An irradiation technique is the Partial Breast Irradiation, which is a special accelerated radiotherapy, and when applicable, it significantly reduces the time required and the suffering of patients (especially the elderly or patients from the province).
IMRT – Intensity Modulated Radiation Therapy
For the external irradiation of the breast, modern techniques of external radiotherapy are now used such as IMRT-Intensity Modulated Radiation Therapy and IGRT-Image Guided Radiation Therapy.
The IMRT, is the most advanced form of external radiotherapy widely applied in clinical practice compared to traditional methods of external radiotherapy. This method, using special technological innovations (subdivision of large radiation fields into smaller with different intensity), achieves the optimum distribution of radiation in the body of the patient. The precise targeting of radiation is greatly increased. We would say that it is the sculpting of radiotherapy, as the shape in the target area to be irradiated can be predetermined with great detail. An extra asset that the IMRT provides to the specialized radiotherapist-oncologist is the use of specific parameters (histograms of dose/volume). These parameters allow immediate prediction of the treatments outcome. Furthermore, they lead to great achievements: the protection of healthy organs (lung and heart) and skin, leading to a significant reduction of the side effects and an improvement of the aesthetic result.
The choice of IMRT technique due to its predominance over conventional techniques, as explained above, is often a must, in particular:
- In patients with tumors located in the left breast (because in this way we have the reduction of the irradiation of the heart)
- In patients with cardiac artificial pacemakers
- In patients with anatomical peculiarities of the chest wall
- In patients with a history of cardiomyopathy or pulmonary disease with limited pulmonary reserves
- In cases where the nodal areas near the breast must get irradiated.
The radiation therapy of the chest wall and / or the supraclavicular fossa after mastectomy, is a necessity in selected patients with these findings in the final histological examination (e.g. positive axillary lymph nodes). Especially for these patients, the use of IMRT is advantageous because it leads to a more precise targeting.
Moreover, when these women have had or are undergoing breast reconstruction surgery, the IMRT, while it offers very good coverage of the target to be shot, it significantly reduces the possibility of shrinkage of the fibrous capsule (side effect of radiotherapy). Significant scientific studies have demonstrated that with the use of IMRT we achieve better uniformity of the radiation dose in the cases where a tissue expander has been used. The expander contains a metal magnetic component which absorbs more radiation dose having as a result for the tissue located behind the metal to take a smaller dose of radiation than the one needed. Using IMRT we have the unique advantage to correct such errors.