Breast Cancer: Radiation Therapy

What is radiation therapy for breast cancer?

Radiation therapy is the use of high-energy radiation (X-rays) to shrink or destroy a tumor in the breast, and any cancer cells that have spread to the lymph nodes above the collar bone and under the breast bone. It may also be used to help stop cancer from coming back.

Radiation therapy is usually used with:

• chemotherapy (medicine used to destroy cancer cells)
• surgery to remove the cancer.

If you have had surgery on your breast, radiation therapy will begin 4 to 5 weeks after surgery, to allow the area to heal. You should ask your healthcare provider about these treatments. You may choose not to have treatment but you should ask your provider how this may increase your risk. Also ask your radiation oncologist how the radiation will affect you. (A radiation oncologist, also called a radiation therapist, is a doctor who specializes in treating tumors with radiation.)

How should I prepare for this procedure?

Follow the instructions your healthcare provider gives you. Do not use creams, powders, or deodorants unless your healthcare provider says it is OK. You should wear clothes that are easy to take off and that do not rub the treated area. Avoid sun exposure during radiation treatment.

What happens during the procedure?

External radiation is usually given during outpatient visits to a hospital or treatment center. You will need to take off the clothing covering your chest. You will lie on a treatment table and raise your arms over your head. Temporary marks made on your skin at a previous visit will help the technologist make sure the radiation is aimed at the place needing treatment.

If you have had your breast removed, you may have a bolus (a cold, rubberlike mat) placed on top of your chest. The technologist will help you lie in the correct position and then leave you alone in the treatment room. The technologist will watch you on a TV monitor and you can talk with him or her over an intercom. You will hear the radiation machine buzz for about 30 seconds as it sends radiation to the place marked on your body. You may have one or more of these treatments done from other angles.

The radiation oncologist calculates the dose of radiation to use on the tumor. Small daily doses are given so that the body can tolerate the treatment better and normal tissues affected by the radiation can recover. The total dose is given over several weeks. For example, you may have treatment for several days in a row, followed by several days without treatment. This pattern is repeated until you have received the total dose of radiation.

The treatment is painless, and is usually done 5 days per week (Monday through Friday). Each session takes between 15 and 30 minutes. When the session is over, you may go home.

During the weeks of treatment your weight will be checked and you may have tests, such as blood cell counts, to check the effect the radiation is having on your body.

What happens after the procedure?

You should talk with your radiation oncologist and the staff about your diet, caring for your skin, and ways to care for yourself. The skin in the treatment area may become red. It may peel like a sunburn. Also, you may lose hair in the treatment area. Check first with the radiation oncologist before you use any drugs or products such as shampoo or makeup while you are getting radiation treatment. You may notice you do not feel like eating. You may also find you need more rest as you have more treatments.

Try to keep your arms limber. They may be sore. You will be given some exercises to help your arms move easily. You should protect your skin from the sun by keeping it covered with clothing.

After your last session, the ink marks will be wiped off your body. Even though you will no longer be having treatments, the radiation will keep acting on the cancer for several weeks. The side effects of the radiation should go away a few weeks after the end of therapy.

Your breast may feel firm or it may change in size. You should keep doing breast self-exams. You should take special care of the arm on the side of the treatment, trying to avoid hurting or stressing it.

Ask your radiation oncologist how active you can be and how often you should return for checkups. Keep on seeing your regular healthcare provider for your other healthcare needs.

What are the benefits of this procedure?

Radiation therapy can cure or help cure the cancer, or it can lessen the symptoms of cancer or its spread.

What are the risks associated with this procedure?

• There is a risk of hurting the healthy cells or forming scar tissue.
• Your skin could be hurt or get darker.
• Your breast may become swollen and tender.
• Your arm on the side of treatment may swell. It may become infected more easily.
• If you are having both radiation therapy and chemotherapy, you may have more side effects.
• The radiation therapy may not destroy all the cancer.
• The cancer may come back.

You should ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You have a fever of 100°F (37.8°C) or higher.
• You have unexpected pain.
• You develop swelling in your arm.

Call during office hours if:

• You have questions about your treatment.

For more information on cancer, contact:

• American Cancer Society, Inc.
  800-ACS-2345 (800-227-2345)
  http://www.cancer.org
• AMC Cancer Research Center and Foundation
  800-525-3777
  http://www.amc.org
• Cancer Information Service
  800-4-CANCER (800-422-6237)
  http://cis.nci.nih.gov