Can You Have Radiation Again if Cancer Comes Back?

If a patient has recurrence in the same area as the original tumor, then sometimes lumpectomy with radiation is still possible.

The answer used to be a definitive "no" but that has changed. Now we have more options for performing breast radiation.

If breast cancer returned following lumpectomy with radiation, the recommended treatment would be mastectomy. Though the standard of care remains full breast radiation after lumpectomy surgery, several clinical trials in the last five years have been offering what is termed "partial breast radiation."

This technique radiates the area where the breast cancer was located and leaves the rest of the breast tissue alone. The rationale for this relies on the fact that most recurrences of breast cancer occur in the same location where the breast cancer originally grew.

If someone has had lumpectomy with partial breast radiation and a new tumor appears in another quadrant of the breast, she would be a good candidate for lumpectomy again (assuming the tumor is small) and partial breast radiation at the site of the new tumor.

If she has recurrence in the same area as the original tumor, then sometimes lumpectomy with radiation is still possible. Each situation is different, though, and depends on many factors, including the radiation dose given to the breast tissue that now has to be radiated again.

In the next two to three years, research studies will provide data telling us a lot more about this newer option for local prevention of recurrence following lumpectomy to treat breast cancer.

It's nice to know that women now have choice between full breast radiation and partial breast radiation. It is also hoped that the studies will show that this method reduces the effects of radiation on the heart and lungs.

Johns Hopkins offers several radiation options, including partial breast radiation using an external beam. In contrast to internal radiation, which involves surgical insertion of rods or radiation seeds inside the breast, external beam radiation is directed externally from the machine to the breast tissue.

Hopkins also offers an accelerated external beam radiation protocol that is completed in less than one week instead of the traditional 6 weeks. Progress is happening!


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