Radiotherapy or radiation treatment (RT) is an integral part of breast cancer management. RT uses megavoltage X-ray to kill any remaining cancer cells that are left over following your breast cancer surgery.
For all women who undergo some form of breast conserving surgery it will be necessary to have the remainder of their breast treated with RT, sometimes also including surrounding lymph node basin. For some patients who have undergone a mastectomy who are at higher risk of cancer recurrence, there will be a recommendation for RT to the chest wall and/or the surrounding lymph node basins. Use of RT can reduce the risk of cancer coming back in the breast, chest wall and/or surrounding lymph node basins dramatically. Recent studies have shown that RT not only reduces the chance of cancer relapsing locally, it also reduces the risk of cancer coming back elsewhere, leading to increased chance of cure for breast cancer.
Typically RT will involve attending a radiation department for 5 weeks for approximately 1/2 hour at a time, Monday to Friday. More recently the treatment time can be reduced in many patients following BCS to 3-4 weeks by using so called hypofractionated radiotherapy. This delivers slightly more radiation dose per daily session, and ends up with the same biological effect but over a shorter period of time. Radiotherapy is mostly well tolerated but can result in some short term skin changes as well as longer term changes in the breast such as increased sensitivity/ tenderness, late complications from radiotherapy such as cardiac disease or second cancer are very rare.
Dr Tim Wang is an experienced radiation oncologist working in the team at Lakeside specialist breast clinic, who will be able to talk to you in more detail about what to expect from your radiation treatment, advise you on any risks associated with RT and how to manage any side effects. Tim has multiple publications on advanced radiotherapy technique to minimize the risk of heart disease after radiotherapy, such as deep inspiration breath hold technique and volumetric arc radiotherapy. He offers treatment in the private sector via Macquarie university hospital and at Westmead public hospital, advanced cardiac sparing radiotherapy techniques including deep inspiratory breath hold technique are available in both hospitals. Tim will also be involved in your longer follow-up, typically seeing you once a year. On the alternate 6 months you will usually see your surgeon who will also see you once a year, usually at the time for your annual breast imaging.