April 7, 2017

Radiation for Breast Cancer Treatment – Why Less Is More

By W. Mark McCollough, MD
Mission Radiation Oncology

Due to a revolution in knowledge of DNA and molecular signatures of tumors, the selective use of cancer treatment such as radiation therapy is evolving toward a trend where less is more.

In turn, the “Choosing Wisely” approach used by experts at Mission Health can limit treatment, avoid toxicity and save costs through use of targeted treatment strategies. This results in a method of care that provides more benefit, aids in breast conservation therapy and causes less harm to the patient.

Breast conservation therapy refers to the use of limited surgery (lumpectomy) as an alternative to breast removal (mastectomy) for qualified patients with breast cancer. Used since the 1970s, lumpectomy has almost always been followed by approximately six weeks of daily radiation. However, the experts at Mission Health are finding new ways to treat breast cancer patients beyond the standard use of extensive radiation.

New Facts = Better Treatment

  • Less patients need radiation – Using factors such as tumor size, node involvement and age in conjunction with biologic markers like receptor status, research has shown that it is safe to omit radiation after lumpectomy in some patients.
  • Less length of treatment – Research demonstrates that selected patients have equivalent outcomes when the radiation is given more rapidly, such that it takes only three or four weeks (rather than the standard six) to complete.
  • Less volume of tissue treated – In a small percentage of patients, partial breast radiation can be administered intraoperatively or for a week after lumpectomy surgery. This technique is not yet widely applicable, but continues to be investigated.

At Mission Health, we use less radiation in its various forms, meaning that more of our patients are eligible for breast conservation. It also means that more patients avoid treatment that may hold little benefit for them.


Dr. McCollough is a board certified radiation oncologist specializing in the treatment of breast cancer in western North Carolina. To learn more about Mission Cancer Care, visit cancer.mission-health.org.