Breast cancer
Radiotherapy
The objective of radiotherapy is to deliver a high dose of radiation to a volume of treatment in order to maximize tumor control, keeping the dose in nearby tissues as low as possible to reduce the probability of severity of complications in normal tissues.
Clinical data has shown around 50% of patients would benefit from IMRT (Intensity Modulated Radiotherapy ) treatment, but it must be performed safely, quickly and efficiently from planning to delivery.
Elekta (creators of our radiotherapy equipment, “Versa HD”) developed rotational IMRT, a delivery technique known in Spanish as Modulated Volumetric Arc Therapy (VMAT).
VMAT ( Volumetric Modulated Arc Therapy ) is an advanced radiation therapy technique that delivers high doses of radiation specifically to the target (tumor) while reducing the dose to surrounding tissue and surrounding organs. With the use of single or multiple high-energy rays or particles that move in the form of interrupted arcs around the patient, this technique allows us to drastically reduce treatment times
This gives VMAT of:
- Greater control.
- Greater flexibility.
- Greater dose compliance.
The Elekta VMAT technique allows optimizing the administration of the dose to the needs of each patient, customizing their treatment according to their pathology. In this way, it provides a highly patient-focused procedure, giving us new method opportunities, while offering the freedom to simultaneously vary a number of parameters during the delivery of radiotherapy without having to compromise your treatment plan or its accuracy by time to administer.
Advantages of the VMAT
- Better compliance and dose homogeneity, especially around the spine.
- Lower average doses of OAR (Organs at Risk) vital, such as: heart, thyroid, esophagus, lung, among others.
- Maximum dose reduction in OARs, said dose reduction, could lead to an improvement in late effects and an increased quality of life.
Radiotherapy in breast cancer
Breast cancer is the most frequent tumor in women, only in Mexico is it considered the most prominent cancer in 2020, with 29,929 incidents per year. At the COC we have a Radiotherapy team that offers:
- Advances in systemic therapy and radiotherapy that have prolonged survival.
- Radiotherapy that reduces the risk of locoregional recurrence after surgery by at least 70%.
- Radiotherapy that prolongs survival in early and advanced stages after radical surgery.
- We have the appropriate technology to apply modern techniques that offer long-term
benefit by controlling late toxicity.
Situation of breast cancer in Mexico
- First cause of death from cancer in Mexico.
- 16% of all neoplasms in women.
- One death every 1.7 hours.
Radiotherapy is a fundamental treatment in breast cancer because it increases survival while allowing the breast to be preserved.
Radiotherapy is recommended for all women who have been treated with partial or conservative breast surgery, regardless of their age, clinical status or tumor characteristics. It is also recommended in some women after a mastectomy based on the findings after it.
Radiotherapy in the treatment of breast tumors
Treatments may include all or part of the breast:
Radiotherapy of the whole breast: External radiotherapy has traditionally been administered with 3DCRT (3D Conformal Radiotherapy) techniques in 25 sessions of 15 minutes duration, 5 days a week, for 5 weeks. Subsequently, an overdose was carried out in the area with the highest risk of cancer recurrence, the primitive tumor bed, administering 8-10 additional sessions, up to a total duration of 6-7 weeks.
At the Chihuahua Cancer Center we use image-guided (IGRT) direct or inverse planning techniques with modulated intensity of the radiation beam (IMRT or VMAT) that offer very high precision at the time of daily treatment administration, improving tolerance and the quality of life of our patients. The systematic use of these techniques allows us to use shortened treatment schemes, with simultaneous overdosing of the tumor bed, managing to reduce the total duration of treatment to 3 weeks (15 sessions) Partial Breast Irradiation: in certain patients with tumors with a good prognosis, there is the possibility of performing a treatment focused exclusively on the area of greatest risk of tumor recurrence, avoiding irradiation of the rest of the Breast.
Partial Irradiation requires extraordinary precision in the administration of Radiotherapy and benefits from the use of respiratory control techniques, defined as GATING, which are a process for continuously monitoring the movement of tumors during normal respiration. techniques are available at our Oncology Center. To these advantages in precision, partial irradiation adds the possibility of reducing its total duration to a single week.
Brachytherapy.
Soon we will have a Brachytherapy team with which we will provide Interstitial Brachytherapy treatments that are evaluated in a personalized way for each patient. Through the temporary insertion of a radioactive source of Iridium-192 through needles in the breast and positioned in the area of maximum risk for the tumor. This technique is indicated as a boost, or in some cases, as a treatment for breast tumors that reappear after a first treatment, as an alternative to a radical mastectomy.