What you can expect as a breast cancer patient

Non-invasive breast cancer

Non-invasive breast cancer is when the abnormal cells haven’t spread from their original location.

Types of non-invasive breast cancer include:

• Ductal carcinoma in situ (DCIS) – is where pre-cancerous cells are found within the milk ducts of the breast. This is treated with surgery and breast radiotherapy
• Lobular carcinoma in situ (LCIS) – is where pre-cancerous cells are found within breast lobules. Although LCIS increases the risk of developing cancer, most women with this condition won’t go on to develop breast cancer. This is usually treated with surgery.

Invasive breast cancer

Invasive breast cancer means the cancer cells have spread to nearby tissue.

Types of invasive breast cancer include:

• Locally advanced breast cancer – where cancer cells have spread from the ducts or lobules into the nearby breast tissue. The cancer may also have spread to lymph nodes in the armpit or near the breastbone. The most common types are invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC).
• Secondary (metastatic or advanced) breast cancer – is where the cancer has spread to other parts of the body, such as the lungs, liver or bones.

Common symptoms of breast cancer include:

• Swelling or lumps in all or part of the breast or armpit
• Irritation or dimpling on the skin
• Pain in the breast or nipple
• The nipple turning inwards (retraction)
• Redness, scaliness or a rash on the skin and/or around the nipple

If you suspect a problem, or notice a change in your breasts, it’s best to get your symptoms checked as soon as possible.

Our one-stop private breast screening clinics at Maidstone and Milton Keynes are held throughout the week, so we can arrange an appointment that works for you.

In most cases, treatment for breast cancer begins with surgery to remove the tumour. Sometimes this is followed by radiotherapy or a combination of chemotherapy and then radiotherapy. You may also be offered hormone treatments. 

No matter what treatment you’re recommended, we have state-of-the art evidence-based technology and treatment protocols to provide the best possible life outcomes.

Breast radiotherapy 

With no waiting lists to worry about, you’ll get fast access to the latest breast cancer treatments. These precisely target abnormal cells while minimising side-effects and avoiding healthy tissue.

What is radiotherapy?

Radiotherapy is a highly effective treatment for breast cancer.

If you have radiotherapy, it’s important to ensure the radiation always reaches the right place and avoids vital organs such as your heart. This is just one of the reasons why we continually invest in the latest proven technologies and treatments and offer a number of techniques to improve the accuracy of your treatment. These can be combined to deliver the most precise dose of radiotherapy to treat your breast cancer.

By combining daily image-guided radiotherapy (IGRT) and surface-guided radiotherapy (SGRT), we are able to provide a superior and easier treatment experience, including:

• Tattoo free treatments – without SGRT, permanent tattoos are used to ensure patients are positioned correctly and can be an unwelcome reminder of your treatment
• Daily imaging means you are always in the correct position, even if the tumour site changes, avoiding healthy tissue and minimising side-effects.
• Should you move during treatment, SGRT ensues that the radiotherapy is automatically paused until you are back in the correct position making treatment more comfortable
• A quicker daily treatment set up, saving you time every day

Deep inspiration breath-hold (DIBH) is a technique used in radiotherapy to reduce the risk of damage to your heart or lungs. If you have left-sided breast cancer, we’ll show you how to use the technique successfully.

During treatment, you’ll be asked to take a deep breath, and hold this while the treatment is delivered. By taking a deep breath in, your lungs fill with air, and your heart will move away from your chest.

We are leading the way in how radiotherapy is used to treat breast cancer in the UK by also offering the following recognised techniques:

Partial breast radiotherapy (PBI)

This technique isn’t widely available in the UK. PBI allows us to guide treatment to just the affected area rather than treat the whole breast. Research has shown this technique reduces breast skin thickening and internal scaring from radiotherapy.

Partial breast radiotherapy minimises the dose of radiotherapy to the lung on the same side as the treated breast, as well as the dose to the heart.

This treatment is best suited to patients who have been diagnosed with early breast cancer that hasn’t spread to the nearby lymph nodes. Your consultant will discuss whether partial breast radiotherapy is right for you during your appointment.

Simultaneous integrated boost (SIB)

SIB is a radiotherapy technique that delivers a higher dose per fraction (or treatment session) to the affected breast area compared to the rest of the breast. By doing so, it reduces the chance of cancer returning to the breast more effectively. The treatment schedule is also reduced by a full week.

This treatment is best suited to patients eligible for an extra dose to the affected breast area, called a breast boost.

Your oncologist refers you to GenesisCare

After you have had the chance to discuss your treatment options with your consultant, you may want to have your radiotherapy treatments at one of our centres. As with all private healthcare providers, we will need a referral from your consultant.

So, whether you have private medical insurance (PMI) or decide to self-pay, if you decide to have treatment at a local GenesisCare centre, you’ll need to ask your consultant for a referral.

Many of our patients find it useful to visit their local centre before starting treatment. If you’d like to do this, please get in touch and we’ll arrange a convenient appointment when you can come in and meet the team.

Once you’ve been referred

Once you’re referred to us, a member of our patient support team will contact you to arrange your treatment planning appointment.

They’ll talk you through what to expect, discuss practical things, like transport to and from the centre, and answer any questions you may have, including how to pay for your treatment.

After the call we’ll send confirmation of your planning appointment and details of your treatment appointment schedule. We’ll also send you information about your planning CT scan and practical information about your treatment to share with others as you wish.

When you arrive at the centre, you’ll be met by one of our patient support team. During this one-hour appointment, you’ll:

• Meet the team
• Complete the paperwork
• Have a consultation with a radiographer who will discuss your treatment and answer any questions
• Have a CT scan of your breast or chest wall (after mastectomy). This scan is then used to plan your treatment. You’ll have to lie flat for this, and the radiographers may ask you to hold your breath for a few seconds during the scan

We’ll also give you a tour of the centre so that you know where everything is and arrange your referral and wellbeing assessment.

Top tips

• You’re welcome to bring someone with you to all of your appointments
• Some people find it helps to bring a notebook with them to jot things down
• Don’t wear clothing with metal fastenings

When you arrive, your radiographer will talk you through your treatment plan.

• The radiotherapy treatment itself is entirely painless
• You will need to lie flat and remain still on the treatment couch
• Your radiographer will help you get into a good comfortable position on the treatment couch
• The radiographer will then leave the room. Don’t worry – they’ll still be able to see and talk to you and give you breathing instructions
• You can bring music with you to listen to during treatment or select from our library
• You’ll be referred to our Wellbeing and Exercise Medicine programmes

You may find these patient stories particular helpful.

Top tips

• Deodorant: don’t use deodorant or body spray around the area being treated
• Shaving: avoid shaving under the arm on the side that’s being treated
• Washing: use warm or lukewarm water and avoid products with perfume
• Moisturising: make sure any moisturiser is fully absorbed before your treatment
• Talcum powder: avoid this as it can make any soreness worse
• Sun: your skin may be very sensitive after radiotherapy, so keep the area treated covered and avoid exposure to the sun
• Clothing: to reduce irritation wear loose-fitting clothing made of natural fibres such as cotton or silk over the treatment area
• Swimming: it’s best to avoid swimming during your treatment and for a month afterwards as it may dry your skin or lead to a skin infection

You will usually have a daily appointment, Monday to Friday, over 3-5 weeks.

At the end of your first week, we’ll ask you to share your first impressions by completing a quick survey.

If you have any questions or concerns, please speak to one of the team, either at your next appointment or over the phone.

There are some common side-effects of radiotherapy which your local team will discuss with you.

Common side-effects for breast cancer radiotherapy include:

• Tiredness: rest whenever you need to but try to keep to your daily routine as much as possible. The Exercise Medicine programme we offer should be a great help here
• Skin changes, including irritation or soreness: your healthcare team will be able to advise you about any creams or medication you should or shouldn’t use to help with this
• Swelling in the arm on the same side as your breast treatment (lymphoedema): Exercise Medicine has been proven to help reduce lymphoedema. If you have any concerns speak to your physiotherapist or personal trainer who can offer help and advice
• Stress and anxiety: Again, Exercise Medicine can help with this, as well as taking part in our Wellbeing programme which includes counselling and relaxation techniques
• Rib tenderness: this can be relieved by taking simple painkillers such as paracetamol

Before you leave, we’ll schedule a follow-up call to check how you are in 2-3 weeks.  Your side-effects could be more prominent for up to 10 days after your last radiotherapy treatment.

Once your treatment course has finished, we’ll send a report to your oncologist and GP, so they’ll both have details of your treatment.

Follow-up

We’ll call you as scheduled. Your oncologist will also arrange a follow-up appointment.