Radiation therapy is an important component in most breast cancer treatment plans. We use it after surgery to destroy remaining cancer cells or in some cases before surgery to shrink a tumor. At the Abramson Cancer Center, our specialized radiation oncologists customize radiation treatment to safely and quickly treat breast cancer.

What Is Radiation Therapy?

Radiation treatment uses high-energy radiation from X-rays and other energy sources to destroy cancer cells. Radiation can be:

• External, delivered as beams from a machine outside the body (external-beam radiation therapy)
• Internal, distributed by radioactive material placed directly in or near a tumor (brachytherapy)

External-beam radiation is most often used to treat breast tumors, though internal radiation may be used in some cases. Learn more about radiation therapy.

Radiation for Breast Cancer: Why Choose the Abramson Cancer Center?

Our radiation oncologists work within a multidisciplinary breast cancer team to coordinate a comprehensive and tailored treatment plan. At the Abramson Cancer Center, you’ll find:

• Unmatched expertise: We are the largest breast cancer radiation program in the area and one of largest in the country. Our radiation oncologists use their expertise and experience to ensure that your treatment is precise and personalized.
• Convenient treatment: We offer expert radiation therapy at more than 10 Penn Medicine locations. You can receive the specialized care you need without traveling far from home.
• Innovative radiation therapies: Penn offers the newest radiation methods available, including proton therapy as well as clinical trials.
• Support during treatment: We offer extensive support services to help manage and alleviate any side effects of radiation therapy. Our team includes nurses, social workers and nutritionists whose goal is to make your experience as positive and painless as possible.

Our Approach to Radiation Therapy for Breast Cancer

We typically use radiation in combination with other breast cancer treatments after a lumpectomy or mastectomy. Our wide range of advanced technology allows us to customize radiation therapy and offer radiation following breast reconstruction. We tailor the treatment to each patient’s diagnosis, anatomy and tumor location.

Safety During Breast Cancer Radiation

The breasts’ proximity to the heart can make delivering radiation a challenge. To reduce the heart’s exposure to radiation, we use precision technology and additional techniques including:

• Extensive 3D planning: Every patient goes through a simulation process before beginning treatment. Our advanced open CT scanners help us create a detailed radiation plan. We use that plan to precisely target cancer cells while trying to avoid healthy organs.
• Deep inspiration breath hold (DIBH): When you hold your breath, your lungs expand and your heart moves away from your chest. Delivering radiation as you hold your breath is clinically proven to lower the dose of radiation to the heart. This technique is standard at Penn for patients with left-sided cancer.
• Prone positioning: Lying prone (face down) during radiation treatment allows the radiation beam to reach breast tumors while reducing exposure to the heart and lung. This can be very helpful with women with large breast sizes, left-sided cancer, or history of lung problems.

Reducing Radiation Treatment Time

We provide the most effective radiation therapy while reducing the time you spend in treatment by using:

• Accelerated radiation: Most patients at Penn receive accelerated (hypofractionated) treatment following a lumpectomy. It decreases the number of treatments and radiation time from six weeks to under four weeks.
• Advanced technology: We use the latest and fastest machines available. Our Varian Halcyon system (photon radiation) can cut the length of each treatment session in half. In most cases a daily treatment can be 5-10 minutes.

Radiation Treatments Used for Breast Cancer

Our radiation oncologists use different techniques to deliver radiation therapy for breast cancer. This allows us to tailor treatment for your needs. Types of radiation therapy we use include:

Conformal Radiation

During conformal radiation, doctors shape (conform) the photon beam to match the unique shape of the breast. CT (computed tomography) scans guide us as we create a 3D map of the breast and adjust the angles of the beams and the radiation strength as needed. Conformal radiation provides maximum radiation to the cancer while reducing damage to surrounding tissue.

Intensity-Modulated Radiation Therapy (IMRT)

During intensity-modulated radiation therapy (IMRT), doctors rely on advanced computer-assisted planning to create complex radiation patterns. IMRT avoids normal tissue better than conventional radiation, making it ideal for more complicated cases. A machine called a linear accelerator varies the intensity of radiation and closely matches the shape of the tumor.

Internal Radiation (brachytherapy)

Internal radiation (brachytherapy) treats cancer from the inside, without the use of external beams. This targeted treatment typically follows a lumpectomy. We rely on breast imaging to guide a small, soft balloon into the space where cancer is most likely to recur. A computer-controlled machine delivers radiation through a catheter into the balloon to treat the area.

Proton Therapy for Breast Cancer

Proton therapy is a targeted radiation treatment that uses protons (positively charged atoms) to destroy cancer cells. Proton beams emit low radiation, resulting in less exposure for healthy breast tissue and a reduced risk of side effects. Proton therapy for breast cancer is available through clinical trials and for select breast cancer patients who meet one of two criteria:

• Challenging anatomy: Breast reconstruction or tumor location may prevent us from treating some women with more standard radiation techniques. Highly accurate proton beams can precisely target hard-to-reach cancer cells while avoiding radiation to the heart or lungs.
• Re-radiation: Too much radiation can irreversibly damage otherwise healthy tissue. If you’ve previously had radiation, proton therapy may reduce additional harm to the tissue surrounding the tumor.