Irradiation in breast cancer

Irradiation in breast cancer is one of the methods of suppressing cancer cells. Let's consider features of an irradiation, indications to its carrying out and possible collateral actions.

Irradiation of cancer cells is carried out by ionizing rays with the help of special equipment. The action of the rays is aimed at changing the structure of cancer cells, which leads to their death. The procedure is carried out at different angles with respect to the neoplasm, which allows achieving a better effect. This method does not affect healthy tissues, since they are not sensitive to the rays. As a rule, irradiation is used simultaneously with chemotherapy and surgical treatment. This helps prevent relapse of the disease and destroy cancer cells that were not removed during the operation.

There are a number of factors that influence the choice of the method of treatment:

• The stage of cancer, the presence of metastases and the size of the tumor.
• Location of metastases.
• Histological structure of cancer cells.
• Age of patients and general condition.

The rays affect only certain places, for example, a tumor in the mammary gland and regional lymph nodes. Irradiation is carried out in several sessions, which allows to minimize the side effects of the procedure. Very often this method is used after breast removal, as a cancer prevention.

Depending on the method of application, radiation therapy is divided into the following types:

• Preoperative - for the destruction of malignant cells along the periphery.
• Postoperative - to destroy cancer cells that remained after the operation.
• Intraoperazionnaya - conducted with organosohranayuschih operations.
• Independent - is necessary for contraindications to surgical treatment.
• Intravascular - is used for nodal forms of oncology.

The use of radiation treatment for breast cancer is possible only for medical reasons, when more than 4 lymphatic regional nodes are involved in the pathological process, large vascular-neural bundles and axillary nodes are affected. The method is effective in organ-saving operations.

[1], [2], [3], [4], [5], [6], [7], [8]

Indications for irradiation

Cancer diseases are characterized not only by the destruction of the affected organs, but also by the metastasis of malignant cells with blood flow to all organs and systems. The main indication for carrying out irradiation is the destruction of bad cells, a reduction in the size of the tumor and control over its growth.

Indications for radiation therapy:

• Minimization of painful symptoms.
• Reducing the risk of pathological fractures in metastases in bone tissues.
• Improve respiratory function and reduce bleeding.
• Reduction of the squeezing resulting from the effect of metastases on the spinal cord and nerve endings.

This method of treatment is a targeted effect on the neoplasm, it does not cause painful sensations, but with prolonged use it can cause discomfort. After therapy, the irradiated tissues become radioactive. Duration of treatment from five days to seven weeks, the session lasts about 30 minutes. Radiation does not cause hair loss, but can lead to a discoloration of the skin. Side effects are temporary.

Depending on the purpose, radiotherapy can be:

• Radical - leads to complete resorption of the tumor.
• Palliative - used in a common malignant process, allows you to prolong the life of the patient and reduce painful symptoms.
• Symptomatic - eliminates the severe signs of pathology and pronounced pain syndrome, which can not be stopped with the help of anesthetics.

Irradiation is part of a comprehensive treatment, but in rare cases it can be used as a monotherapy. Timely application of the method allows to remove the tumor at early stages, reducing the risk of relapse by 50-60%, and with combination therapy by 80-90%.

Breast cancer screening regimens

There are many options for using radiation therapy, which depend on the stage of cancer, the characteristics of the patient's body and the course of the disease. The irradiation schedules are compiled individually for each patient. When developing a treatment plan, the doctor chooses the option of maximum positive effect with minimal side effects. On the mammary gland, markings are applied for convenient laser application. Irradiation is performed with the help of special X-ray equipment, which accurately determines at what angle to direct the radiation beam. The procedure is laborious and can take a lot of time.

The choice of the irradiation scheme depends on such factors as:

• Localization and prevalence of the pathological process.
• Histological structure of the tumor.
• The stage and nature of growth of the tumor.

In the initial stages of cancer, when the tumor size is within 2 cm and the lymph nodes are not enlarged, radiation therapy is performed both before the operation and after. This scheme is also irradiated in the last stages of oncology, to prevent recurrence of the disease and the destruction of residual cancer cells.

The procedure can be carried out in the following modes:

• External - is carried out in a hospital using an X-ray machine. Treatment is 30-40 sessions, that is 5 times a week for 4-6 weeks.
• Internal - used less often than the outer one. For the procedure, implants with radioactive preparations are used. In the chest, small incisions are made, into which the catheters with the medicine are administered. The incisions are made so that there is access to the affected tissues of the gland. The duration of the session is 5-6 minutes, daily for 7 days.

If the cancer metastasized, then the radioactive rays are tuned so that they affect all lesions, for example, on the bones of the skeleton, the spine, regional lymph nodes. After the termination of the course of therapy, the gland tissues are gradually restored.

[9], [10], [11]

Irradiation after surgery for breast cancer

Surgical treatment of oncology involves the use of additional methods that improve the results of therapy. Irradiation after surgery for breast cancer is necessary to completely remove malignant cells and prevent recurrence of the disease. This is due to the inability to completely excise all glandular tissue, especially adjacent to the skin and extending along the pectoral muscles. If after surgery remains a little tissue with malignant cells, then this can cause a relapse of cancer.

1. Postoperative irradiation

It takes place 2-4 weeks after surgery. Indications for its conduct are suspicions of inefficiency of the performed operation. The main goal of treatment:

• Irradiation of supraclavicular lymph nodes (for prophylaxis).
• Effects on tissues and regional lymph nodes that have not been removed.
• Destruction of cells with pathological changes that remained in the operating area.

2. Intraoperative

Used for organ-saving operations. It is necessary to remove the cancer cells that remained after the excision of the tissues.

3. Independent

It is performed with inoperable forms of cancer, with patients refusing surgery and having contraindications to surgical intervention.

Effects of irradiation in breast cancer

The treatment of malignant diseases is a long process, during which a variety of therapies with different effects and side effects are used. The consequences of irradiation in breast cancer directly depend on the stage of cancer and can be manifested by many organs and systems.

• Cutaneous adverse reactions

As a rule, when exposed to radiation, reddening appears on the skin, itching, mild soreness and peeling, which is similar to sunburn. But unlike solar radiation, the reaction to irradiation manifests itself gradually and only in some areas. During therapy, the skin can acquire a red tint, and some areas are more intense color (axillary region, fold under the breast, inner part of the gland). Such reactions can be both moderate and pronounced. To reduce skin side effects, wear loose clothes made from natural fabrics, use a bra made of cotton materials or do not wear it at all.

• Negative effects on the chest

After radiotherapy, the mammary gland becomes dense, puffiness develops, which leads to painful sensations. The most sensitive part of the breast is the nipple, it becomes very irritated. After treatment, swelling gradually decreases, the gland acquires a formal shape, the skin looks firm and youthful.

• Painful sensations in the armpits

Discomfort in the armpit can be associated with previous surgical intervention. As a rule, there is numbness of the skin due to damaged nerves, soreness in the region of the incision, swelling due to violations of lymph drainage. Irradiation enhances these sensations, but after therapy the pain is minimized.

• Rapid fatigue and fatigue

Associated with the effects of radiation on the body, the negative effects of previous chemotherapy or surgery. Stress and lifestyle changes due to therapy, also have a negative impact on overall well-being. To reduce fatigue, you must comply with sleep and rest, maintain regular physical activity and adhere to a healthy diet.

• Negative manifestations of internal organs

According to medical research, radiation therapy negatively affects the state of the cardiovascular system and lungs. This is due to the fact that a small dose of radiation enters the lungs, which are located under the anterior thoracic wall. Because of irradiation, scar tissue can form in them. This complication is detected with the help of radiography, and it manifests itself as a dry cough and shortness of breath. If the symptoms are pronounced, then the patients are prescribed steroid agents.

• Pain in pectoral muscles

During and after therapy, shooting pain may occur that is similar to that of electric shock. The cause of discomfort is associated with irritation of nerve fibers. To eliminate discomfort, use anti-inflammatory drugs. After a complete irradiation course, the discomfort passes by itself.

• Muscle Cloth Seal

During and after radiotherapy, many patients are faced with the fact that the muscles in the chest become stiff and dense. The main cause of pathology is the formation of scar tissue due to exposure to radiation. It is radiation that causes compaction and stiffness. Anesthetics are used to eliminate this complication.

• Risk of fracture of ribs

If the irradiation is performed after a mastectomy, the risk of fracture increases substantially, which is due to the lack of a muscular framework. Even if an implant was installed after the treatment, it does not protect the bone costal tissue.

Irradiation in breast cancer is a method of treatment that can be used both before and after surgery. Thanks to this method, it is possible to completely remove malignant cells from the body, which minimizes the possibility of relapses.

[12], [13], [14], [15], [16], [17]