number of radiation treatments? 28 vs. 33?

Boosts are usually given around the surgical site to reduce the chance of recurrence in that area.  They usually give them when the margins are less than 5mm. 

    By                       Pam Stephan    ,         About.com Guide             

Updated May 17, 2010

Early-stage breast cancer is often treated with a lumpectomy or mastectomy and radiation.  Even though the tumor may have been small and no metastasis was found, women and their doctors still look for ways to prevent a recurrence.  The technique of giving a radiation boost at the end of treatment has been very effective in keeping breast cancer from coming back.

A Little Extra At The End of Radiation

A radiation boost is one or more extra treatments, given at a higher dose than routine treatments, and targeted at the tumor bed.  This extra dose covers a small area and affects the tissue where cancer is most likely to return.  Radiation boost treatments are given after the regular sessions of radiation are complete.  Women who are 40 years old or younger at time of treatment get the most benefit from a radiation boost, but patients of all ages will have a lower risk of recurrence if they receive a booster treatment.

The Boost Dose Benefits Patients with Early Stage Breast Cancer

For patients diagnosed with early stage breast cancer, either ductal carcinoma in situ (DCIS) or invasive breast cancer, a radiation boost protects against recurrence.  Most patients who have a lumpectomy will qualify for radiation with a boost, and in some rare cases, mastectomy patients may also have radiation and the boost.  There is some disagreement among radiation oncologists as to whether or not a radiation boost really benefits a patient diagnosed with DCIS, but it has become the standard of care.

Having a Radiation Boost

Breast cancer patients may have whole breast radiation (WBI) or partial breast radiation (given with external beams or brachytherapy), after which boost doses are given.  If you're having a lumpectomy and are planning on radiation, surgical clips may be placed at the time of surgery, to help your radiation oncology team target your tumor bed during treatment.  Your boost dose may be given with external radiation, via interstitial catheters, or from within a brachytherapy applicator.  The targeted boost dose may be given in one session, or during five to seven daily sessions. Because the dose is greater than a standard treatment and very focused on a small area of tissue, some radiation fibrosis can occur at the boost site.  In most cases, this should not be bothersome.

Radiation Boost May Mean Fewer Mastectomies, Longer Life

After being diagnosed with breast cancer, the first decision you may face is whether to have a lumpectomy or a mastectomy.  You have to weigh that decision with the fact that breast cancer is most likely to recur in the same breast, right at the tumor site.  Many women opt to remove the whole breast, in hopes of never having breast cancer come back.  A radiation boost is designed to prevent recurrence at the tumor site, even after a lumpectomy.  Research has shown that women who had a radiation boost had fewer local recurrences, as compared to those patients who didn't have the boost. Doctors hope that, because of better radiation techniques, more women will be able to choose lumpectomy over a mastectomy, and have a better quality of life after treatment.

You really should ask the Drs. but I suspect that 28 is the regular and 33 is with 5 boost.  I had 28 reg and 6 boost for a total of 34 treatments.  My RO did not tell me about boost either he just said 34 treatments.  By the time I started radiation I had heard about boost and asked the techs about it and they gave me the breakdown

Vicky, I've heard that  women who had chemo consider radiation to be much easier. (I got to skip chemo. In my case, the fatigue set in half way through rads. I finished 2 weeks ago and my energy is much better now.) The best advice I got was to schedule naps (and go to bed early). Also, exercise helps. I aimed to walk 1/2 hr a day (though sometimes I only made it for 20 mins). I also went to a "guided imagery" class throughout my treatment. The days I went I got the best sleep ever. So maybe try something like that (available on CD) My cancer buddy (at the support center) worked through rads (and she rode her bike to/from treatment!). So like everything, I think this varies for each patient.

I agree - ask your RO.  I had 25 regular zaps plus 8 boosts making 33 total treatments.

Maxine, you got a lot of good information here. I am almost finished with radiation. Just 5 more boosts. It was soooo much easier than chemo. I never had fatigue (had that during chemo), but everyone's treatment is just a bit different. The worst thing for me about radiation is redness, like a bad sunburn, and itchiness. Go to the June radiation boards to get a better idea of what to expect. There is a lot of support here to help you get through every step of this journey.

I had the Canadian protocol done which was 20 total rounds of radiation, 15 regular and 5 boosts. The Canadian protocol is where they give you higher doses of radiation during each treatment, so you have less treatments over all.
My radiation oncologist told me that studies have shown less side effects with the Canadian protocol, while still delivering the same amount of radiation as standard treatments.
I was pleased with the results.....I got my radiation finished faster than if I had gone with standard treatments and my skin held up incredibly well.