Radiation treatment overview from Radiology.com:
Breast conservation surgery removes the breast tumor and a margin of surrounding normal tissues. Radiation therapy usually follows a lumpectomy to eliminate any microscopic cancer cells in the remaining breast tissue. The purpose is to give women the same cure rate they would have if they were treated with a mastectomy but to leave the breast intact, with an appearance and texture as close as possible to what they had before treatment. It is estimated that 75 percent to 80 percent of patients can be treated with breast conservation therapy rather than mastectomy with excellent results. Years of clinical study have proven that breast conservation therapy offers the same cure rate as mastectomy.
Is radiation therapy necessary if the margins of the removed tissue are negative?
Many studies have reviewed this approach for patients with invasive cancers. Nearly all show that the risk of relapse in the breast is much higher when radiation is not used (20 percent to 40 percent) than when it is used(5 percent to 10 percent). Having breast cancer reappear in this way is a very traumatic event psychologically. Also, patients may need to have a mastectomy to be cured in this situation, so in more cases they may lose the breast than if they had undergone radiation therapy initially. Finally, not everyone who has a recurrence in the breast can be cured. Therefore, radiation therapy after lumpectomy is the standard treatment around the world.
There are several recent studies in which older patients with small, favorable invasive cancers have had a low risk of local relapse when treated with lumpectomy and hormonal therapy without radiation therapy. There is still uncertainty about the long-term results with this approach or about which individuals will do best without radiation therapy. This issue should be discussed in detail with your doctor.
For patients with noninvasive cancer (known as "ductal carcinoma in situ") matters are more complicated. Lumpectomy without radiation works well for many patients. However, there is disagreement on who can be treated safely with just a lumpectomy. This should be discussed in detail with your doctor.
What are possible side effects of radiation therapy?
Most patients develop mild fatigue that builds up gradually over the course of therapy. This slowly goes away one to two months following the radiation therapy. Most patients develop dull aches or sharp shooting pains in the breast that may last for a few seconds or minutes. It is rare for patients to need any medication for this. The most common side effect needing attention is skin reaction. Most patients develop reddening, dryness and itching of the skin after a few weeks. Some patients develop substantial irritation.
Skin care recommendations include:
•Keeping the skin clean and dry using warm water and gentle soap
•Avoiding extreme temperatures while bathing
•Avoiding trauma to the skin and sun exposure (use a sunscreen with at least SPF 30)
•Avoiding shaving the treatment area with a razor blade (use an electric razor if necessary)
•Avoiding use of perfumes, cosmetics, after-shave or deodorants in the treatment area (use cornstarch with or without baking soda in place of deodorants)
•Using only recommended unscented creams or lotions after daily treatment
Some patients develop a sunburn-like reaction with blistering and peeling of the skin, called "moist desquamation." This usually occurs in the fold under the breast or in the fold between the breast and the arm, or sometimes in the area given a radiation boost. Skin reactions usually heal completely within a few weeks of completing radiotherapy.
So far so good and if I am lucky, it will be a long time before I see any of the symptoms, if at all. Some of you prefer the clinical info so here it is. We shall see...
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