Radiation for breast cancer

Radiation therapy for breast cancer is one of the methods of suppressing cancer cells. Let's consider the features of radiation, indications for its implementation and possible side effects.

Irradiation of cancer cells is carried out with ionizing rays using special equipment. The action of the rays is aimed at changing the structure of cancer cells, which leads to their death. The procedure is carried out at different angles in relation to the neoplasm, which allows for a better effect. This method does not affect healthy tissues, since they are not sensitive to rays. As a rule, irradiation is used simultaneously with chemotherapy and surgical treatment. This helps prevent relapses of the disease and destroy cancer cells that were not removed during surgery.

There are a number of factors that influence the choice of treatment method:

• Cancer stage, presence of metastases and tumor size.
• Location of metastases.
• Histological structure of cancer cells.
• Age of patients and general condition.

The rays affect only certain areas, for example, a tumor in the mammary gland and regional lymph nodes. Irradiation is carried out in several sessions, which allows minimizing the side effects of the procedure. Very often, this method is used after breast removal, as a cancer prevention measure.

Depending on the method of application, radiation therapy is divided into the following types:

• Preoperative – to destroy malignant cells at the periphery.
• Postoperative – to destroy cancer cells that remain after surgery.
• Intraoperative – performed during organ-preserving operations.
• Independent – necessary if surgical treatment is contraindicated.
• Intra-tissue – used for nodular forms of oncology.

The use of radiation therapy for breast cancer is possible only according to medical indications, when more than 4 regional lymph nodes are involved in the pathological process, large vascular-nerve bundles and axillary nodes are affected. The method is effective in organ-preserving operations.

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Indications for irradiation

Cancerous diseases are characterized not only by the destruction of the affected organs, but also by the metastasis of malignant cells with the blood flow to all organs and systems. The main indication for radiation is the destruction of bad cells, reduction of tumor size and control over its growth.

Indications for radiation therapy:

• Minimizing painful symptoms.
• Reducing the risk of pathological fractures in bone tissue metastases.
• Improvement of respiratory function and reduction of bleeding.
• Reducing the compression caused by the action of metastases on the spinal cord and nerve endings.

This method of treatment is a targeted effect on the tumor, it does not cause painful sensations, but with prolonged use it can cause discomfort. After therapy, the irradiated tissues become radioactive. The duration of treatment is from five days to seven weeks, the session lasts about 30 minutes. Radiation does not cause hair loss, but can lead to a change in skin color. Side effects are temporary.

Depending on the goal, radiotherapy can be:

• Radical – leads to complete resorption of the tumor.
• Palliative – used in cases of widespread malignant processes, allows to prolong the patient’s life and reduce painful symptoms.
• Symptomatic – eliminates severe signs of pathology and pronounced pain syndrome that cannot be relieved with painkillers.

Irradiation is part of complex treatment, but in rare cases it can be used as monotherapy. Timely use of the method allows to remove the tumor at early stages, reducing the risk of relapse by 50-60%, and with combined therapy by 80-90%.

Breast Cancer Radiation Treatment Schemes

There are many options for using radiation therapy, which depend on the stage of cancer, the characteristics of the patient's body and the course of the disease. Irradiation schemes are made individually for each patient. When developing a treatment plan, the doctor selects the option with the maximum positive effect with minimal side effects. Markings are applied to the mammary gland for convenient use of the laser. Irradiation is performed using special X-ray equipment, which accurately determines at what angle to direct the radiation beam. The procedure is painstaking and can take a long time.

The choice of irradiation scheme depends on factors such as:

• Localization and prevalence of the pathological process.
• Histological structure of the tumor.
• Stage and nature of tumor growth.

At the initial stages of cancer, when the tumor size is within 2 cm and the lymph nodes are not enlarged, radiation therapy is performed both before and after surgery. According to this scheme, radiation is also performed at the last stages of oncology, to prevent relapses of the disease and destroy residual cancer cells.

The procedure can be carried out in the following modes:

• External – performed in a hospital setting using an X-ray machine. Treatment consists of 30-40 sessions, i.e. 5 times a week for 4-6 weeks.
• Internal – used less often than external. The procedure involves implants with radioactive drugs. Small incisions are made in the chest, into which catheters with the drug are inserted. The incisions are made so that there is access to the affected tissues of the gland. The duration of the session is 5-6 minutes, daily for 7 days.

If the cancer has metastasized, the radioactive rays are adjusted so that they affect all affected areas, for example, the bones of the skeleton, the spine, and regional lymph nodes. After the course of therapy, the gland tissues gradually recover.

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Radiation after breast cancer surgery

Surgical treatment of oncology involves the use of additional methods that improve the results of therapy. Irradiation after surgery for breast cancer is necessary to completely remove malignant cells and prevent relapses of the disease. This is due to the impossibility of completely excising all glandular tissue, especially adjacent to the skin and running along the pectoral muscles. If a little tissue with malignant cells remains after surgery, this can cause a relapse of the cancer.

1. Postoperative irradiation

It is performed 2-4 weeks after surgery. The indication for its implementation is suspicion of the ineffectiveness of the performed operation. The main goal of treatment:

• Irradiation of supraclavicular lymph nodes (for preventive purposes).
• Impact on tissues and regional lymph nodes that were not removed.
• Destruction of cells with pathological changes that remain in the surgical area.

2. Intraoperative

Used in organ-preserving surgeries. Necessary to remove cancer cells that remain after tissue excision.

3. Independent

It is performed for inoperable forms of cancer, when patients refuse surgery and when there are contraindications to surgical intervention.

Consequences of radiation in breast cancer

Treatment of malignant diseases is a long process, during which many methods of therapy with different effects and side effects are used. The consequences of radiation in breast cancer directly depend on the stage of cancer and can manifest themselves in many organs and systems.

• Skin adverse reactions

Typically, when exposed to radiation, the skin becomes red, itchy, slightly painful, and flaky, similar to sunburn. But unlike solar radiation, the reaction to radiation occurs gradually and only in certain areas. During therapy, the skin may become red, and some areas may become more intensely colored (underarms, folds under the breast, the inside of the gland). Such reactions may be moderate or severe. To reduce skin side effects, wear loose clothing made of natural fabrics, wear a cotton bra, or do not wear a bra at all.

• Negative effects on the chest

After radiotherapy, the mammary gland becomes dense, swelling appears, which leads to painful sensations. The most sensitive part of the breast - the nipple, becomes very irritated. After treatment, the swelling gradually subsides, the gland acquires a formed shape, the skin looks elastic and rejuvenated.

• Pain in the armpits

Discomfort in the armpit area may be related to previous surgery. Typically, there is numbness of the skin due to damaged nerves, pain in the incision area, swelling due to impaired lymph drainage. Irradiation increases these sensations, but after therapy the pain is minimized.

• Rapid fatigue and tiredness

Associated with the effects of radiation on the body, negative effects from previous chemotherapy or surgery. Stress and lifestyle changes due to therapy also negatively affect overall well-being. To reduce fatigue, you need to maintain a sleep and rest regimen, engage in regular physical activity and stick to a healthy diet.

• Negative manifestations from internal organs

According to medical research, radiation therapy has a negative impact on the cardiovascular system and lungs. This is due to the fact that a small dose of radiation enters the lungs, which are located under the anterior chest wall. Due to the radiation, scar tissue can form in them. This complication is detected by X-ray, and it manifests itself as a dry cough and shortness of breath. If the symptoms are pronounced, then patients are prescribed steroids.

• Pain in the pectoral muscles

During and after the therapy, shooting pains may appear, which are similar to the effect of electric shock. The cause of discomfort is associated with irritation of nerve fibers. Anti-inflammatory drugs are used to eliminate unpleasant sensations. After a full course of radiation, the discomfort goes away on its own.

• Muscle tissue compaction

During and after radiotherapy, many patients experience that the muscles in the chest area become stiff and dense. The main cause of the pathology is the formation of scar tissue due to radiation exposure. It is the radiation that causes compaction and stiffness. To eliminate this complication, painkillers are used.

• Risk of rib fracture

If radiation is performed after a mastectomy, the risk of fracture increases significantly due to the lack of a muscular framework. Even if an implant was installed after treatment, it does not protect the bone rib tissue.

Radiation therapy for breast cancer is a treatment that can be used both before and after surgery. It can completely remove malignant cells from the body, minimizing the chance of recurrence.

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