Radiation Therapy For Breast Cancer
Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is often used to treat breast cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.
Radiation therapy is given for different reasons. You may have radiation therapy to:
- lower the risk of the cancer coming back, or recurring, after surgery
- shrink a tumour before surgery
- treat breast cancer that comes back, or recurs, in the area of a mastectomy
- relieve pain or control the symptoms of advanced breast cancer
Doctors use external beam radiation therapy to treat breast cancer. During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it.
Some women may not be able to have radiation therapy because they already had radiation therapy to the chest or breast. Doctors may not offer radiation therapy to women with lung problems, damaged heart muscles and certain connective tissue diseases.
Problems Moving Your Arm And Shoulder
Radiotherapy might make it harder to move your arm and shoulder. This can affect your activities and work. It usually improves when the treatment finishes. Your nurse or physiotherapist can give you exercises to help.
Its important to continue the arm exercise you were shown after your surgery. This will make it easier for you to lift your arm to the correct position during radiotherapy. It can also help stop your arm and shoulder from becoming stiff.
- There is help available ask the hospital for support
- Talk to your friends and family about how you are feeling
- Ask about local support groups
- Your GP or hospital can provide counselling
- You can get help and support online through forums
If you’re experiencing a side effect that hasn’t been covered in this video, you can find more information on the Cancer Research UK website.
On screen text: For more information go to: cruk.org/radiotherapy/side-effects
Pain In The Breast Or Chest Area
You may have aches, twinges or sharp pains in the breast or chest area.
Although these are usually mild, they can continue for months or even years, but they usually become milder and less frequent over time.
You may also have stiffness and discomfort around the shoulder and breast or chest area during and after treatment.
Continuing to do arm and shoulder exercises during radiotherapy and for several months afterwards may help minimise or prevent stiffness or discomfort.
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Coping With Physical Side Effects
There are many things you and your radiation team can do to relieve side effects.
Try these tips for managing skin side effects:
- Wear loose clothing thats soft and comfortable when it touches the treatment area.
- Be gentle when you wash. Choose mild, fragrance-free soap and warm water. When drying, pat gently with a clean towel during the time youre receiving radiation therapy treatments, and in the first few weeks after treatment ends.
- Try to avoid rubbing or scratching the area.
- Avoid using bandages or makeup on the area.
- Your doctor will recommend or prescribe gels, ointments, or lotions to keep your skin moisturized and relieve irritation. Stick to the brands your doctor recommends to make sure youre treating your skin safely.
- Ask your radiation team for sunscreen recommendations to protect sun-sensitive treatment areas. Its also a good idea to keep the area safe from direct sunlight with protective clothing. Clothes that help protect from sun damage usually have UPF on the label.
For help with fatigue, ask your healthcare team about these strategies:
- Physical activity or exercise
- Counseling to help shift your thoughts about fatigue and for help managing sleep issues
- Complementary therapies such as relaxation techniques or music therapy
- Nutrition adjustments
Theres also help for other, long-term radiation side effects:
When Should I Call The Doctor
You should call your healthcare provider if you experience:
- Severe skin or breast inflammation.
- Signs of infection, such as fever, chills or weeping skin wounds.
A note from Cleveland Clinic
Radiation therapy can lower the risk of cancer recurrence and cancer spread. The treatment affects everyone differently. Most side effects go away in a few months after treatments end. Some problems last longer. You should tell your healthcare provider about any problems you have while getting treatment. Your provider may change the therapy slightly to minimize issues while still effectively treating the cancer.
Last reviewed by a Cleveland Clinic medical professional on 03/19/2021.
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Types Of Radiation Therapy
- External beam radiation is most commonly used to treat breast cancer. A machine outside your body aims a beam of radiation on the area affected by the disease.
- Brachytherapy delivers radiation to the cancer through something implanted in your body.
- Proton therapy sends highly targeted radiation just to your breast tissue and not into your heart or lungs.
Breast Cancer Radiation Side Effects
It is important to remember that not everyone will experience breast cancer radiation side effects. Its also highly unlikely that anyone would experience all of them either, and they may appear differently depending on the individual experience.1. Changes to the SkinSkin reactions associated with radiation therapy include:
You might find that your skin becomes darker, thinner or dryer than it was, due to the radiation treatment.
Your skin may also burn more easily from sun exposure and may be prone to infection and breakdown.
Operation scars often remain tender or sensitive for a long time after treatment ends.
Some women can develop small red blotches on the breast caused by dilated blood vessels under the skin. This condition is known as telangiectasia . Telangiectasia is not a sign of cancer recurrence, but it usually doesnt go away on its own. If you’re worried or concerned about any changes or experiencing pain, speak to your doctor or nurse.Skin Care After Radiation Therapy For Breast Cancer
2. Effects of Radiation Therapy on Breast Tissue Oedema: Or swelling of the breast, may persist for months or years after treatment.
Fibrosis: A few women develop hardening or thickening of the breast tissue. This can cause the breast to feel and look harder and smaller than it was. In severe cases, this can make the radiated breast appear much different than the healthy breast.
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What Is Radiation Recall
Radiation recall is a rash that looks like a severe sunburn. It is rare but it can happen when certain types of chemotherapy are given during or soon after external-beam radiation therapy.
The rash appears on the part of the body that received radiation therapy. Symptoms may include redness, tenderness, swelling, wet sores, and peeling skin.
Typically, these effects start within days or weeks of starting radiation therapy. But they can also appear months or years later. Doctors treat radiation recall with medications called corticosteroids. Rarely, it may be necessary to wait until the skin heals to continue with chemotherapy.
Side Effects Of Radiation For Breast Cancer
Radiation therapy is a common part of breast cancer treatment. It may be used alone, or in conjunction with other therapies. As with any kind of medical procedure, there can be side effects. Side effects can vary, depending on the kind of radiation therapy you have and your individual response to it.
Knowing what to expect, and potential side effects, can help you prepare for your treatment.
Skin changes are some of the main side effects of external radiation. These changes occur in the area being treated by the radiation. Its similar to a sunburn, and can include:
- redness and itching
- darkening of the skin
These changes happen gradually over the course of treatment, and in some people it can last for years after treatment. Some people also develop spider veins in certain areas months to years after treatment.
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Skin And Tissue Imperfections
Radiation can also cause the skin over an implant or tissue flap to become tighter, tougher, and more rigid. In some cases, a treatment called fat grafting can help soften and improve the skin and/or thicken the layer of tissue between an implant and the skin.
During a fat grafting procedure, fat tissue is removed from another part of your body usually your thighs, belly, or buttocks by liposuction. The tissue is then processed into liquid and injected into the breast area. The fat that survives establishes a blood supply within a few days. In some cases, very little of the fat survives. In the best case scenario, about half of the fat that is injected will stay there permanently, while the rest will be reabsorbed by the body. Several sessions of fat grafting may be needed to get the best results.
If youre considering fat grafting, talk with your plastic surgeon about whether your results are likely to match your expectations. Even though fat grafting is used to improve skin and tissue imperfections after radiation therapy, fat grafting doesnt take as well in radiated tissue as it does in non-radiated tissue. Its also important to know that once you take fat from a donor site on the body such as the belly to use for fat grafting, then you wont be able to use tissue/fat from that site again for breast reconstruction. If you decide you want a flap reconstruction in the future, you may have already used up a key tissue source.
What Are The Physical Side Effects
Receiving the radiation will not be painful. Side effects vary from person to person and depend on the site being treated. The most common side effects in the treatment of breast cancer are:
- Uncomfortable sensations in the treated breast
Please talk to your doctor or nurse if you have concerns about side effects before you begin treatment or if you have questions about managing your side effects during treatment.
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Internal Radiation Therapy Use In Breast Cancer
The main type of internal radiation therapy used to treat breast cancer is called High-Dose Rate brachytherapy. HDR brachytherapy can be used for some patients with early-stage breast cancer. After a lumpectomy, a procedure is performed to place an applicator into the breast. This applicator contains a few tubes that hold the radioactive seeds. Over the course of a few days, the seeds will be placed in the applicator to kill any remaining cancer cells left inside the breast. Once treatment is done, the applicator is removed. HDR brachytherapy is a much shorter process than external beam radiation therapy for breast cancer but is not available to every patient based on the size, stage, and type of breast cancer.
Coping With Emotional Side Effects
Daily radiation therapy treatments can trigger many different emotions. Fear, anger, or sadness can come up at any point in treatment. Coming to the treatment center every day can be a regular reminder of your diagnosis, fears about cancer coming back, and for many people, the entire cancer experience. In other words, it can feel overwhelming.
Fortunately, there are ways to get the treatment you need and still have some balance in your life. Katharine Winner, MSW, LSW, who works closely with radiation oncologists to provide emotional support to people receiving radiation therapy, says, Its important to find a balance between treatment and everyday life, when possible, to help maintain a sense of normalcy. We can help arrange your schedule to accommodate the important things outside of treatment: work, time with family, self-care.
We want to help find the best way to realign your schedule to accommodate radiation. Theres a reason why youre doing radiation: to treat the cancer and prolong your life. Our goal is that treatment doesnt stall your life and that you can still do the things you love and enjoy doing. See how you can reschedule yourself to get a good balance for getting through treatment.
I like to ask, What are your plans this week/weekend? What do you look forward to doing after radiation is completed? I want to know what is important in your life and what you can focus on outside of treatment to help push through those difficult days, says Winner.
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Why Choose To Have Your Breast Radiation Therapy At Memorial Sloan Kettering
- In order to deliver radiation in the best possible way, it takes a dedicated team of doctors, nurses, therapists, physicists, and treatment planners. Our breast cancer team is one of the largest and most experienced in the country.
- Our radiation oncologists have access to and experience with every single form of radiation therapy available. There is not just one best type of radiation for all of the women we care for. But with our deep experience, we can select the best technique for each individual woman and tailor our approach as needed.
- Our team of medical physicists ensures that the radiation dose each woman receives is accurately and safely targeted to cancer tissue and spares nearby normal tissue.
- We consider the details of each unique woman. Our publications have demonstrated that our personalized care leads to superior outcomes.
Radiation Therapy After Lumpectomy
A lumpectomy is a breast-conserving surgery that only removes the cancer and surrounding tissue to keep as much of the breast as possible. Patients often receive external beam radiation therapy or HDR brachytherapy following their surgery to ensure that any potential cancer cells are gone. This makes the cancer less likely to return, although its not a guarantee.
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When Is Radiation Therapy Used For Breast Cancer
Radiation therapy may be recommended as a treatment option following a lumpectomy or to treat more advanced stages of cancer. It may also be suggested to use other treatments, such as chemotherapy combined with radiation therapy. This is called neoadjuvant therapy and is largely dependent on each patients individualized treatment plan.
Radioprotective Drugs For Reducing Side Effects
One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.
Not all doctors agree on how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.
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Early And Late Effects Of Radiation Therapy
- Early side effects happen during or shortly after treatment. These side effects tend to be short-term, mild, and treatable. Theyre usually gone within a few weeks after treatment ends. The most common early side effects are fatigue and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to this area.
- Late side effects can take months or even years to develop. They can occur in any normal tissue in the body that has received radiation. The risk of late side effects depends on the area treated as well as the radiation dose that was used. Careful treatment planning can help avoid serious long-term side effects. Its always best to talk to your radiation oncologist about the risk of long-term side effects.
How Does Radiation Therapy Work
Radiation therapy uses special high-energy X-rays or particles to damage a cancer cells DNA. When a cancer cells DNA is damaged, it cant divide successfully and it dies.
Radiation therapy damages both healthy cells and cancer cells in the treatment area. Still, radiation affects cancer cells more than normal cells. Cancer cells grow and divide faster than healthy cells and also are less organized. Because of this, it’s harder for cancer cells to repair the damage done by radiation. So cancer cells are more easily destroyed by radiation, while healthy cells are better able to repair themselves and survive the treatment.
The treatment area may include the breast area, the lymph nodes, or another part of the body if the cancer has spread.
Radiation treatments are carefully planned to make sure you receive the greatest benefits and the fewest side effects possible.
There are two main types of radiation therapy used to treat breast cancer:
External beam radiation is given by a large machine called a linear accelerator. The machine aims a beam of radiation at the treatment area.
Internal radiation, called brachytherapy by doctors, uses a radioactive substance sealed in seeds or tiny tubes that are placed inside your body directly into the cancer or the place where the cancer was.
Your doctor will look at your pathology report and calculate your risk of breast cancer recurrence based on a number of factors, including:
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Possible Side Effects Of Breast Cancer Radiation Therapy
Learn more about the 9 possible long term side effects of radiation therapy for breast cancer. While not everyone undergoing breast cancer radiation therapy will experience more than the short-term discomfort of sensitive skin or the frustration of feeling wiped out physically, there are some possible long-term issues.
For many, the end of their radiation treatment is also the end of their treatment for cancer. However its always good to know what to expect after your treatment.
What Emotional Responses Might I Expect
You may or may not experience anxiety or fear when you begin your treatment. Most people tell us that their concerns lessen as they adapt to the new environment and treatment.
Please speak to the staff if you feel that you need either emotional or practical support. There is a social worker on staff in the Radiation Oncology department. This may be a time when you think again about support groups or one-to-one consultation for the feelings that arise or to support your coping. For information about support services, please call the Breast Care Center at 353-7070.
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