receive a booster treatment.
The Boost Dose Benefits Patients with Early Stage Breast Cancer
For patients diagnosed with early stage breast cancer, either ductal carcinoma in situ (DCIS) or invasive breast cancer, a radiation boost protects against recurrence. Most patients who have a lumpectomy will qualify for radiation with a boost, and in some rare cases, mastectomy patients may also have radiation and the boost. There is some disagreement among radiation oncologists as to whether or not a radiation boost really benefits a patient diagnosed with DCIS, but it has become the standard of care.
Having a Radiation Boost
Breast cancer patients may have whole breast radiation (WBI) or partial breast radiation (given with external beams or brachytherapy), after which boost doses are given. If you're having a lumpectomy and are planning on radiation, surgical clips may be placed at the time of surgery, to help your radiation oncology team target your tumor bed during treatment. Your boost dose may be given with external radiation, via interstitial catheters, or from within a brachytherapy applicator. The targeted boost dose may be given in one session, or during five to seven daily sessions. Because the dose is greater than a standard treatment and very focused on a small area of tissue, some radiation fibrosis can occur at the boost site. In most cases, this should not be bothersome.
Radiation Boost May Mean Fewer Mastectomies, Longer Life
After being diagnosed with breast cancer, the first decision you may face is whether to have a lumpectomy or a mastectomy. You have to weigh that decision with the fact that breast cancer is most likely to recur in the same breast, right at the tumor site. Many women opt to remove the whole breast, in hopes of never having breast cancer come back. A radiation boost is designed to prevent recurrence at the tumor site, even after a lumpectomy. Research has shown that women who had a radiation boost had fewer local recurrences, as compared to those patients who didn't have the boost. Doctors hope that, because of better radiation techniques, more women will be able to choose lumpectomy over a mastectomy, and have a better quality of life after treatment.
Breast Cancer Radiation Therapy, Detailed Guide. American Cancer Society. Last Revised: 09/18/2009.
Impact of Radiation Dose on Local Control, Fibrosis and Survival after Breast Conserving Treatment: 10 Years Results of the EORTC Trial 22881-10882. Bartelink H, Horiot J, Poortmans P, et al. Proceedings from the 29th Annual San Antonio Breast Cancer Symposium. San Antonio, Texas. Presented on December 14, 2006.