Breast Cancer
Breast cancer is the most common cancer in women — and one of the most treatable. Radiation therapy after surgery lowers the chance the cancer comes back.
About breast cancer
Breast cancer is the most common cancer among women. In the course of a year, about 250,000 women are diagnosed with it. One in eight women will develop breast cancer at some point in her lifetime.
Breast cancer is usually thought of as a woman's disease, but men develop it too — about 2,600 men are diagnosed each year. Any new lump or change deserves attention regardless of who notices it.
The outlook is genuinely good. About 83 percent of people diagnosed with breast cancer are still alive more than ten years after diagnosis, and roughly 2.8 million breast cancer survivors are living in the United States today.
Your treatment depends on the biology and location of your tumor, the stage of the disease, your age and overall health, and your own preferences. The most common first step is surgery — either removing the tumor and a margin of tissue around it (lumpectomy) or removing the whole breast (mastectomy). Radiation therapy typically follows a lumpectomy, and sometimes follows a mastectomy as well.
Signs and symptoms
The most common sign is a lump in the breast. Lumps vary: they can be large or small, soft or hard, painless or painful. Other changes are worth reporting too.
- A new lump in the breast or underarm
- A change in the skin texture of the breast
- A change in the shape or size of the breast
- Pain anywhere in the breast or nipple
- Tenderness of the nipples
- Clear or bloody discharge from the nipple
When to call
These symptoms have many possible causes, most of them not cancer. But they are worth a conversation. If something has changed and hasn't resolved, contact your primary care physician — early evaluation is what makes treatment straightforward.
How we treat it
Radiation therapy uses high-energy rays to destroy cancer cells that surgery cannot see. It lowers the risk of the tumor returning and improves the chance of long-term survival. It is also well tolerated — most side effects are mild and temporary. Which technique your physician recommends depends on the surgery you had and what was found during it.
Whole Breast Radiation After Lumpectomy
This is the usual course after a lumpectomy. Radiation from a linear accelerator treats the whole breast and, if needed, nearby lymph node areas, destroying cancer cells too small to detect. Treatment usually begins about three to four weeks after surgery and runs three to seven weeks, depending on what was found during your operation.
Accelerated Partial Breast Irradiation with 3-D CRT
Ongoing research suggests it may be safe for some patients to treat only the part of the breast where the tumor was. This version is delivered by a linear accelerator much like standard whole breast radiation, but focused tightly on the area around the surgery. Treatment is given twice a day over about one week.
Breast Brachytherapy
The other approach to partial breast irradiation. Flexible plastic tubes called catheters, or a small balloon, are placed directly into the cavity where the lump was removed. A small radioactive seed is guided into place and left for a few minutes according to the plan your radiation oncologist designed. The procedure is repeated twice daily for five days, then the catheters or balloon are removed and treatment is finished.
Chest Wall Radiation After Mastectomy
After a mastectomy, your physician may recommend radiation to the chest wall and nearby lymph node areas. Whether this is right for you depends on several factors, so it is a decision to make together with both your surgeon and your radiation oncologist before treatment begins.
What treatment involves
Before treatment starts, you will come in for a planning session called simulation. It maps the exact area to be treated and involves X-rays, a CT scan, or both. A radiation therapist will place tiny tattoo-like marks on your skin so you can be positioned precisely for each daily treatment.
A full course of whole breast radiation usually runs three to seven weeks, with treatment given once a day. Each session takes only a few minutes and is painless. Most of the appointment is spent lining you up in exactly the same position as the day before.
You will meet with your radiation oncologist regularly during treatment. Tell us about anything that feels off — managing side effects is part of the work, not an interruption to it.
Possible side effects
Side effects are usually temporary and typically resolve shortly after treatment ends. Tell your care team about any discomfort — managing it is part of the treatment, not an interruption to it.
- Fatigue that builds over the weeks of treatment
- Skin in the treated area that turns pink or tan, like a sunburn
- Dryness, itching or peeling of the skin
- Tenderness, swelling or a feeling of heaviness in the breast
- Occasional twinges or aches in the treated breast
Caring for yourself during treatment
- Rest when you need to, and don't hesitate to ask for help.
- Follow your care team's advice — and ask when anything is unclear.
- Tell us about every medication, vitamin and supplement you take.
- Eat a balanced diet and drink plenty of fluids.
- Treat skin in the treatment area gently: no sun, no hot or cold packs, and only lotions your team has approved.
- Lean on support groups, family and friends. Coping is part of treatment.
Trusted resources
- Breastcancer.org — www.breastcancer.org
- Living Beyond Breast Cancer — www.lbbc.org
- National Breast Cancer Foundation — www.nationalbreastcancer.org
- SHARE Cancer Support — www.sharecancersupport.org
- Sisters Network — www.sistersnetworkinc.org
- RT Answers (American Society for Radiation Oncology) — www.rtanswers.org
Clinical background adapted from materials by the American Society for Radiation Oncology (rtanswers.org) and the American Cancer Society.
Cancers We Treat
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