At a prominent state hospital, a 45-year-old woman is receiving a ‘combined modality' treatment for the initial stage of breast cancer. State the two aspects included in this treatment. State the methods by which a radiation oncologist can administer these therapies. Additionally, state four major differences between the two modes of treatment.

To answer your question, let's break it down step by step.

1. Combined Modality Treatment for Breast Cancer:
Combined modality treatment refers to the simultaneous use of multiple treatment methods to manage cancer. In the case of breast cancer, the two aspects commonly included in combined modality treatment are surgery and radiation therapy.

2. Administration of Therapies by a Radiation Oncologist:
A radiation oncologist can administer these therapies through different methods, depending on the specific treatment plan:

- External Beam Radiation Therapy: This involves using a machine called a linear accelerator to deliver high-energy radiation beams precisely targeted at the site of the tumor.
- Brachytherapy: In this method, the radiation oncologist places radioactive implants in or near the tumor to deliver radiation directly to the affected area.
- Intraoperative Radiation Therapy (IORT): This technique involves delivering a concentrated dose of radiation directly to the tumor site during surgery.

Now, let's move on to the four major differences between surgery and radiation therapy in the context of breast cancer treatment:

1. Treatment Approach: Surgery is a localized treatment that involves the physical removal of the tumor, while radiation therapy is a systemic treatment that uses high-energy radiation to destroy cancer cells.

2. Timing: Surgery is usually performed as an early treatment, while radiation therapy may be utilized before or after surgery, depending on the specific case.

3. Side Effects: Surgery can have immediate post-operative effects, such as pain, swelling, or infection, while radiation therapy often leads to delayed side effects like skin changes, fatigue, or long-term tissue damage.

4. Ability to Preserve Breast: Surgery may involve removing the tumor (lumpectomy) or the entire breast (mastectomy), whereas radiation therapy can allow for breast preservation by targeting the affected area without surgical removal.

Remember, this answer is specifically based on the description you provided, so it's essential to consult with medical professionals for accurate and personalized information regarding breast cancer treatment.