Radiation Therapy for Early Stage Breast Cancer

This guest post is by Dr. Matthew Katz, radiation oncologist. Dr. Katz will be our #BCSM Tweetchat guest for Monday 10/27/14. He will be discussing some of the new research that came out of the recent American Society for Radiation Oncology annual meeting. Dr. Katz is the former chair of the Communications Committee for ASTRO, and is a member of the External Advisory Board for the Mayo Clinic Social Media Health Network. He blogs at Radiation Nation and can be found on twitter as @subatomicdoc . He has been a regular participant in the #BCSM chats since they started in 2011 – we are thrilled that he will be joining us to discuss highlights from the ASTRO meeting.


Since the 1980s, doing a breast-preserving surgery with radiation afterwards has been a standard treatment approach for many women with early stage breast cancer. Just as surgery, chemotherapy and other treatments have improved over the past 30 years, so has radiation therapy.

The American Society for Radiation Oncology, or ASTRO, had its annual meeting in September with new research. Here are some of the main themes related to breast conservation:

1.  Shorter treatment times. Patients usually receive breast radiation daily over 5 – 6 ½ weeks in the U.S., but increasingly evidence supports shorter treatments in 3 – 4 weeks.  This is called hypofractionation, and more research at ASTRO’s annual meeting supported hypofractionated breast radiation.

2. Less breast radiation. The standard approach has been to treat the whole breast after a smaller breast surgery, to ensure any cancer cells that may be left in the breast get treatment. However, there has been support for partial breast irradiation (PBI). More research at ASTRO discussed the pros and cons of smaller radiation fields.

3. More lymph node radiation. Many breast cancer patients have a sentinel lymph node biopsy, but the trend has been toward less invasive node surgery. When a positive lymph node is found, further surgery may or may not be needed. In an era of improving chemotherapy and hormone therapy, there is a debate whether radiation is helpful in treating lymph nodes when no further surgery is done after a positive sentinel node biopsy.

Lots of other topics were discussed at ASTRO, from using radiation after mastectomy to its role in recurrent and metastatic disease. Radiation oncology is a technology-heavy field, so lots of medical physics and gadgets to make the radiation more precise.  But for the purpose of discussion in our next Twitter chat, let’s focus on breast preserving treatment and we can see what other areas may be worth discussion at future chats.

Thanks to Alicia, Jody and Deanna for the chance to share with the #bcsm community!