“Is radiation therapy recommended for breast cancer?”
My friend's mother was diagnosed with breast cancer in the 2nd stage, and their family is weighing their options. I know that they're consider radiation therapy over chemotherapy. Is radiation therapy recommended for breast cancer?
7 Answers
It isn't one or the other. RT is routine after lumpectomy, but there are several ways to do the RT. Some are short, some half the breast. The chemo decision or hormone decision depends on the size of the lymph nodes.
The two things have different purposes. Radiation works with surgery to control the disease in the breast. It is recommended in certain tumors of large size and/or positive lymph nodes. If she has a lot lumpectomy then radiation is needed. Chemotherapy or hormone therapy is there to try and prevent or postpone any spread of the cancer to other organs. Whether it is the right thing to do depends on several issue
1) how big was the cancer
2) were lymph nodes involved
3) what type of breast cancer is it. Different types need different therapies.
4) was there an Oncotype done? If so what I as the number result
So many things to consider. Surgery +/- radiation is for local control in the breast and on the chest. Chemotherapy and/ or hormone therapy is for the rest of the body
1) how big was the cancer
2) were lymph nodes involved
3) what type of breast cancer is it. Different types need different therapies.
4) was there an Oncotype done? If so what I as the number result
So many things to consider. Surgery +/- radiation is for local control in the breast and on the chest. Chemotherapy and/ or hormone therapy is for the rest of the body
Yes if she had lumpectomy and node sampling. She will need radiation therapy if she had mastectomy with positive surgical margins or positive metastasis In axillary lymph nodes
Dr. Joshua N. Halpern
Radiation Oncologist
For stage 2 breast cancer, radiation is not needed if the breast is removed (Mastectomy). If only the cancer lump was removed, there are indications for local radiation, as chemotherapy does not reach effectively the bed of the tumor as the blood supply would have been compromised after the surgery. Radiation will reduce the local recurrence from about 40% to about 5% or less based on the specific case, so it is very effective.
Radiation plays a large role in the treatment of most breast cancers, and would be considered part of the standard of care. There are exceptions such as smaller tumors where the patient has a mastectomy.
Radiation, applied correctly, can allow patients to avoid mastectomies with an equal chance for survival in many cases.
Roger Macklis
Roger Macklis
Dear Concerned Family Friend,
Thank you for posting the question regarding your friends mother’s diagnosis of Stage II breast cancer. The stages of breast cancer are assigned based on several factors 1) the size of the breast tumor 2) the nodal status (the presence or absence of positive nodes) and 3) metastasis to other sites such as the contralateral breast (the opposite breast), bone, liver, lung or brain. Thus, stages I-III are localized to the breast and regional nodes, while stage IV has spread to other sites.Stages I-III can be further subdivided based on several criteria such as the size of the breast tumor and nodal status. This, of course, is also true for stage II breast cancer (the stage of your friend’s mother-as stated in your inquiry). Stage II breast cancer could signify a tumor size of 2-5 cm and positive nodes, or a tumor size greater than 5 cm without involvement of nodes.In both scenarios, chemotherapy would be recommended after surgery, as prescribed by her medical oncologist. If she elects to undergo breast conservation surgery (excision of the tumor without removing the entire breast), regardless of the subset of stage II, adjuvant radiation therapy (radiation therapy after surgery) is recommended as the standard of care. In the setting of mastectomy (removal of the entire breast), if her stage II breast cancer is attributed to tumor size 2-5 cm and positive nodes, adjuvant post-mastectomy radiation therapy is certainly recommended. However, if her stage II disease denotes tumor size > 5 cm with negative nodes (nodes not involved with cancer), then adjuvant radiation therapy after mastectomy (post-mastectomy radiation therapy) is usually recommended. However, your radiation oncologist will likely enter a detailed discussion with your friend’s mother and family, during which all factors will be considered, including patient age and medical comorbidities, and pathological features including, but not limited to, margin status and tumor grade. I hope that the explanation herein amply addresses your question and provides information for further discussion with the oncology team participating in the care of your friend’s mother.
Best Regards,
Dr. EB
Thank you for posting the question regarding your friends mother’s diagnosis of Stage II breast cancer. The stages of breast cancer are assigned based on several factors 1) the size of the breast tumor 2) the nodal status (the presence or absence of positive nodes) and 3) metastasis to other sites such as the contralateral breast (the opposite breast), bone, liver, lung or brain. Thus, stages I-III are localized to the breast and regional nodes, while stage IV has spread to other sites.Stages I-III can be further subdivided based on several criteria such as the size of the breast tumor and nodal status. This, of course, is also true for stage II breast cancer (the stage of your friend’s mother-as stated in your inquiry). Stage II breast cancer could signify a tumor size of 2-5 cm and positive nodes, or a tumor size greater than 5 cm without involvement of nodes.In both scenarios, chemotherapy would be recommended after surgery, as prescribed by her medical oncologist. If she elects to undergo breast conservation surgery (excision of the tumor without removing the entire breast), regardless of the subset of stage II, adjuvant radiation therapy (radiation therapy after surgery) is recommended as the standard of care. In the setting of mastectomy (removal of the entire breast), if her stage II breast cancer is attributed to tumor size 2-5 cm and positive nodes, adjuvant post-mastectomy radiation therapy is certainly recommended. However, if her stage II disease denotes tumor size > 5 cm with negative nodes (nodes not involved with cancer), then adjuvant radiation therapy after mastectomy (post-mastectomy radiation therapy) is usually recommended. However, your radiation oncologist will likely enter a detailed discussion with your friend’s mother and family, during which all factors will be considered, including patient age and medical comorbidities, and pathological features including, but not limited to, margin status and tumor grade. I hope that the explanation herein amply addresses your question and provides information for further discussion with the oncology team participating in the care of your friend’s mother.
Best Regards,
Dr. EB
