Radiation Therapy

Radiation therapy uses high-energy beams or implanted pellets to damage cancer cells. The cells eventually die, and the tumor may decrease in size. Radiation therapy focuses on the cancer cells. Healthy tissues are avoided as much as possible.

Radiation before surgery can help kill cancer cells that are growing fast. This is called neoadjuvant radiation.

Radiation after surgery  can help kill any cancer cells that remain. It can also help stop the cancer from returning. This is called adjuvant radiation. It is usually done after surgery once the wound has healed.

External beam radiation: This directs the beam to the whole breast. It is done after surgery. Treatment is given in small doses. Usually, doses are done for 15 minutes per day, 5 days per week. Therapy takes about 1 to 7 weeks.

External partial-breast irradiation: This focuses the beam on the area around the cancer. This area has the highest risk of recurrence. The treatment is delivered over 5 to 10 days. It is not clear if this treatment works better than radiation to the whole breast. That is still being studied.⁴²

Internal partial breast radiation: This involves placing radioactive pellets, or "seeds," in or near the site of the cancer. The pellets are later removed. This is also called brachytherapy.

Proton therapy: This uses positively charged particles called protons to kill cancer cells. This can give less radiation to normal tissue.⁷⁹ This is also called proton beam therapy.

• Some of the side effects from radiation include: ⁸⁰
  • Fatigue (feeling tired)
  • Skin changes
  • Swelling
  • Hair loss
• The skin at the radiation site may be red, sore, and sensitive or numb. It may also look slightly darker and the pores may be larger. The breast may change size. It may get larger because of fluid build-up. It may get smaller because of scar tissue. These side effects may last long after radiation treatment is complete.
• Scar tissue can form in the breast and chest wall. This is known as fibrosis. It can occur 4 to 12 months after radiation therapy. It can progress over several years and may be painful and limit function.⁴³
• Brachytherapy may also have side effects. These may include pain, swelling, and bleeding where the pellets are inserted.