Radiotherapy, or radiation, has been used for the treatment of breast cancer for many years. Thanks to advanced technology and improved techniques, radiotherapy can now be used very accurately and effectively.
Radiotherapy is the treatment of disease, mainly cancer, using x-rays and similar radiations.
Radio therapy is usually recommended after a lumpectomy (partial mastectomy) and sometimes after a total mastectomy to destroy cancer cells that could still be present in the breast area or lymph nodes.
After the breast tissue has been removed, and in some cases the lymph nodes as well, the surrounding tissue is treated with radiation to destroy any remaining cancer cells.
A lumpectomy involves the removal of the tumour and a small amount of surrounding tissue. It is always followed by radiation of the remaining area of the breast. This treatment is recommended in the early stages of breast cancer, when the tumour is still relatively small.
Cancer cells are usually more sensitive to radiation, but normal cells can also be affected. Radiotherapy is therefore administered with great care to ensure that the treatment is as effective as possible, with as little damage to healthy tissue as possible.
Surgery is followed by a recovery period. Radiotherapy can start once the wound has healed.
The radiotherapist will evaluate the case. If the radiotherapy is recommended, the radiotherapist will discuss the treatment, side effects and expectation of success with you, the patient, before you consent to the treatment.
Feel free to discuss the following with the radiotherapist:

  • The procedure and treatment programme that is recommended
  • The purpose of the treatment
  • The risks and side effects that are associated with the treatment
  • How it will affect your appearance and how you will feel after treatment.

Treatment

The doctor in charge of the treatment is a radiotherapist, or radiation oncologist, a specialist in the treatment of cancer with radiation. The treatment is administered by a team of radiographers, who administer the treatment as prescribed by the radiation oncologist. The team also includes nursing staff and technicians.
Radiotherapy is usually administered in small doses over a period of a few days or weeks, to limit damage to normal tissue. The treatment is like an x-ray examination, but it lasts longer. The patient must remain in a prescribed position without moving. The radiation is administered by means of a machine. This machine does not touch the patient or cause any sensation or discomfort. Although the patient is alone in the treatment room, the staff are in contact with the patient by means of a video camera and voice monitor.
Before actual treatment starts, there is a planning session, or simulation. During this session no treatment is given, but the exact position of the area to receive radiation is determine, as well as your position during radiation. An immobilisation device might be designed to help you remain in the same position during each treatment session. A technician will mark the treatment area on your skin with ink, to ensure that the treatment is given on the same area every time. These markings should remain on your skin, and will be reapplied should they fade.
Different kinds of machines are used, for example cobalt machines, linear accelerators or x-ray machines. The machines are fairly large, with moving parts that are used to radiate the breast from different angles. When they are working some machine make a noise almost like an electrical mixer. The machine do not touch the patient or cause any sensation or discomfort.
The number of treatment sessions depend on the radiation dose required, it is usually given over a period of six to seven weeks, five days per week, Monday to Friday. To protect healthy tissue, the treatment is given in small doses, the treatment itself lasts only a few minutes, but it takes a bit longer to place you in exactly the correct position.

Side effects

Most patients do not experience significant side effects. Possible side effects depend on the nature of the treatment. The staff monitor patients closely to identify and handle problem areas:

  • Fatigue can be expected, particularly towards the end of the treatment period. Most people continue their daily activities and work routine, but it is advisable to get enough rest, avoid stress and have balanced meals. If you follow a regular exercise programme, consult the medical team.
  • You might have a slight swelling or feeling of heaviness in the breast. Sometimes the breast becomes smaller and firmer after radiotherapy.
  • Skin irritation, like minor degree of sunburn might occur on the treated areas about 12 hours after exposure. However modern techniques ensure that the electromagnetic rays used during radiation affect the skin as little as possible. In some cases, dryness and flaking of the skin may occur.

After Treatment

  • Most of the changes to the breast disappear after six to 12 months. While there is marks on the skin. Skin irritation should subside about two weeks after completion of treatment, although the skin might still be flaky. The treated area might feel a bit harder than the surrounding area.
  • You can start applying unscented moisturising cream, using small circular motions. Use a creamy soap for washing the skin.
  • Protect the skin on the treatment areas as much as possible. Avoid exposure to direct heat, sunlight, sunscreen containing alcohol, sun lamps and chemicals.
  • Avoid infection, burns, injuries to the hand and arm, insect bites and tight elastic or jewellery around the affected arm. Consult your doctor before beginning to shave under your arms.
  • Fatigue will lessen gradually, but adapt your activity level to your energy level. Continue exercising the affected arm, for example by using that arm to comb your hair.
  • The radiotherapist will inform you about follow-up visits and breast self-examination. Follow-up visits every three to six months for three years are usually recommended, including regular mammograms.
For most women breast surgery and radiotherapy bring about a temporary interruption in their lives, after which they continue leading a full and productive life, with a normal routine. In many cases breast cancer is cured by surgery and radiotherapy, but radiotherapy also plays a major role in controlling symptoms and improving the quality of life of cancer-patients.