Our Summary

This research paper discusses different types of radiation therapy used to treat breast cancer following a lumpectomy, a surgery to remove tumors from the breast. The traditional method, whole-breast irradiation (WBI), has been used for many years and involves treating the entire breast over the course of 5 to 7 weeks. However, this can be inconvenient for patients and expensive.

An alternative method, known as hypofractionated WBI, can be completed in 3 to 4 weeks. Based on long-term studies, this method is now often preferred for certain patients. Another option is accelerated partial-breast irradiation, which involves a much shorter treatment schedule. Although there have been fewer studies on this method, early results indicate that it could be an effective alternative to WBI for some patients.

The paper highlights the need for further research to better understand which patients would benefit most from each type of radiation treatment.

FAQs

  1. What is the standard care after a lumpectomy?
  2. How does standard whole-breast irradiation compare to hypofractionated WBI and accelerated partial-breast irradiation?
  3. Who are the suitable candidates for accelerated partial-breast irradiation?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lumpectomy is to discuss the option of adjuvant whole-breast irradiation after the procedure. This treatment has been shown to achieve durable tumor control with low toxicity, and there are now shorter treatment regimens available such as hypofractionated WBI or accelerated partial-breast irradiation. It is important to discuss these options with your doctor to determine the best course of treatment for your individual situation.

Suitable For

Patients who are typically recommended for lumpectomy include those with early-stage breast cancer, smaller tumor size, and no evidence of lymph node involvement. Lumpectomy may also be recommended for patients who are not suitable candidates for mastectomy or who prefer breast-conserving therapy. Additionally, patients who are able to undergo adjuvant whole-breast irradiation following lumpectomy are also good candidates for this treatment.

Timeline

Before lumpectomy:

  • Patient undergoes diagnostic tests such as mammograms, ultrasounds, and biopsies to diagnose breast cancer.
  • Patient discusses treatment options with their healthcare team, including lumpectomy as a breast-conserving surgery option.
  • Patient may undergo pre-operative tests and consultations to prepare for the surgery.

After lumpectomy:

  • Patient may experience pain, swelling, and discomfort at the surgical site.
  • Patient may have drains in place to remove excess fluid from the surgery site.
  • Patient will have follow-up appointments with their healthcare team to monitor healing and discuss further treatment options.
  • Patient may undergo adjuvant treatments such as radiation therapy, chemotherapy, or hormone therapy to reduce the risk of cancer recurrence.
  • Patient will have regular follow-up appointments and screenings to monitor for any signs of cancer recurrence.

What to Ask Your Doctor

  1. What are the potential risks and benefits of undergoing a lumpectomy?
  2. How long is the recovery process following a lumpectomy?
  3. Will I need adjuvant whole-breast irradiation after the lumpectomy?
  4. What are the differences between standard-fractionation WBI and hypofractionated WBI?
  5. Am I a candidate for accelerated partial-breast irradiation as an alternative to WBI?
  6. What are the potential side effects of the different types of radiation therapy options?
  7. What is the likelihood of cancer recurrence after undergoing a lumpectomy with radiation therapy?
  8. How often will I need follow-up appointments after the lumpectomy?
  9. Are there any lifestyle changes or restrictions I should be aware of post-lumpectomy?
  10. Are there any clinical trials or new treatments that I should consider in addition to standard treatment options?

Reference

Authors: Ohri N, Haffty BG. Journal: Surg Oncol Clin N Am. 2018 Jan;27(1):181-194. doi: 10.1016/j.soc.2017.07.006. PMID: 29132560