Adjuvant breast radiation therapy is a fundamental component that substantially reduces the risk of local recurrences in both noninvasive and invasive breast cancer, along with ductal carcinoma in situ (DCIS). Overall survival rates improve when given after breast conservation surgery. Historically, the typical breast radiation regime is whole breast irradiation (WBI), which is delivered over 5 to 6 weeks. Unfortunately excessive radiation exposure to healthy tissue can produce side effects to the heart, skin, lung, and ribs. Today shorter courses of radiation are being used, reducing the burden on patients. Accelerated hypofractionated external beam whole breast radiation is the most optimal treatment for non-invasive breast cancer.
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APBI can be delivered by brachytherapy or by external beam radiation therapy techniques. Accelerated partial breast irradiation is another technique used to deliver a course of radiotherapy over an even shorter time, usually 5 days. Brachytherapy provides a reduction in treatment length and loss prevention of healthy tissue. This treatment option employs a fractionated dose of 3.4 Gy administered BID over 5 days. Additionally, this course of treatment reduces the exposure time thus reducing risk by infection based on the implanted device. Prior studies of APBI used brachytherapy, but currently the thrust in the field is moving towards conformal external beam radiation. Improvements are in part a result of targeting and dosimetric planning due to advancement in treatment planning. Partial breast radiation, also known as APBI was developed to address issues of cost and for those patients who had demographic challenges and patients who have age related health issues. According to a three year outcome trial in Canada, continued support of randomize APBI trials due to sufficient cosmesis and toxicity and prognosis for survival improved local control and disease free survival. External beam treatment is non-invasive. After a positive pathology report treatment can be executed without the patient having to undergo an additional invasive surgical …show more content…
Image guidance is not new to radiation therapy, but as technology has evolved so has the accuracy of radiation delivery. IGRT uses imaging to extreme precision throughout the entire course of radiation therapy for each individual patient. The ongoing advances in dosimetric planning and delivery require the need for improved accuracy through daily IGRT. Nevertheless, the tumor being treated is often a soft tissue mass within the body that moves and using bony landmarks alone could cause an error in treatment. The advancement in IGRT technology has improved drastically with daily imaging and correction, which allows for reduced tumor margins and increases in curative radiation doses. The IGRT matching between the treatment planned position and the IGRT at the time of treatment may be manually performed or by automated by software. IGRT most often uses imaging to make sure the radiation is being precisely targeted to the treatment area in ensure minimal dose to healthy cells and organs. IGRT uses a variety of 2D, 3D, and 4D imaging techniques to position the patient and target the radiation so that your treatment is focused on the tumor. Implanted fiducial markers or external surface markers may be used as
APBI can be delivered by brachytherapy or by external beam radiation therapy techniques. Accelerated partial breast irradiation is another technique used to deliver a course of radiotherapy over an even shorter time, usually 5 days. Brachytherapy provides a reduction in treatment length and loss prevention of healthy tissue. This treatment option employs a fractionated dose of 3.4 Gy administered BID over 5 days. Additionally, this course of treatment reduces the exposure time thus reducing risk by infection based on the implanted device. Prior studies of APBI used brachytherapy, but currently the thrust in the field is moving towards conformal external beam radiation. Improvements are in part a result of targeting and dosimetric planning due to advancement in treatment planning. Partial breast radiation, also known as APBI was developed to address issues of cost and for those patients who had demographic challenges and patients who have age related health issues. According to a three year outcome trial in Canada, continued support of randomize APBI trials due to sufficient cosmesis and toxicity and prognosis for survival improved local control and disease free survival. External beam treatment is non-invasive. After a positive pathology report treatment can be executed without the patient having to undergo an additional invasive surgical …show more content…
Image guidance is not new to radiation therapy, but as technology has evolved so has the accuracy of radiation delivery. IGRT uses imaging to extreme precision throughout the entire course of radiation therapy for each individual patient. The ongoing advances in dosimetric planning and delivery require the need for improved accuracy through daily IGRT. Nevertheless, the tumor being treated is often a soft tissue mass within the body that moves and using bony landmarks alone could cause an error in treatment. The advancement in IGRT technology has improved drastically with daily imaging and correction, which allows for reduced tumor margins and increases in curative radiation doses. The IGRT matching between the treatment planned position and the IGRT at the time of treatment may be manually performed or by automated by software. IGRT most often uses imaging to make sure the radiation is being precisely targeted to the treatment area in ensure minimal dose to healthy cells and organs. IGRT uses a variety of 2D, 3D, and 4D imaging techniques to position the patient and target the radiation so that your treatment is focused on the tumor. Implanted fiducial markers or external surface markers may be used as