Breast cancer is the most commonly diagnosed cancer in women in the United States, with hundreds of thousands of new cases diagnosed each year. Fortunately, advances in screening, surgery, systemic therapy, and radiation therapy have led to excellent outcomes for many patients.
Many breast cancers are found through routine mammography before they cause any symptoms. When symptoms are present, they may include a new lump or thickening in the breast or underarm, a change in breast size or shape, skin dimpling or irritation, changes in the nipple, or nipple discharge that is not breast milk. Most breast changes are not cancer, but any new or persistent change should be evaluated by a healthcare professional.
Treatment for breast cancer is individualized and typically involves a combination of surgery, systemic therapy, and radiation therapy, depending on the type and stage of cancer. For patients undergoing breast-conserving surgery (lumpectomy), radiation therapy is commonly recommended to reduce the risk of cancer returning in the breast. Some patients may receive chemotherapy, hormone therapy, targeted therapy, or immunotherapy before or after surgery based on the biology of their cancer. For selected patients undergoing mastectomy, post-mastectomy radiation therapy may be recommended based on tumor size, lymph node involvement, and other risk factors. Our multidisciplinary approach ensures that each patient’s treatment plan is tailored to achieve excellent cancer control while preserving quality of life.
Our approach is individualized. Depending on the size and location of the tumor, surgical findings, lymph node involvement, breast anatomy, age, and other factors, we may recommend whole-breast radiation, partial-breast radiation, brachytherapy, or post-mastectomy radiation therapy.
Whole-breast radiation treats the entire breast after lumpectomy to reduce the risk of cancer returning in the breast. With modern radiation planning, treatment can be delivered precisely while minimizing radiation exposure to nearby organs. For many patients, treatment can be completed in a short course (range from 1-4 weeks), allowing you to return to your normal activities with minimal disruption.
For carefully selected patients, it may not be necessary to treat the entire breast. Partial-breast radiation focuses treatment on the area surrounding the original tumor, where the risk of recurrence is highest. Because a smaller volume of breast tissue is treated, partial-breast radiation can reduce radiation exposure to normal tissue and may allow for an even shorter course of treatment. It is an excellent option for appropriately selected patients.
Brachytherapy is an advanced form of radiation therapy in which the radiation source is placed directly within or immediately next to the area where the tumor was removed. This allows us to deliver a highly focused dose of radiation while limiting exposure to surrounding healthy tissue. Breast brachytherapy can be used as a form of partial-breast irradiation in selected patients and may offer a convenient treatment schedule.
Radiation therapy may also be recommended after mastectomy for patients who have a higher risk of the cancer returning on the chest wall or in nearby lymph nodes. This may include patients with larger tumors, involved lymph nodes, or other features that increase the risk of recurrence. Our modern radiation techniques allow us to precisely treat the chest wall and regional lymph nodes while minimizing radiation exposure to the heart, lungs, and other nearby tissues.
For patients with left-sided breast cancer, protecting the heart is especially important. We use a technique called deep inspiration breath hold (DIBH) to help minimize radiation exposure to the heart. During treatment, you take a deep breath and hold it for a short period. As the lungs expand, the heart moves farther away from the breast and chest wall. The radiation is then delivered while you remain in this position. This technique can significantly reduce the amount of radiation received by the heart while maintaining effective treatment of the breast or chest wall.
For some patients, we can deliver radiation while you are lying face down (prone) rather than on your back. In this position, the breast hangs away from the chest wall, which can help separate the breast tissue from the heart and lungs. A prone setup can be particularly helpful for patients with larger breasts or anatomy that places the heart or lungs closer to the treatment field. Careful treatment planning and imaging allow us to determine whether prone positioning will provide an advantage for you.
IMRT is an advanced radiation technique that allows us to precisely shape and control the radiation dose delivered to the breast or chest wall. By adjusting the intensity of the radiation across the treatment area, IMRT can provide excellent coverage of the areas at risk while reducing unnecessary radiation exposure to surrounding healthy tissues, including the heart and lungs. When appropriate, IMRT can be combined with techniques such as DIBH or prone positioning to further minimize exposure to critical organs.
Most patients tolerate modern breast radiation therapy very well. Common short-term effects may include skin redness or irritation, breast swelling or tenderness, and fatigue. These effects typically develop gradually during treatment and improve over the weeks following completion.
Long-term side effects are less common with modern radiation techniques. Some patients may experience subtle changes in breast firmness, size, or appearance. Our advanced treatment-planning techniques—including DIBH and prone positioning when appropriate—are designed to minimize radiation exposure to the heart and lungs and reduce the risk of long-term complications.
Your radiation team will monitor you throughout treatment and provide personalized recommendations for skin care, fatigue management, and maintaining your normal activities whenever possible. Schedule a consultation with our specialists at our centers in the greater Chicagoland area. Call 847-698-0600 ext. 112.
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