Breast cancer radiotherapy

Radiation therapy (also known as radiotherapy) is used for breast cancer in the various stages of the disease to help cure the disease after surgical removal of the tumor as a post-operative treatment (curative radiotherapy). Radiotherapy focuses high-energy X-rays on the tumor or remaining tumor cells in order to kill them in a targeted manner.


Radiotherapy can also be used if the cancer has already spread, in which case radiotherapy can prevent or alleviate symptoms caused by metastases, e.g. in the bones(palliative radiotherapy).

Radiotherapy is carried out as an outpatient treatment, is non-invasive (i.e. does not require anesthesia) and can therefore be easily integrated into everyday private and professional life. Fractionated treatment is usually necessary for breast cancer. This means that the total dose is divided into several daily fractions and the treatment is usually carried out over a period of 3-4 weeks. Close and personal support is a matter of course for us.

Palliative radiotherapy to alleviate symptoms or treat metastases, on the other hand, can be significantly shorter depending on the situation and may only last for 1-10 sessions.

The Department of Radiation Oncology at the USZ uses only the most modern techniques for precise irradiation of the breast or thoracic wall with few side effects. Standard techniques in our clinic include intensity-modulated radiotherapy (IMRT) and the technical advancement VMAT (volumetric modulated arc therapy), “fast” high-energy electrons, high-dose-rate (HDR) brachytherapy, image-guided adjustment and radiation therapy (IGRT), as well as treatment using the breath-hold technique (DIBH) for left-sided breast cancer.

You will be looked after by experts in the treatment of breast cancer.

For many patients, we are already offering the treatment of tomorrow: in clinical trials, we are continuously working to improve the treatment of breast cancer in order to make it even more effective and tolerable. To the overview of currently open studies.

Postoperative treatment

Radiotherapy for breast cancer always takes place after surgery and is referred to as postoperative or adjuvant radiotherapy. Depending on the extent of the breast cancer, chemotherapy may also be necessary. In this case, chemotherapy would be given before any necessary radiotherapy. Anti-hormonal therapy, on the other hand, can also be carried out at the same time as radiotherapy.

By irradiating the entire breast and saturating the dose locally in the tumor bed, we significantly reduce the risk of a recurrence in the breast. This also optimizes the chances of recovery. If lymph nodes are affected, these risk regions can also be irradiated. Radiotherapy is usually tolerated without any problems and only takes a few minutes.

In order to protect the surrounding tissue in the best possible way, we use state-of-the-art technology at our clinic. In the case of left-sided breast cancer, for example, the radiation can be adapted to the patient’s breathing and radiation is delivered in deep inspiration. We call this technique deep inspiration breath hold or DIBH.

  • Haviland JS, Owen JR, Dewar JA, Agrawal RK, Barrett J, Barrett-Lee PJ, Dobbs HJ, Hopwood P, Lawton PA, Magee BJ, Mills J, Simmons S, Sydenham MA, Venables K, Bliss JM, Yarnold JR; START Trialists’ Group. The UK Standardization of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomized controlled trials. Lancet Oncol. 2013 Oct;14(11):1086-1094. doi: 10.1016/S1470-2045(13)70386-3. Epub 2013 Sep 19. PMID: 24055415.
  • Janssen S, Glanzmann C, Lang S, Verlaan S, Streller T, Linsenmeier C, Rades D, Studer G. Hypofractionated Radiotherapy for Breast Cancer Including Risk-adapted Boost: Update on Tolerance and Efficacy of an Accelerated START A Regime. Anticancer Res. 2016 May;36(5):2513-22. PMID: 27127166.
  • Duma MN, Baumann R, Budach W, Dunst J, Feyer P, Fietkau R, Haase W, Harms W, Hehr T, Krug D, Piroth MD, Sedlmayer F, Souchon R, Sauer R; Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO). Heart-sparing radiotherapy techniques in breast cancer patients: a recommendation of the breast cancer expert panel of the German society of radiation oncology (DEGRO). Radiation Oncol. 2019 Oct;195(10):861-871. English. doi: 10.1007/s00066-019-01495-w. Epub
  • Murray Brunt A, Haviland JS, Wheatley DA, Sydenham MA, Alhasso A, Bloomfield DJ, Chan C, Churn M, Cleator S, Coles CE, Goodman A, Harnett A, Hopwood P, Kirby AM, Kirwan CC, Morris C, Nabi Z, Sawyer E, Somaiah N, Stones L, Syndicus I, Bliss JM, Yarnold JR; FAST-Forward Trial Management Group. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomized, phase 3 trial. 2020 May 23;395(10237):1613-1626. doi: 10.1016/S0140-6736(20)30932-6. Epub 2020 Apr 28. PMID: 32580883; PMCID: PMC7262592.

Metastases in breast cancer, e.g. in the brain or bones

Breast cancer is an aggressive type of cancer that often forms metastases during the course of the disease: this is called metastasis. Common sites of metastasis are the lung, adrenal gland, bones or liver. Radiotherapy is a highly effective method with few side effects to prevent or treat symptoms caused by metastases. This is usually done in combination with chemotherapy, immunotherapy or other targeted therapy. The smaller the metastases are and the earlier they are irradiated, the better the results. Today, metastases in the body can be treated in a focused manner in just a few effective radiation sessions.

For tumor foci in the abdominal area, e.g. liver or upper abdomen, we carry out body stereotactic radiotherapy (SBRT) on our MRI hybrid accelerator. State-of-the-art radiation technology is combined with MRI images. The radiation is thus carried out under MRI monitoring of the tumor, so that the highest precision is combined with the best imaging. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.

Today, brain metastases are treated at our center in most patients by means of a single high-dose radiation treatment: this is called radiosurgery.

Metastases at other locations in the body can now also be treated in a focused manner in just a few effective radiation sessions.

Metastatic breast cancer is a clinical and scientific focus of our clinic. We pass on our knowledge in a large number of international courses and congresses.

State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety.

At the same time, we work closely with our colleagues in medical oncology to guarantee “one-stop” treatment. We also consult with our colleagues in palliative medicine at an early stage.

In clinical trials, we are continuously trying to improve the treatment of breast cancer in order to make it even more effective and tolerable. To the overview of currently open studies.

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Responsible doctors

Claudia Linsenmeier, Dr. med.

Attending Physician with extended responsibilites, Department of Radiation Oncology

Tel. +41 44 255 26 73
Specialties: Focus on breast/gynecology, Gastro-Intestinal Radio-Oncology, Pediatric radio-oncology

Primoz Petric, Ph.D., Prof. Dr. med.

Attending Physician with extended responsibilites, Department of Radiation Oncology

Tel. +41 44 255 26 73
Specialties: Radiotherapy of gynecological and breast cancers., Brachytherapy of various tumor types, using MRI and/or CT for personalized irradiation., Intracavitary and interstitial brachytherapy with real-time Ultrasound guidance.

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