In the past, radiation treatment for breast cancer typically required a long course of daily therapy. Many women developed painful burns and unsightly skin changes toward the end of treatment. Advances in technology over the past 10 years now allow radiation therapy to be given in as little as five treatments to only a small portion of the breast, instead of 16 to 30 treatments to the entire region of the body. This greatly reduces the collateral damage done to the adjacent healthy breast tissue, heart
and lungs.^1,2,3

This new technique is called stereotactic body radiotherapy (SBRT) and is now offered when accelerated partial breast irradiation (APBI) is warranted over standard whole-breast radiation. The advancement reduces the chances of a serious skin burn and blistering from 18% to only 1%. In other words, 99% of women complete treatment with very few side effects.¹

This new option for radiation therapy is now possible because modern equipment can image the breast prior to each treatment and detect the surgical bed with great accuracy. During surgeries preceding radiation, surgeons may also place fiducials or small clips to help oncologists treat the precise location. Where standard radiation therapy commonly leaves marks on the skin, some centers also offer “tatoo-less” treatment options.

SBRT may not be appropriate for everyone but is a great option for women deemed “suitable” by National Comprehensive Cancer Network guidelines. These women are 50+ years old, have stage I malignancies less than 2cm in size, and cancers that are estrogen receptor positive cancer (ER+), grade 1 or 2, and with no lymph node involvement. Those who have had surgery to remove malignancies are also considered candidates.

APBI shares the same low recurrence rates as standard whole breast radiation therapy for patients that meet these criteria. Studies show that after 10 years, over 90% of women remained breast cancer free with either whole breast or accelerated partial breast radiation.^4,5

If these criteria are met, this shortened radiation treatment course is also ideal for women over 70 years old who do not tolerate the five years of anti-estrogen therapy but still require post-surgery treatment to prevent recurrences.

Cure rates for breast cancer have greatly improved, so the next step in treatment care is to limit side effects and optimize a patient’s quality of life. For more information on this new treatment option, please consult with a radiation oncologist.

Carolyn Barnes, MD, is a board certified radiation oncologist specializing in the treatment of various malignancies including breast cancer. She is with Radiant Cancer Care in Rancho Mirage and can be reached at (760) 202.3946. For more information, visit www.radiantcancercare.com.

References: 1) Clin Breast Cancer 2021;21:231-238; https://pubmed.ncbi.nlm.nih.gov/33121891; 2) Clin Breast Cancer 2024;24:253-260; https://www.sciencedirect.com/science/article/abs/pii/S1526820923003282; 3) https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf260/8116780; 4) https://pubmed.ncbi.nlm.nih.gov/25605582; 5) https://pubmed.ncbi.nlm.nih.gov/32840419