Boost Dose

Through the first five to six weeks of your treatment, you will receive radiation to your entire breast area. During the final week or two, you also will receive a supplemental dose targeted directly to the area around your surgery, where the cancer had been. This dose is called the "boost" and is usually delivered with external radiation. A smaller treatment field is used for the boost dose. Another planning and set-up session is usually required before the boost radiation is started.

External radiation boost

A boost dose delivered with external radiation is very similar to the usual method of treating the whole breast. Most women get their boost dose with a special form of external radiation called electrons. This form is used because the dose can be targeted specifically to a small area near the skin surface, sparing the tissue underneath. You will receive this dose from the same machine that is used for your other therapy, and you'll probably lie in the same position.

Internal radiation boost

Internal radiation, also called brachytherapy, is not as common as external radiation for giving a boost dose. But it is used in some treatment centers. If you get a boost dose with internal radiation, you will have small tubes or catheters sewn under your skin in the area where the cancer was. Next, small bits of radioactive material called seeds are placed in these tubes so they can emit radiation to the nearby tissue.

In most cases, you will have these "seeds" within you for a day or two. During treatment, you stay in the hospital because there is radioactivity inside you. Special precautions are taken to keep you and everyone else safe. Your nurses, doctors, and visitors are allowed to visit for only a short time while the radiation seeds are in the tubes. No one will be able to be very close to you. Once the treatment is done, the radioactive seeds, the stitches, and the tubes are removed. Then you can go home.

A newer method lets you receive internal radiation as an outpatient. The process uses high-dose rate seeds that are briefly implanted and then taken out before you leave the treatment center. With this internal radiation you will still have catheters under your skin, but you do not remain radioactive when you leave.

A number of studies are investigating the value of internal radiation as the only form of radiation treatment. For more information, visit the section on partial-breast radiation.