Journal of Medical Physics and Applied Sciences

Description

Breast cancer remains one of the most prevalent forms of cancer among women worldwide, necessitating a multidimensional approach to treatment. Among the arsenal of therapies available, radiotherapy stands as a critical pillar in both earlystage and advanced breast cancer management. This article explores the role, types, efficacy and advancements in breast cancer radiotherapy, highlighting its impact on patient outcomes and quality of life. Radiotherapy also known as radiation therapy, involves the use of high-energy radiation to target and destroy cancer cells. In breast cancer treatment, radiotherapy is primarily employed after surgical interventions, such as lumpectomy or mastectomy, to eradicate remaining cancer cells and reduce the risk of recurrence. The primary objectives of radiotherapy in breast cancer include targeting residual cancer cells in the breast or surrounding tissues. Minimizing the chances of cancer returning in the treated area. Enhancing overall survival rates by complementing surgical and systemic therapies. There are two primary types of breast cancer radiotherapy, External Beam Radiotherapy (EBRT) and Internal or Brachytherapy. Local tumor control is a primary objective in the treatment of breast cancer with radiotherapy. This term refers to the effective management and elimination of cancerous cells within the localized region of the breast, thereby preventing recurrence in the treated area. Achieving local tumor control is crucial because the presence of residual cancer cells post-surgery can lead to local recurrence, which is associated with poorer outcomes and can necessitate additional treatments. Here, we delve into the importance, mechanisms and strategies involved in attaining local tumor control through radiotherapy in breast cancer.

External beam radiotherapy

This technique delivers high-energy X-rays or photons from an external machine directly to the breast tissue. EBRT is typically administered daily over several weeks, with each session lasting a few minutes. It allows precise targeting of the tumor bed while sparing surrounding healthy tissues. Brachytherapy involves placing radioactive sources directly into the lumpectomy cavity or adjacent tissues. This method delivers a high dose of radiation locally while minimizing exposure to surrounding organs. It is often used in select cases to shorten treatment duration and reduce side effects. The efficacy of radiotherapy in breast cancer treatment is well-established through extensive clinical research and long-term studies. Key benefits include, Radiotherapy significantly reduces the risk of cancer recurrence in the treated breast. Improved overall survival rates have been observed when radiotherapy is combined with surgery and systemic therapies. For women undergoing breast-conserving surgery radiotherapy is crucial in maintaining breast shape and function. Recent advancements in technology have revolutionized the field of breast cancer radiotherapy, enhancing precision and minimizing side effects:

Modulated radiation therapy

Intensity Modulated Radiation Therapy (IMRT) allows for more precise targeting of tumors by adjusting the intensity of radiation beams, thereby minimizing exposure to healthy tissues. Image- Guided Radiation Therapy (IGRT) uses advanced imaging techniques to verify the position of the tumor immediately before and during treatment, ensuring accurate radiation delivery. SBRT delivers high doses of radiation in a few sessions, specifically beneficial for small, early-stage breast cancers or metastatic lesions. Proton therapy utilizes protons instead of Xrays, depositing radiation precisely at the tumor site with minimal damage to surrounding tissues, potentially reducing long-term side effects. While effective, radiotherapy can cause short-term side effects such as skin irritation, fatigue and breast swelling. Advances in treatment planning and delivery techniques have helped minimize these effects. Moreover, long-term implications such as cardiac toxicity and secondary cancers are closely monitored and managed through advanced screening and personalized treatment plans. Breast cancer radiotherapy plays a pivotal role in the comprehensive management of breast cancer, offering significant benefits in terms of local control and overall survival rates. With ongoing advancements in technology and treatment protocols, the future promises even more refined and personalized approaches to radiotherapy, further improving outcomes and quality of life for breast cancer patients worldwide. As research continues to evolve, the integration of radiotherapy with surgery and systemic therapies underscores its indispensable role in combating this complex disease.