NCCN Guidelines for Patients® | Stage 0 Breast Cancer - page 24

NCCN Guidelines for Patients
Stage 0 Breast Cancer, Version 1.2014
Lumpectomy and radiation therapy
A lumpectomy followed by radiation therapy is
strongly recommended for the treatment of DCIS.
Adding radiation therapy to a lumpectomy that
removes a cancer-free surgical margin has been
shown to help stop the return of cancer within the
breast. This combined treatment is called breast-
conserving therapy because most of the normal
breast tissue won’t be removed. It is an option for
many but not all women with DCIS.
Radiation therapy is given after a lumpectomy that
removed cancer-free margins. See page 21 for more
information on a lumpectomy. Radiation therapy uses
high-energy rays to treat cancer. The rays damage
the genes in cells. This either kills the cancer cells or
stops new cancer cells from being made.
Most of the breast will be treated with radiation. This
is called whole breast radiation. Radiation is delivered
using a machine outside the body, as shown in
Figure 6.
This method of delivery is known as EBRT
Before being treated with radiation, pictures of
the tumor should be taken with CT (
omography). A CT scan takes many x-rays of the
breast from different angles to make detailed pictures,
called images. Before the scan, a contrast dye may
be injected into your vein to make the pictures clearer.
Contrast dye is a safe drug but may cause you to feel
flushed or get hives. Rarely, serious allergic reactions
occur. Tell your doctor if you have had bad reactions
Imaging the breast before radiation is called
simulation. During the scan, you will need to lie on a
table that moves slowly through the tunnel in the CT
machine. Your doctors will use the images to decide
the radiation dose and to shape the radiation beams.
Beams are shaped with computer software and
hardware added to the radiation machine. The beams
are shaped so that normal tissue is spared.
There are other methods that can be used to spare
normal tissue. Moreover, there are ways to protect
your heart if radiation will be given in that area.
Figure 6. EBRT machine
Whole-breast radiation is delivered using an
EBRT machine.
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