What to expect from your breast cancer radiation therapy

Patients with breast cancer may receive radiation therapy (sometimes referred to as radiotherapy) at some point in their treatment course. Radiation therapy is mostly used in combination with other treatments, so patients with breast cancer may receive radiation therapy as well as other therapies including surgery (lumpectomy or mastectomy), chemotherapy, endocrine (hormone-based) therapy or immunotherapy. Radiation therapy is recommended for patients with breast cancer because it can help to decrease the risk of your breast cancer recurring after surgery.^1,2

Radiation therapy is used to kill cancer cells or to stop them from growing and spreading. It can be used in the early stages of cancer treatment or after it has started to spread and can also be used to help relieve pain and discomfort from cancer that has spread.³

Radiation therapy uses carefully controlled doses of radiation to destroy or damage cancer cells, usually in the form of focused, high-energy particles such as x-rays or protons. By precisely targeting the breast tissue and lymph nodes, radiation therapy aims to stop the growth and/or spread of the cancer cells while minimising side effects and preserving surrounding healthy tissues.³

The main type of radiation therapy used to treat breast cancer is external beam radiation therapy (EBRT).¹ EBRT uses a linear accelerator (or LINAC) machine to deliver high-energy radiation beams from outside your body to the cancer cells. Advanced techniques can be used to accurately deliver a precise dose of radiation to the targeted treatment area.³

Radiation therapy is often delivered in ‘fractions’, which divides the total radiation dose your doctor prescribes into smaller daily doses. Delivering radiation doses in fractions provides time between treatment sessions for the cancer cells to die while the healthy cells can repair themselves after being exposed to radiation.³

Before starting radiation therapy, your treatment team – including your radiation oncologist and nurse – will review your health record, discuss your general health and diagnosis, and explain more about the treatment process, options, and potential side effects.³

You will also have a computed tomography (CT) simulation appointment. This is a planning session with your radiation therapists, who will take CT scans to help your radiation oncologist develop a personalised treatment plan.^2,3

This appointment is also used to determine the appropriate position for your body to be in during your radiation therapy sessions. The position will depend on the exact area of the breast you are having treated and may require your arms to be above your head, on your chest, or by your side. Marks may be drawn directly onto your skin to outline the treatment area using a special skin marker – this helps your radiation therapists accurately replicate your body position in each of your treatment sessions.^2,3

At your first treatment session, you will be positioned on the treatment bed in the same position as during your CT scan. Your skin markings and individual treatment plan will be used to deliver the prescribed radiation therapy. You will need to lie still while the LINAC machine delivers your radiation treatment from several different angles. While the radiation is being delivered, your radiation therapists will monitor you from another room. You will always be able to communicate with them through an intercom during your treatment and they can pause the treatment if required.^2,3

The rest of your radiation therapy treatment sessions will be similar to your first session. The total number of treatment sessions will depend on your individual treatment plan, but most patients with breast cancer receive daily radiation on 5 consecutive days per week for 3 to 6 weeks. Each individual treatment session usually takes about 10 to 30 minutes to complete.^1,2 While you’re receiving treatment, you may feel like listening to music to help you relax. You can discuss this option with your radiation therapists.³

You will not be radioactive during or after external beam radiotherapy treatment. You can safely mix with other people, including children and pregnant women, at any time during and after your treatment. After each treatment session, most people can continue to carry out their usual daily activities, including work.³ If you have any concerns about your treatment, please speak to your doctor or care team. Your doctor and nursing team will check-in with you regularly and can provide you with information to help manage any side effects that you may experience.

Once you have completed your course of radiation therapy, you will have a follow-up appointment with your radiation oncologist, which is often 1 to 3 months after your last treatment session. Your doctor will review your progress, assess any late side effects, and see how you responded to treatment. Your nursing team will also follow-up with you after you finish your treatments to help you manage any ongoing symptoms or side effects.³

Disclaimer

Any medical procedure or treatment involving the use of radiation carries risks, including skin irritation and associated pain. Before proceeding with treatment, you should discuss the risks and benefits of the treatment with an appropriately qualified health practitioner. Individual treatment outcomes and experiences will vary.