Radiotherapy for breast cancer
What does radiotherapy for breast cancer involve?
Radiotherapy (or radiation therapy) is a type of cancer treatment that targets and destroys cancer cells using radiation.
There are essentially two types of radiotherapy:
- External radiotherapy – a machine directs focused radiation through the skin to the tumour
- Internal radiotherapy – the radiation source is placed inside the body at the tumour site
Most people who undergo radiotherapy for breast cancer receive external radiation.
Unlike other cancer treatments, radiotherapy is a localised treatment. This means it is only applied to the area requiring treatment and not to the rest of the body.
There are various radiotherapy techniques. The most common are:
- Volumetric modulated arc therapy (VMAT) – a form of external radiotherapy in which the radiation dose and shape can be adjusted during treatment
- Stereotactic ablative radiotherapy (SABR) – a highly precise and targeted treatment for secondary breast cancer that better protects healthy tissue
When is radiotherapy recommended?
Radiotherapy is one of the most important treatments for breast cancer. When deciding on your treatment plan, your doctor will take into account the type, size and stage of the cancer, as well as your general well-being. If your treatment plan includes breast-conserving surgery, you will most likely receive radiotherapy to the breast after the operation.
There are various options for radiotherapy in breast cancer:
- Before surgery – to shrink the tumour (neoadjuvant radiotherapy), though this is rarely used
- After surgery – to reduce the risk of recurrence by targeting and destroying any remaining cancer cells (adjuvant radiotherapy)
- As the main treatment – can be considered as the primary therapy alongside drug therapy if surgery is not an option
- If the cancer has spread (metastases or secondary breast cancer) – to treat the symptoms by controlling the growth and progression of the cancer (palliative radiotherapy)
- If the cancer recurs (local recurrence) – when surgery is not an option
Your doctor will run tests to better understand your cancer, including genetic, genomic and molecular tests. They will then discuss the results with you and a group of specialists, including experts in radiation oncology.
If you and the team conclude that radiotherapy is right for you, we can provide this at one of our highly regarded partner clinics. All other treatments will continue at your Affidea brustCare centre.
What to expect during radiotherapy
How the treatment is administered
If you undergo breast surgery, your doctor may recommend follow-up radiotherapy.
In the case of secondary breast cancer, whether and how you are given radiotherapy depends on where the cancer has spread.
After the operation
In the case of radiotherapy after surgery, treatment usually begins approximately six weeks after the operation. It can begin once the wound has healed and you are able to lift and move your arm.
Where you are treated depends on the type of breast surgery.
- After breast-conserving surgery, the whole breast or part of it is treated. For some patients, an additional dose may be administered at the tumour site if necessary.
- After a mastectomy, the chest wall may need to be treated.
In some patients, the lymph nodes in the armpit, around the collarbone and behind the breastbone are also targeted with radiotherapy.
Duration of treatment
Radiotherapy is an outpatient treatment, meaning you can go home after each session. The actual radiation lasts only a few minutes. The entire appointment may last around 15 to 30 minutes.
The standard treatment is five sessions per week with a break at the weekend. Depending on the prescribed radiotherapy schedule, treatment can last between one and six weeks.
Effects of treatment
Radiotherapy can cause two types of side effects:
- Acute side effects, which occur during treatment and usually improve after treatment has ended
- Late side effects, which develop weeks or months after completion of treatment and can sometimes be permanent
How radiotherapy affects you depends on the dose and duration of treatment, whether you are receiving other treatments, and your general well-being. Careful planning can help to minimise treatment-related side effects.
Your breast care nurse will support you every step of the way, helping you understand what to expect and how we can support you in dealing with the side effects of radiotherapy for breast cancer.
Acute side effects
Fatigue, hair loss in the armpit area and skin reactions in the treatment area are common. Your breast care nurse can offer you medication during this time and advise you on skin care.
Side effects usually only develop in the area being treated, are temporary and subside shortly after the radiotherapy has ended.
Late side effects
Most side effects improve after treatment finishes, but some may appear weeks, months or even years after radiotherapy. Your care team will explain the possible late side effects of your treatment and what signs to look out for.
We use modern radiotherapy techniques to minimise treatment-related side effects, such as the Deep Inspiration Breath Hold (DIBH) breathing technique.
