Radiotherapy Techniques in Breast Cancer Management
Summary
Radiotherapy is integral to breast cancer care, employed after breast-conserving surgery, following mastectomy in high-risk cases, and for palliation. Conventional whole-breast external beam radiotherapy (EBRT) typically uses daily fractions over three to six weeks. Hypofractionated regimens increase the dose per fraction to shorten overall treatment time while maintaining tumour control and limiting normal-tissue toxicity. Partial-breast irradiation confines the high-dose region to the tumour bed, reducing exposure to uninvolved breast. Advanced delivery methods such as intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) sculpt dose distributions to spare the heart and lungs. Single-dose intraoperative radiotherapy (IORT) delivers radiation at the time of lumpectomy. Regional nodal irradiation targets axillary, supraclavicular and internal mammary lymphatic regions in node-positive or high-risk patients. Emerging approaches including proton therapy and adaptive planning promise further refinement of the therapeutic ratio.
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Radiotherapy Techniques in Breast Cancer Management publication trend
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Technical terms
Hypofractionation: Delivery of larger radiation doses per fraction over fewer treatment sessions.
Partial-breast irradiation: Targeted radiotherapy confined to the tumour bed and a small surrounding margin.
Intensity-modulated radiotherapy (IMRT): Technique that modulates beam intensity to conform dose to complex target shapes.
Intraoperative radiotherapy (IORT): Administration of a single high radiation dose directly to the tumour bed during surgery.
Regional nodal irradiation: Radiation directed to lymphatic drainage areas such as axillary, supraclavicular and internal mammary nodes.
References
- Radiotherapy to regional nodes in early breast cancer: an individual patient data meta-analysis of 14 324 women in 16 trials. The Lancet (2023).
- Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. The Lancet (2020).
- Long term survival and local control outcomes from single dose targeted intraoperative radiotherapy during lumpectomy (TARGIT-IORT) for early breast cancer: TARGIT-A randomised clinical trial. The BMJ (2020).
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