Radiation therapy has an important role in treating all stages of breast cancer because it is so effective and relatively safe. It may be appropriate for people with stage 0 through stage III breast cancer after lumpectomy or mastectomy. Radiation can also be very helpful to people with stage IV cancer that has spread to other parts of the body.

After lumpectomy

Radiation therapy is recommended to most people who have lumpectomy (lumpectomy plus radiation is sometimes called breast-preservation surgery). Radiation attempts to destroy any cancer cells that may have been left in the breast after the tumor was removed.

Typically a doctor will recommend lumpectomy followed by whole breast radiation if the cancer is:

• early stage
• 4 centimeters or smaller
• located in one site
• removed with clear margins

After mastectomy

Radiation therapy may be recommended after mastectomy to destroy any breast calls that may remain at the mastectomy site. During breast removal, it's difficult to take out every cell of breast tissue, especially the tissue behind the skin in front of the breast or back along the muscle behind the breast. Usually any leftover breast cells are normal. But because it's possible for some breast cancer cells to linger, there is a risk of recurrence in the area where the breast was. Based on your pathology report, your doctor may recommend radiation therapy if you’ve had a mastectomy.

These factors are associated with a high risk of recurrence after mastectomy. Radiation may be recommended if any of these factors are present:

• The cancer is 5 centimeters or larger (the cancer can be 1 lump, a series of lumps, or even microscopic lumps that together are 5 centimeters or larger).
• The cancer had invaded the lymph channels and blood vessels in the breast.
• The removed tissue has a positive margin of resection.
• Four or more lymph nodes were involved OR, for pre-menopausal women, at least 1 lymph node was involved.
• The cancer has invaded the skin (with locally advanced or inflammatory breast cancer).

Based on these risk of recurrence factors, about 20% to 30% of people are considered at high risk of recurrence after mastectomy. Radiation would be recommended to help reduce this risk by up to 70% (for example, a 30% risk may be reduced to just under 10%). Treatment is given to the area where the breast used to be and sometimes to the lymph node regions nearby.

Some people have a moderate risk of recurrence. They're in the "gray zone" because the cancer has characteristics that increase their risk, but not to a point where the risk is considered high. For example, you might have a 4 centimeter cancer and 2 lymph nodes involved. You and your doctor need to carefully consider your unique situation. Some people in the gray zone want to know they have done everything reasonable to treat the cancer, to avoid or reduce the risk of ever having to deal with it again. Others in the gray zone may decide not to go through with radiation therapy after a discussion with their doctors.

• < Page
• 1
• 2
• 3
• >