Radiation therapy for breast cancer

Radiation therapy for breast cancer uses high-energy X-rays, protons or other particles to kill cancer cells. Rapidly growing cells, such as cancer cells, are more susceptible to the effects of radiation therapy than are normal cells. The X-rays or particles are painless and invisible. You are not radioactive after treatment, so it is safe to be around other people, including children.

Radiation therapy kills cancer cells. It's often used after surgery to reduce the risk that the cancer will come back. It can also be used to provide relief from pain and other symptoms of advanced breast cancer.

Side effects from radiation therapy differ significantly depending on the type of treatment and which tissues are treated. Side effects tend to be most significant toward the end of your radiation treatment. After your sessions are complete, it may be several days or weeks before side effects clear up. Common side effects during treatment may include: Mild to moderate fatigue Skin irritation, such as itchiness, redness, peeling or blistering, similar to what you might experience with a sunburn Breast swelling Depending on which tissues are exposed, radiation therapy may cause or increase the risk of: Arm swelling (lymphedema) if the lymph nodes under the arm are treated Damage or complications leading to removal of an implant if you had breast reconstruction with an implant after mastectomy Rarely, radiation therapy may cause or increase the risk of: Rib fracture or chest wall tenderness Inflamed lung tissue or heart damage Secondary cancers, such as bone or muscle cancers (sarcomas) or lung cancer

Before your radiation treatments, you'll meet with your radiation therapy team, which may include: A radiation oncologist, a doctor who specializes in treating cancer with radiation. Your radiation oncologist determines the appropriate therapy for you, follows your progress and adjusts your treatment, if necessary. A radiation oncology medical physicist and a dosimetrist, who make calculations and measurements regarding your radiation dosage and its delivery. A radiation oncology nurse, nurse practitioner or physician assistant, who answers questions about treatments and side effects and helps you manage your health during treatment. Radiation therapists, who operate the radiation equipment and administer your treatments. Before you begin treatment, your radiation oncologist will review your medical history with you and give you a physical exam to determine whether you would benefit from radiation therapy. Your doctor will also discuss the potential benefits and side effects of your radiation therapy.

Radiation therapy usually begins three to eight weeks after surgery unless chemotherapy is planned. When chemotherapy is planned, radiation usually starts three to four weeks after chemotherapy is finished. You will likely have radiation therapy as an outpatient at a hospital or other treatment facility. A common treatment schedule (course) historically has included one radiation treatment a day, five days a week (usually Monday through Friday), for five or six weeks. This course is still commonly used in people who require radiation to the lymph nodes. Increasingly, doctors are recommending shorter treatment schedules (hypofractionated treatment). Whole-breast irradiation can frequently be shortened to one to four weeks. Partial-breast irradiation may be completed in five days or less. These hypofractionated treatment schedules work as well as the longer one and may reduce the risk of some side effects. Your radiation oncologist can help decide the course that is right for you.