Radiation therapy techniques for newly diagnosed, non-metastatic breast cancer
- Lori J Pierce, MD
Lori J Pierce, MD
- Section Editor — Radiation Therapy
- Professor of Radiation Oncology
- University of Michigan School of Medicine
Radiation therapy (RT) is a critical component of therapy for women with newly diagnosed, non-metastatic breast cancer. RT techniques for women with newly diagnosed, non-metastatic invasive breast cancer will be reviewed here. An overview of RT techniques in cancer treatment is discussed separately. (See "Radiation therapy techniques in cancer treatment".)
The approach to adjuvant RT for women with newly diagnosed, non-metastatic breast cancer and the long-term complications of breast RT are covered separately. (See "Adjuvant radiation therapy for women with newly diagnosed, non-metastatic breast cancer" and "Patterns of relapse and long-term complications of therapy in breast cancer survivors".)
CHOICE OF PARTICLES FOR RADIATION THERAPY
Therapeutic radiation consists of the delivery of radiation beams comprised of electrons or photons. Photons completely pass through tissues, so when used, they must be angled to traverse the target tissue only so as to avoid critical normal tissue (eg, the heart). In contrast, electrons traverse only to a specific depth (determined by the energy needed) and hence can be tailored to target the tissue of interest while sparing critical tissue. Therefore, they can be delivered directly over critical tissues. (See "Radiation therapy techniques in cancer treatment", section on 'Photons versus electrons'.)
Three anatomic regions must be considered in defining the target volume (figure 1) (see "Adjuvant radiation therapy for women with newly diagnosed, non-metastatic breast cancer"):
●The breast or chest wall (depending on the surgical approach used), which constitute the primary radiation therapy (RT) field (See 'Primary field' below.)
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- CHOICE OF PARTICLES FOR RADIATION THERAPY
- TREATMENT PLANNING
- Primary field
- Regional field
- VIRTUAL (CT-BASED) SIMULATION
- Clinical issues
- WHOLE-BREAST RADIATION THERAPY
- Dose and fractionation
- Approach to the patient with large breasts
- ACCELERATED PARTIAL BREAST IRRADIATION
- External beam radiation therapy
- - Conformal external beam radiotherapy
- - Intensity-modulated radiotherapy
- - Interstitial brachytherapy
- - Intracavitary brachytherapy
- Intraoperative radiation therapy
- Technical considerations
- - Dosing
- - Verification of conformance
- POSTMASTECTOMY RADIATION THERAPY
- REGIONAL NODE RADIATION THERAPY
- RT BOOST
- NOVEL RT PLANNING AND DELIVERY TECHNIQUES