Breast Cancer – Our Treatment Options

Breast Cancer: Detection & Treatment Options

Diagnosing Breast Cancer

When breast cancer is found early, the success rate is nearly 100%. But when and how often do you start looking? The American Cancer Society recommends breast screenings annually for women over 45 and continuing as long as you are in good health. Other organizations, including the Mayo Clinic and your radiology oncologists at Orange County Cyberknife and Radiation Oncology Center, suggest you begin annual screenings at age 40.  However, the U.S. Preventive Services Task Force (USPSTF) recently contradicted this advice, recommending mammograms for women between the ages of 50 and 74 every two years.

Whenever you decide to begin breast cancer screenings, Orange County Cyberknife will work directly with your imaging center to access all of the information needed to create the optimal treatment plan for you.

Types Of Radiation Therapy For Breast Cancer

Breast cancer may show up in many different ways. It could just be a small spot found on an annual mammogram. Or it could be a web of cancerous cells spread throughout the breast and body. These varied types of breast cancer require a variety of treatment options, such as surgery, chemotherapy, and radiation therapy. When it comes to treating your breast cancer with radiation therapy, Orange County Cyberknife and Radiation Oncology Center is your expert choice.

  • CyberKnife (Stereotactic Body Radiation Therapy, or SBRT)  Usually, breast cancer treatment begins with a lumpectomy, or removal of the tumor from the breast, followed by whole or partial radiation treatment. The CyberKnife comes into play for breast cancer in later stages when the breast cancer has metastasized to other parts of the body, such as the lungs, brain, or spine. The CyberKnife Robotic Radiosurgery System beams high doses of radiation directly to your cancerous cells while you rest on an outpatient treatment couch. Because CyberKnife can target and track these tumors in all areas while minimizing risk to surrounding healthy tissue and organs, it can provide you with the best possible outcomes. The flexible, robotic arm of CyberKnife can deliver high-doses of radiation in multiple angles to best treat the size, position, and shape of even the smallest metastasized tumor. This minimizes the radiation exposure to healthy surrounding tissue and organs and limits some of the short and long-term side effects common with conventional treatments. Unlike other methods of radiation delivery, CyberKnife is made to move with your body and the tumor, tracking the smallest of movements and adjusting the beams of high-dose radiation directly to the cancerous cells using sophisticated software and continuous x-rays. Essentially, CyberKnife follows your tumor. Much shorter than traditional radiation treatment, CyberKnife treatment is one short daily treatment administered in one to five days. Orange County Cyberknife was one of the first cancer treatment centers to offer this advanced radiation therapy.

External Radiation Therapies

  • Electron Therapy –  Electron therapy may be a good choice when you need to destroy cancer cells close to the skin’s surface. Electrons have different physical properties, but work the same way as photons when it comes to treating cancer. However, electrons release their energy close to the skin’s surface so are commonly used to treat superficial tumors such as skin cancers and superficial lymph nodes which may be involved with a tumor, such as breast cancer. Because the radiation doesn’t penetrate much past the skin, other organs and tissue are not negatively affected.
  • 3D Conformal Radiation Therapy for Breast Cancer – Three-dimensional (3D) conformal radiation therapy is a technique where the beams of radiation used in treatment are shaped to match the tumor. Previously, radiation treatment matched the height and width of the tumor, meaning that healthy tissue was exposed to the beams. Advances in imaging technology have made it possible to locate and treat the tumor more precisely. Conformal radiation therapy uses the targeting information to focus precisely on the tumor, while avoiding the healthy surrounding tissue. This exact targeting makes it possible to use higher levels of radiation in treatment, which are more effective in shrinking and killing tumors. Three-dimensional conformal therapy is, in many ways, similar to intensity-modulated radiation therapy (IMRT); both are used to target cancer while sparing healthy tissue. The radiation oncologist will determine which therapy is best for you, depending on your tumor’s shape and location.
    • Intensity Modulated Radiation Therapy (IMRT)-  IMRT is an effective treatment a special computer program is used to deliver a consistent dose of radiation to the breast. This technology prevents so-called hot spots (areas that receive more radiation than others due to the shape of the breast). It also minimizes acute (immediate) and late (delayed) side effects. In special situations, IMRT is also used to limit the radiation dose to organs close to the breast or lymph nodes being treated.
    • Advanced Image Guided Radiation Therapy (IGRT) – Orange County Cyberknife and Radiation Oncology Center houses the most advanced equipment including the IGRT which can track and capture your breast tumor using high-resolution, three-dimensional images as it moves or adjusts from day-to-day. This treatment option pinpoints exactly where your tumor is so that you can focus the treatment on only that area, leaving the rest of the surrounding tissue unharmed. When treating metastatic breast cancer, IGRT is able to target tumors where they have spread with precision and high-dose radiation, excluding surrounding vital organs. With IGRT, innovative radiographic, fluoroscopic and cone-beam CT modes are combined with software that automatically repositions the radiation beam and adjusts as the patient moves. This enables clinicians to verify that treatments are completely in sync with respiration.
    • RapidArc Radiotherapy Technology or Volumetric Arc Therapy (VMAT) – RapidArc is a form of IMRT that delivers treatments two to eight times faster than our other dynamic treatments and it increases precision. Unlike traditional IMRT that requires multiple rotations around the patient or makes repeated stops and starts to treat the tumor from different angles, this volumetric arc therapy delivers precice 3-D doses with a single 360° rotation of the machine, typically in less than two minutes. It uses your treatment planning algorithm to simultaneously change the rotation speed, the shape of the treatment aperture, and the delivery dose rate. The shape and position of the tumor are determined from computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) diagnostic studies. This permits improved dose sculpturing over 3-D conformal radiation therapy.

Internal Radiation Therapies

Accelerated Partial Breast Irradiation (APBI):

  • MammoSite Targeted Radiation Therapy – Women who choose a lumpectomy rather than a full mastectomy need radiation treatment following surgery. APBI is designed specifically to treat early stages of breast cancer quickly and efficiently by delivering radiation directly into the tumor cavity from inside the body. Orange County radiation oncologists work directly with breast surgeons to treat the cavity after surgery. Radiation therapy is usually performed one to four weeks after a lumpectomy. The temporary devices for example MammoSite or Savi applicator is placed in the cavity by the breast surgeon. The device stays there throughout the treatment, usually 5 days. During your approximately 10 minutes of treatment, the radiation is delivered into the applicators through a wire or cable inserted into a catheter and then removed between treatments. The radiation is delivered based on your treatment plan that is created by your radiation oncologist and the physicist. Treatment plan is usually two treatments per day, 5-6 hours apart, for five days. After the final treatment, the MammoSite or the Savi device is easily removed by the radiation oncologist.
  • Breast Intraoperative Radiation Therapy (IORT) – When you have early-stage cancer, your medical team may suggest radiation treatment during surgery, immediately after the removal of your breast tumor. Orange County CyberKnife’s leaders in Radiation Oncology are at the forefront of development in this exciting treatment of delivering radiation directly to the tumor bed during surgery. IORT delivers a concentrated dose of radiation therapy to a tumor bed during surgery. It allows immediate radiation that can kill any microscopic tumor cells left behind after tumor removal. This treatment spares healthy organs like your skin, heart, and lungs from the effects of radiation. This advanced radiation method drastically reduces the treatment from three to five weeks of traditional radiation therapy, to one single four to five minute treatment during surgery.
  • High Dose Rate Brachytherapy (HDR) – This extremely precise radiation therapy can destroy breast cancer by using an intense source of radiation delivered through temporarily-placed applicators implanted into the tumor site. It is delivered internally via a computer-controlled machine typically in two to ten convenient treatments. HDR minimizes the risk of common side effects due to its ability to focus the radiation directly on the cancerous cells. This also reduces the danger of radiation exposure to nearby vital structures like the heart and lungs. The radiation is delivered into the applicators through a wire or cable inserted into a catheter and then removed between treatments. Orange County radiologists can vary the position of the wire and the length the radiation is administered to satisfy the shape and need of the cancer. At the end of the treatment, all traces of radiation are removed. Because of the high-dose rate and precision, HDR is often used as an alternative to surgery.
  • Hyperthermia (Thermal therapy or Thermotherapy) – Our doctors are worldwide leaders in the field of hyperthermia. Non-invasive hyperthermia treatment focuses on exposing tumors to extremely high temperatures to stimulate blood flow, increase oxygenation and make the tumor cells more responsive to radiation. By adding hyperthermia to radiation therapy, radiation oncologists can better control tumors with high doses of radiation while minimizing side-effects and damage to healthy tissue. Hyperthermia has also been proven effective with recurrent breast cancer, where the prognosis can be grim. If you’ve already had a full dose of radiation, a second full dose is usually not recommended because of the damage it could cause to healthy tissue. Hyperthermia treatment has the ability to increase the effectiveness of radiation on re-treatment, giving new hope for patients with recurrent cancers.

Contact Us To Find Out More

We look forward to explaining each of these treatment methods to you on your first visit to Orange County CyberKnife We will ensure that you know the radiation options available to you at our comprehensive cancer center. Call us today at (714) 962-7100 with any questions. Check out our team of oncology radiologists and find out how we can treat tumors throughout your body using the most advanced non-surgical and non-invasive radiation therapy systems available. Check out what other patients say about our cancer care. You can trust us to help choose a treatment option that is right for you.

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