NewYork-Presbyterian's Department of Radiation Oncology provides patients with the most comprehensive treatment options for the management of breast cancer available. All are provided in modern settings where patient privacy and comfort are foremost.
There are two main types of radiation treatments, external and internal, that can be used based on the needs of the patient. External beam radiation is delivered using a linear accelerator that produces high energy x-ray or electron beams. Internal radiation or brachytherapy uses radioactive sources placed within the breast to deliver a therapeutic dose of radiation.
External Beam Radiotherapy
External beam radiation is the most common form of radiotherapy. Painless radiation treatments are delivered in a series of daily sessions. Each treatment session lasts less than 30 minutes and is given Monday through Friday, for anywhere from five days to seven weeks.
Radiotherapy hardware, software, treatment planning and delivery methods have advanced dramatically in recent years. These advances allow us to more accurately target the cancer with higher doses of radiation, while minimizing damage to adjacent healthy tissue. NewYork-Presbyterian utilizes the following state-of-the-art treatment techniques during our external beam breast treatments when required by the individual needs of each patient.
Intensity Modulated Radiation Therapy (IMRT) and 3-Dimensional Conformal Radiotherapy (3D-CRT)
3D-CRT combines multiple radiation treatment fields to deliver very precise doses of radiation to the breast and spare surrounding normal tissue. Intensity modulated radiation therapy (IMRT) is a form of 3D-CRT that further modifies the radiation by varying the intensity of the radiation beams. It is also used in specific cases when beneficial.
Prone Breast Treatments
Radiation for breast cancer is typically delivered with the patient lying on their back. At NewYork-Presbyterian we also have the technology and expertise to deliver customized treatments with the patient lying face down (prone). According to the patient's individual anatomy, this may be a superior method for some patients and result in fewer side effects.
Several new brachytherapy treatment methods have recently emerged for the treatment of small, early stage breast cancers. These "partial breast techniques" only treat the region of the breast that directly surrounds the lump or tumor. These techniques often give superior cosmetic results since the radiation is concentrated in a small area.
Partial Breast Brachytherapy Treatments
The Department of Radiation Oncology offers partial breast treatments that are sometimes referred to as MammoSite Breast® brachytherapy or Contura breast brachytherapy. These options are often used in combination with a lumpectomy to treat early stage breast cancer. With this method, therapeutic doses of radiation can be delivered to breast tissue in a relatively short time — twice a day over five days — and with minimal discomfort.
For this procedure a catheter is temporarily placed in the breast immediately following the removal of a tumor (lumpectomy). The catheter is later used to deliver a high dose of radiation to the tissue that surrounds the cavity that formerly contained the tumor.
Since the radiation is centered within the site of the former tumor, the radiation dose to healthy tissue is minimized and often yields excellent cosmetic results. Typically ten treatments are given over a one week period instead of the up to seven weeks required for external beam breast therapy.
Temporary seed implants
On rare occasions, radioactive seeds may be directly placed in the tumor site at the time of surgery. They remain in place for several days while they deliver the radiation dose and are then removed. This very specialized technique is employed when conventional radiation treatments are not suitable.