Most
women who have been diagnosed with breast cancer will undergo some form of
treatment for the disease. The most favorable course of treatment will depend
on a number of factors, including the size and location of the breast tumor,
the stage of the cancer, and results of other laboratory tests. This section
provides information on the treatment options for breast cancer, discusses how
to cope with the side effects of treatment, and addresses important aspects to
consider before and after breast cancer treatment.
Radiation
therapy (or radiotherapy) uses high-energy rays to stop cancer cells from
growing and dividing. Radiation therapy is often used to destroy any remaining
breast cancer cells in the breast, chest wall, or axilla (underarm) area after
surgery. Occasionally, radiation therapy is used before surgery to shrink the
size of a tumor. A common treatment for early stage breast cancer is
breast-conserving therapy. Breast-conserving therapy (BCT) is the surgical
removal of a breast lump (lumpectomy) and a surrounding margin of normal breast
tissue. BCT is typically followed by at least six to seven weeks of radiation
therapy.
Treatment with radiation usually begins one month after surgery,
allowing the breast tissue adequate time to heal. Radiation therapy may
occasionally be recommended for women to destroy remaining cancer cells after mastectomy
(surgical removal of the affected breast) or to shrink tumors in patients with
advanced breast cancer.
The
most common type of radiation therapy used on women with breast cancer is called
external beam radiation. External beam radiation is delivered from a source
outside the body on the specific area of the body that has been affected by the
cancer. Experts compare the experience of external beam radiation to having a diagnostic
x-ray, except that radiation is usually administered for a longer period of
time and at a higher dose.
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Before
radiation therapy begins, the physician will measure the correct angles for
aiming the radiation beam at the specific area of the body and make ink marks
on the patient’s skin. As part of treatment after breast surgery, patients
are typically treated with radiation five times per week for at least six weeks
in an outpatient clinical setting. Each treatment generally lasts a few
minutes; the entire radiation session after machine set-up typically lasts 15
to 30 minutes. The procedure itself is pain-free. While the radiation is being
administered, the technologist will leave the room and monitor the patient on a
closed-circuit television. However, patients should be able to communicate with
the technologist at any time over an intercom system.
Side
effects of external beam therapy vary among patients. The most common side
effect is fatigue. Fatigue (extreme tiredness) can be especially bothersome in
the later weeks of treatment. Patients who experience fatigue after radiation
sessions should get plenty of rest and try to maintain an active lifestyle.
While many patients can still work and participate in normal activities during
radiation therapy, some patients find it necessary to limit their work or
activities until treatment has been completed.
Other
common side effects of radiation therapy are neutropenia
(sharp decrease in white blood cell count) swelling of the breast, a feeling of
heaviness in the breast, a sunburn-type appearance of the breast skin, and loss
of appetite. These side effects usually disappear after six to 12 months. Near
the end of treatment with radiation, the breast skin may become moist. Patients
should try to wearing loose fitting clothing and expose the skin to air as much
as possible to help the skin heal quickly.
Temporary
Side Effects of Radiation Therapy
- Fatigue
- Neutropenia
(reduction in white blood cells)
- Breast swelling
or tenderness
- Feeling of
heaviness in the breast
- Sunburn-like
appearance of the breast skin
- Loss of appetite
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In
most cases, the breast will look and feel the same after radiation therapy is
completed, though it may be more firm. In rare cases, radiation therapy may
cause changes in the breast size. Breasts may become larger due to fluid
build-up (seroma) or smaller due to tissue changes. Some women may find that
the breast skin is more sensitive after radiation, while others may find that
it is less sensitive. Radiation therapy of the axillary (underarm) lymph nodes
may cause lymphedema (chronic swelling of the arm) in some women. Women who
have radiation to the lymph nodes will usually be instructed on arm exercises
and other activities to help prevent lymphedema.
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