Doctors Focus on Improving Radiation Therapy Accuracy in Early-Stage Breast Cancer

Julia White MD in radiation therapy treatment suite

Women with stage I breast cancer have the option to choose between breast-conserving surgery (lumpectomy) followed by radiation therapy or a full-breast removal (mastectomy). In the past, many patients struggled with the choice as they weighed the fear of recurrence against potential side effects of radiation therapy.

But a growing body of recent scientific data suggests that a lumpectomy combined with radiation therapy is just as effective – if not more so – than a mastectomy, says Julia White, MD, director of breast radiation oncology at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).

Women with early-stage breast cancer are increasingly making the decision to keep their breasts. Nationwide, 70 percent of stage I breast cancer patients are choosing a lumpectomy followed by radiation.

“Our challenge is to continue improving the accuracy of radiation therapy to ensure our patients are receiving the most precise, optimal dosing for cancer control that also avoids overtreatment,” says White.

Breast radiation therapy has changed dramatically in the past decade, resulting in sophisticated tools that allow radiation oncologists to carefully calculate treatment dosages and pinpoint treatment location to minimize damage to surrounding healthy tissues and organs.

At the OSUCCC – James, breast radiation is delivered in a prone (face-down) position to keep radiation exposure outside the chest wall, avoiding the collateral damage to the heart and lungs. White was instrumental in developing the prone breast radiation board and treatment protocols now used across the United States.

Prone breast board 4x3

“The challenge now is to improve geometric accuracy of the breast radiation therapy by using real-time imaging map to specifically guide each woman’s radiation treatment based on the specific location of her tumor within the breast,” says White.

Radiation Before Surgery in Early Stage Breast Cancer

In collaboration with OSUCCC – James breast cancer surgeon William Farrar, MD, White is leading a new clinical trial to evaluate the effectiveness of upfront partial breast irradiation in low-risk, early stage breast cancer patients age 60 or older.

In this phase II trial, women will receive accelerated, image-guided partial breast radiation prior to undergoing a lumpectomy.

“We are not changing the elements of care in this trial – but we are changing the order in which a woman receives them with the goal of improving both treatment accuracy through real-time imaging guidance and post-treatment cosmetic outcomes,” explains White.

Women over age 60 with stage I breast cancer who will be treated with a lumpectomy and radiation may qualify for the trial. Prior to radiation treatment, each study participant will have two imaging tests that are then fused to create a 3D map that will allow oncologists to deliver super-selective treatment based on the unique shape and location of the breast tumor. Participants will then receive image-guided radiation therapy two times a day for one week followed by a lumpectomy approximately three to four weeks later.

“We believe this approach has the potential to improve radiation treatment accuracy because we can more precisely target the affected tissues when the tumor is still present. It could also reduce deformities of the breast that often occur when radiation is given after surgery.”

Visit our breast cancer treatment team page to learn more about the OSUCCC – James breast cancer team or call 1-800-293-5066.