Radiation therapy for breast cancer uses high-powered X-rays to kill cancer cells. Rapidly growing cells, such as cancer cells, are more susceptible to the effects of radiation therapy than are normal cells.
One of two approaches may be used with radiation therapy for breast cancer:
External radiation. External beam radiation, the standard type of radiation therapy, delivers radiation in the form of high-powered energy beams, such as X-rays, to your entire breast from a machine outside your body. This is the most common type of radiation therapy used for breast cancer.
Internal radiation. Internal radiation (brachytherapy) involves temporarily placing small radioactive devices in your breast near the tumor site to deliver radiation to affected breast tissue. Internal radiation may be used as an extra radiation boost after external radiation or for small, contained tumors.
Radiation therapy may be used to treat breast cancer at almost every stage. It’s an effective way to reduce your risk of breast cancer recurring after surgery. It can also help control the spread of breast cancer and offer pain relief for advanced breast cancer.
Radiation After Lumpectomy
Radiation therapy for breast cancer is almost always recommended after surgery that removes only the tumor (lumpectomy). A lumpectomy alone, without radiation therapy, carries a relatively high risk of cancer recurrence in the affected breast months or years later because of microscopic deposits of cancer left behind after surgery. Radiation helps to destroy remaining cancer cells.
Lumpectomy combined with radiation therapy is often referred to as breast-conservation therapy. In clinical trials comparing lumpectomy with and without radiation therapy, the addition of radiation therapy after a lumpectomy resulted in significantly decreased rates of breast cancer recurrence and proved to be as effective as having the entire breast removed.
Radiation After Mastectomy
Removal of the entire breast (mastectomy) usually means you won’t need radiation therapy. But radiation therapy is sometimes recommended for women at high risk of cancer recurrence.
Factors that may put you at high risk of breast cancer recurrence in your chest wall include:
Lymph nodes with signs of breast cancer. Underarm (axillary) lymph nodes that test positive for cancer cells are an indication that some cancer cells have spread from the primary tumor. The more positive nodes you have, the more likely your doctor is to recommend radiation therapy. Experts agree that having four or more positive nodes is a clear indication for radiation therapy after mastectomy, although data suggest that even women with fewer positive lymph nodes may benefit from radiation therapy.
Large tumor size. A tumor greater than 5 centimeters (about 2 inches) generally carries a higher risk of recurrence than do smaller tumors.
Tissue margins with signs of breast cancer. After breast tissue is removed, the margins of the tissue are examined for signs of cancer cells. Very narrow margins or margins that test positive for cancer cells are a risk factor for recurrence.
Radiation therapy can also be used to treat:
- Breast tumors that cannot be surgically removed.
- Inflammatory breast cancer, an aggressive type of breast cancer that spreads to the lymph channels of the skin covering the breast. People who have this type of breast cancer typically receive chemotherapy before a mastectomy, followed by radiation, to decrease the chance of recurrence.
- Radiation for managing metastatic complications
If breast cancer has spread to other parts of your body (metastasized) and a tumor is causing pain or some other symptom, radiation can be used to shrink the tumor and ease that symptom.
Both external and internal radiation therapy have potential side effects:
External radiation therapy
- Mild to moderate fatigue (fatigue tends to increase over the course of treatment)
- Skin irritation — such as itchiness, redness, peeling or blistering — similar to what you might experience with a sunburn (skin irritation tends to increase over the course of treatment)
- Breast swelling
- Changes in skin sensation
Rarely, radiation therapy may cause:
- Arm swelling (lymphedema)
- Rib fracture or chest wall tenderness
- Inflamed lung tissue
- Heart damage
- Secondary cancers, such as bone or muscle cancers (sarcomas) or lung cancer
Internal radiation therapy
Internal radiation therapy usually produces fewer skin reactions, although the treated area may be sore and tender for a few months after treatment.
Other possible side effects include:
- Rib fracture or chest wall tenderness
How To Prepare
You’ll meet with your radiation therapy team, health care professionals who work together to plan and provide your radiation treatment. Team members usually include:
- A radiation oncologist, a doctor who specializes in treating cancer with radiation. He or she determines the appropriate therapy for you, follows your progress and adjusts your treatment, if necessary.
- A radiation physicist and a dosimetrist, who make calculations and measurements regarding your radiation dosage and its delivery.
- A radiation oncology nurse, who can answer questions about the treatments and side effects, and help you manage your health during treatment.
- A radiation therapist, who operates the radiation equipment and administers your treatments.
- Your radiation oncologist will review your medical history with you and give you a physical exam to check your overall health before you begin radiation therapy. Your oncologist can also discuss the potential benefits and side effects of your radiation therapy.
External radiation therapy
Before your first treatment session, you’ll go through a simulation in which a radiation oncologist carefully maps your breast area to pinpoint the precise location of your treatment. During the simulation:
- A radiation therapist helps you into a position best suited to pinpoint the affected area and avoid damage to surrounding normal tissue. Sometimes pads or other devices are used to help you hold the position.
- Using a CT scanner, the radiation oncologist locates the treatment area. You’ll hear noise from the CT equipment as it moves around you. Try to relax and remain as still as possible to help ensure consistent, accurate treatments.
- Ink marks or tiny permanent tattoo dots are placed on your skin to guide the radiation therapist in administering the radiation. Be sure not to wash ink marks off until you’re told to do so. If the marks can’t be seen, you may need to go through the mapping process again.
- The dosimetrist, radiation physicist and radiation oncologist use computer software to plan the dose of radiation you’ll receive. Once the simulation and planning are complete, you can begin treatment. For each session, avoid wearing jewelry, latex bandages, powder, lotion or deodorant on or near your treatment area. These substances can interfere with delivery of the radiation.
- Internal radiation therapy
Before internal brachytherapy is started, a special device for the radioactive implants is placed in the area from where the tumor was taken (tumor bed). This may be done during your cancer surgery or as a separate procedure.
If the radiation device is implanted during a separate procedure, it often requires a brief hospital stay. You’ll be given local, regional or general anesthetic for the procedure. Once the holder is implanted, you can likely go home.
Internal radiation therapy
There are two approaches to internal radiation therapy for breast cancer:
Intracavitary brachytherapy. A small, deflated balloon attached to a thin tube (catheter) or a cage of small catheters is inserted in the tumor bed, with the end of the tubes sticking out of the breast. The balloon is filled with saline solution and left in place throughout the course of treatment. That’s where the radioactive implants are inserted.
Interstitial brachytherapy. Several small catheters are inserted in the breast around the tumor bed to serve as holders for small radioactive pellets. These catheters are generally left in place throughout the course of treatment.
What To Expect
The typical schedule for external radiation treatments is five days a week for four to six weeks. You’ll receive radiation as an outpatient at a hospital or other treatment facility. You may be able to schedule your sessions at the same time each day.
The duration of internal radiation therapy for breast cancer is much shorter, usually five days. Internal radiation sessions are typically done on an outpatient basis.
A typical radiation therapy session generally follows this process:
- When you arrive at the hospital or treatment facility, you’re taken to a special room that’s used specifically for radiation therapy.
- You may need to remove your clothes and put on a hospital gown.
- The radiation therapist helps you into the position you were in during the simulation process.
- The therapist leaves the room and turns on the machine that delivers the radiation (linear accelerator).
- Although the therapist isn’t in the room during the treatment, he or she will monitor you from another room on a television screen. Usually you and the therapist can talk through an intercom. If you feel sick or uncomfortable, tell your therapist, who can stop the process if necessary.
- Delivery of the radiation lasts a few minutes, but expect to spend 15 to 30 minutes for each visit.
A newer method is accelerated partial breast irradiation. This method targets radiation at the breast area that contained the tumor, rather than the entire breast. It’s also given in fewer, higher doses than standard external beam radiation therapy.
Radiation therapy is painless. You may feel some discomfort from lying in the required position, but this is generally short-lived.
After the session, you’re free to go about your regular activities. Generally no special precautions are needed.
In some cases, once the main radiation therapy sessions have been completed, your doctor may recommend a boost treatment to the tumor bed to further reduce the risk of recurrence. A radiation boost may involve more external radiation therapy sessions or internal radiation therapy.
For internal radiation, the radioactive seeds are inserted twice a day for a few minutes in the implanted radiation device. This is usually done on an outpatient basis, and you can leave between sessions.
After the course of treatment is over, the device is removed. Usually you’re given pain medication before the holders are removed. The area may be sore or tender for a few months.
After you complete radiation therapy, your radiation oncologist will schedule follow-up visits to monitor your progress, look for late side effects and check for signs of recurrence. You’ll need less frequent follow-up visits the longer you’re cancer-free, but you’re likely to see your medical oncologist for the rest of your life.
When your radiation therapy is completed, tell your doctor or nurse if you experience:
- Persistent pain
- New lumps, bruises, rashes, swelling or bleeding
- Persistent digestive complaints such as appetite changes, nausea, vomiting, diarrhea or constipation
- Unexplained weight loss
- A fever or cough that doesn’t go away
- Any other bothersome symptoms
Also On HelloBeautiful:
100 Reasons Why I Can't Stop Looking At Blue Ivy
1. Mommy & Me
2. Blue. #May10 #NYC
3. Blue Ivy & Jay Z Sip Tea
Blue is surely the apple of Daddy's eye.
4. Blue Ivy & Beyonce Smell The Roses
Beyonce seems like the coolest mom.
5. Blue Ivy & Beyonce Soar The Big Skies
6. Blue Ivy & Mommy
7. Daddy & Me
Blue Ivy walks across mommy's at-home photoshoot, but it's the most adorable photobomb ever!
9. One Big Happy Family
The royal family, Bey, Jay & Blue are all out shopping and we're sure they spent our entire life's savings in 30 minutes or less.
10. Beyoncé, Jay Z & Blue in Beverly Hills — Nov. 11
Beyonce in these heels though?!
11. Beyoncé & Blue in NYC — Nov. 4
Look at Blue in her adorable little bow!
12. Beyoncé & Blue spotted in NYC — Nov. 4
Blue holding on to mommy for dear life.
13. Beyoncé & Blue spotted in NYC — Nov. 4
Momma Bey looking fierce with her mini me in tow.
14. Blue dressed as Michael Jackson.
15. Blue & Ivy
Just look at that face. Seriously, Jay could never deny this child! She knows how to make all his mean mugs!
16. Beyoncé, Jay Z & Blue in Beverly Hills — Nov. 11
Look at that cutie!
17. Beyoncé, Jay Z & Blue in Beverly Hills — Nov. 11
OMG Blue in a top knot? Yasss!
Blue has grown up to be an adorable toddler! We're swooning over this photo of her playing on the beach.
Looks like Blue is taking a walk in mom's shoes...literally.
20. Beyoncé & Blue
There's nothing like being cuddled up in mom's arms.
Blue is looking all kinds of adorable! Look at that left hand go! LOL.
22. Blue On The Big Screen
Bey & Jay look at Blue during a video played at an "On The Run" tour stop. How precious!
23. Pardon Blue's Back
She's growing up so fast! We're loving the top knot. Take that Blue Ivy hair critics!
24. Jump Around
Bey & Blue share an adorable moment on the trampoline. Hello summer!
25. Rocking Some Cute Ponytails
Blue Ivy was spotted with a new 'do! Bey & Jay's mini-me was holding on to her father during a little day stroll.
26. Strolling With Mom & Dad
Blue, Jay and Bey all spotted in East Hampton.
27. Blue Has A Manicure Day With Mama Bey
"Me and my Blue, and my Blue Blue, riding🐝"
28. Hanging Out With Mom
Baby Blue is walking to the door, and it looks like Bey is trying to keep up!
29. Trying On Some Heels
Will Blue be slaying a performance in the near future?
30. Holding On To Mom
Blue looks like she has something to say to Bey.
31. Playing A Game Of Tennis
Blue walks on the tennis court.
32. Cuddling With Mom
Blue & Beyonce have some much-needed cuddle time.
33. Blue Ivy
"The blueprint 🐝"
34. Bey & Blue Take A Stroll
Doesn't Blue look adorable with her colorful dress and cute hair ribbon?
35. The Carter Lounge Together
The family was seen out and about.
36. Jay Z Carries Blue While Bey Looks On
Jay carries Blue in his arms.
37. Leading The Way
Blue Ivy looks too cute with her bowler hat and Mama Bey watching from behind. She's really growing up!
38. Out On The Town
Blue Ivy & Momma Bey enjoy some much deserved time off in Spain.
39. Traveling With Mom and Dad
Blue is used to traveling with Mama Bey and Poppa Jay, but she also looked a little flustered at some moments. It's ok, baby Blue!
40. A Day At The Park
Poppa Jay Z lets Blue Ivy have her way with the bouncy horse.
41. It's A Family Affair
Beyonce, Jay and Blue jetsetting in Dublin.
Blue dressed up like a hipster and plays a quick game of peekaboo! How adorable!
43. OMG It's Blue's Beautiful Face!
FINALLY! We get to see how beautiful Blue is! Look at the adorable headband! "Blue 💙"
44. Blue Ivy
Life's a beach!
45. Brooklyn Stand Up!
"Beyonce & Blue"
46. Blue Ivy's Got Her Own iPhone
"Momma, what's your password?"
47. Beyonce's Lazy Day With Blue
"Momma, I asked you for your password!"
48. When Blue Ivy Takes Your Phone, Beyonce Be Like...
"Fine, I'll go ask Daddy!"
49. Blue Ivy On Tour
"Bey & Blue"
50. It's Playtime
Beyonce & Blue take some time out to play.
51. A Chilly Day In NYC
"Beyoncé, Jay Z and Blue Ivy in NYC - Jan. 19"
52. All Bundled Up
The royal family makes their way to their fancy car.
53. Kisses From Dad
Blue's all bundled up, getting love from Daddy.
54. Blue At The White House
Blue Ivy's taking after mommy and writing a letter.
55. Blue Loves Bo
The White House pup, Bo is showing Blue Ivy some love.
56. The Carters At The White House
Check out the royal family checking out the scene at the White House.
57. It's Christmas Time Again
Blue and Bey checking out the White House Christmas tree.
58. Blue Lovin' Bo
Blue Ivy, dressed like a Princess, showing Bo some love.
59. Like Father, Like Daughter
Blue playing dress up with Daddy's hat.
60. Fun Times With Mommy
Blue Ivy spends some QT with mommy.
61. Mommy & Me
Blue and Bey take a break for some snacks.
62. Silvery Blue
Beyonce carries Blue, while the adorable toddler rocks a metallic jacket that we want and need.
63. The Holy Grail
Blue, Bey & Jay
64. One Big Happy Family
"#miami #newyear #2014"
"Beyoncé & Blue 💙"
66. Blue & Daddy In A Blue Jacket
"Jay and Blue 💙 #NewYear #2014 #Miami"
67. Hold On To Me
"Happy New Year Mommy!"
68. Dora Dora Dora The Explorer
"Beyoncé, Blue and Dora the Explorer"
69. Daddy & Bey
"Look over there Blue, you own that too."
70. Blue's Big B-Day
"Mommy make sure they can only see the back of my head."
71. Painted Faces For Blue's Bday
"Let me get down Mommy, I wanna play!"
72. Kisses From Mommy
Beyonce and Blue prepping for Momma Tina's Masquerade Ball
73. Talk To The Hand!
Beyonce, Jay Z and Blue Ivy were spotted leaving Joey's restaurant in Miami, on January 8th, and Blue had a message for the paps! Talk to the hand!
74. Me & My Daddy
While Beyonce's arm rested, Jay carried Blue from Joey's restaurant, in Miami on January 8th.
75. Blue's First Words
"I'm ready to slay right along with you, Ma!"
76. Imagine The Sound Of This Lullaby
A newborn Blue Ivy gets serenaded by her superstar mother.
77. Don't Mess With Blue!
Every now and again, Blue Ivy reminds you...she is her father's child!
78. All Gold Everything
Blue Ivy takes after her dad's swag. The inseparable duo were spotted in South Beach, Miami illuminating the streets outside their hotel with their yellow luster!
79. All Of The Lights!
"Mommy! All the pretty colors are so blinding! I'm...just..so..overwhelmed! When's my shot coming?! When's my shot coming?!" Blue plays on set with Bey at her 'Blow' video shoot.
80. Hey Blue!
"I can be happy sometimes, see?"
81. Blue Ivy With Daddy
"Why are we clapping, again? I'm not in the shot."
82. Jay Z Tries To Get Blue To Listen To "Magna Carta Holy Grail"
"Daddy, I'm more of a Nas fan."
83. Stepping With Mom
"Wait, Ma. I want the camera to see all angles of this sick dress!"
84. Splashin' & Playin'
"Mom, this water is clean, right? Because I'm not trying to splash in water I can't trust."
85. Beyonce Discusses Important Matters
"Mommy, I completely get it. Yes, I promise to watch the throne."
86. Mommy's Hugs
"Ok, Ma. I love you to pieces, but I like oxygen too." Bey may be the Queen, but this scene from her video "Blue" makes it look as if she can't get enough of being Mom.
87. Blue Ivy Twirls
"Aaaahh, I'm having so much fun not thinking about anything...wiippeee...oh, wait...getting a little sick."
88. Just So You Know...
"I run things. Don't get it twisted."
89. Mommy & Me Loungin'
"Oh, Mommy, I'm so tired of seeing the wigs you snatched last night all on our floor. It's so exhausting. Like, when're they getting picked up? Not now? Oh. Ok."
90. A Kiss For Blue
"Mommy, let me sleep, dang!"
91. Slurpin' On That Milk...Slurpin' Slurpin' On That Milk
"Mommy, gimme that bottle!"
We could watch this adorable GIF of Blue Ivy nonstop forever!
93. Jay Sneaks In Kisses
"Dadddd! Get..Away!..I don't want...No, ugh..No kisses!"
94. Blue Stares Back...
"Hey! Who's that?!"
95. Blue Still Doesn't Get Why Anyone's Here
"No, really, who are you? You're getting to close."
96. Blue and Bey Out For Lunch
"I'm over this now. People just won't let us be. Mom, why can't we just be?!"
97. Blue Is One Tough Cookie
"Ma, please let me just kick them in the face. Like, please, I can't see through all these lights."
98. Blue Jetsets With Jay
"Dad, do we own this boat? I just figured we owned everything, so..."
99. Beyonce Keeps Blue Covered
"Mommy, I think you forgot my feet. I'm cold right now. Are we inside?"
100. Beyonce LOVES Her Blue
Look at that face, how could you not kiss it?!