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Limiting Radiation Exposure in Breast Cancer Therapy

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One fundamental question in treating ductal carcinoma in situ (DCIS) with adjuvant radiation is: Can partial breast radiation offer the same clinical outcome as whole breast radiation? Lemuel Ariaratnam, MD, chief of radiation oncology at Fox Chase Virtua Health Cancer Program explains:" The literature suggests that tumors of 2.5 centimeters or less can be successfully treated with partial breast radiation." Studies are now underway to compare these two radiation modalities for DCIS patients.

Radiation is often standard adjuvant therapy for DCIS patients who undergo lumpectomy for early stage breast cancer and precancerous masses. NCI reports that adding radiation therapy to breastconserving surgery can reduce the risk of recurrence by 47 percent.1 However, radiation side effects can occur and include reddening, darkening, and peeling of the breast tissue, breast tenderness or swelling, radiation pneumonitis, and cardiac toxicity in leftsided DCIS patients.

Catherine Kim, MD, Virtua radiation oncologist, adds: "?ere is great interest in partial breast radiation (PBI) and other techniques that limit radiation dose and make it more conformal. Our goal is to deliver as high a conformal dose as possible while limiting toxicity to nearby tissue."Age criteria for PBI is >45 years, based on the American Society of Breast Surgeons recommendations.

Dr. Kim explains: "Tumor depth, margins and grade help determine which type of radiation treatment is most appropriate. For some patients, whole breast radiation using advanced planning techniques is more appropriate."

"Advance planning techniques can improve dose homogeneity and distribution and improve target coverage in some cases.However, its appropriateness is still being studied," concludes Dr. Ariaratnam.

This Virtua Physician article was last updated: August 22, 2008