Radiation therapy is painless and uses high-energy particles or rays (like a more intense X-ray) to kill cancerous cells. It is delivered by our radiation oncologists — specialists who form a key part of our team and have spent years in the field of breast health.
Our program offers a variety of effective radiation therapy, including intraoperative radiotherapy (IORT) — a new approach that combines surgery and a single dose of radiation in the same visit. MedStar Georgetown University Hospital and MedStar Washington Hospital Center were the first D.C. area hospitals to offer this service.
We use radiation therapy in several ways:
- After breast-conserving lumpectomy (i.e., partial mastectomy) to reduce the chance cancer will return to the breast or the lymph nodes
- Following a mastectomy, when the tumor is larger or the cancer has spread to lymph nodes
- When the cancer has spread to other areas of the body
We use two types of radiation, and offer partial breast irradiation to lumpectomy patients when appropriate:
- External Beam Radiation: The most frequently used, it focuses radiation on the breast from external machines. External therapy is usually given over a six-week period. Technologies include:
- Intensity Modulated Radiation Therapy (IMRT): customizable to different parts of the treatment area
- 3D Conformal Radiation Therapy (3D-CRT): beams conform to the tumor, sparing healthy tissue
- Internal Radiation (Brachytherapy): Radioactive seeds or pellets are place in the beast tissue near the tumor. This option depends on tumor size, location and other factors and is not appropriate for all patients.
Intraoperative Radiation Therapy (IORT)
MedStar Georgetown University Hospital and MedStar Washington Hospital Center are participating in a clinical trial offering a new type of radiation — intraoperative radiation therapy (IORT).
Instead of repeat follow-up visits for radiation therapy, patients undergoing breast-conserving surgery (lumpectomy, i.e., partial mastectomy) receive a single dose of radiation immediately after the tumor is removed, directed at the spot where it sat. The surgeon then closes the incision. While data is still getting collected, initial results show that this approach offers:
- Effectiveness and Safety: IORT appears as safe and effective as whole breast radiation. The new method also allows doctors to kill lingering cancer cells immediately at the source of the tumor — the place cancer most often returns.
- Sparing Healthy Tissue: Less radiation is delivered to surrounding healthy tissue.
- Speed and Comfort: Getting the radiation adds only another 20 to 40 minutes to the operation, during which the patient is asleep. The combined outpatient procedure —performed entirely in the operating room — takes about two to three hours, and the patient returns home the same day.
- Convenience: The single dose means patients don’t have to go through the normal regimen: waiting four weeks after surgery to receive radiation, then needing to travel for up to 30 treatment sessions spread over six weeks. If all is well with the lymph nodes and margins after IORT, no further radiation and no chemotherapy is required.
Not every patient is a candidate for IORT, and the experts at the MedStar Breast Health Program can discuss personalized treatment options with you. Lumpectomy patients will meet with a radiation oncologist and a surgeon from the same hospital to determine if they are a good candidate. Eligibility depends on:
- Age: 50 years or older
- Cancer Type: early-stage cancer that has not spread
- Tumor Size: three centimeters or less
- Other factors your physicians will assess