Men and women discussing breast cancerAbout breast cancer radiotherapy

This page tells you about radiotherapy for breast cancer. You can find information about

 

A quick guide to what's on this page

About breast cancer radiotherapy

Radiotherapy is cancer treatment using radiation. It used often to treat breast cancer. Doctors mostly use radiotherapy after breast surgery, as it lowers the risk of the cancer coming back.

How and where you have treatment

You have your treatment in the hospital radiotherapy department. You may have treatment once a day, from Monday to Friday, with a rest at the weekend. This means you will have to travel to the hospital every weekday. The course of treatment usually lasts either 3 or 5 weeks.

At your first visit you lie under a large machine called a simulator. The doctor uses this to plan your treatment. You will have a pinprick tattoo made on your skin. The radiographers use this to line up the radiotherapy machine accurately every time. You may also have marks drawn on your body with a felt tip pen.

Each treatment only takes a few minutes. The treatment does not hurt, and it does not make you radioactive.

More rarely radiation is given directly to the area of the breast where the cancer was removed. This is called internal radiotherapy or brachytherapy.

 

What radiotherapy is

Radiotherapy is cancer treatment using radiation to destroy cancer cells. It used often to treat breast cancer.

Doctors mostly use radiotherapy treatment after breast surgery - breast conserving surgery or mastectomy. A review of research trials into surgery and radiotherapy showed that radiotherapy treatment lowers the risk of the cancer coming back either in the remaining breast tissue or in lymph nodes that are treated. It also helps some women live longer. You can read a brief summary of this review of radiotherapy for early breast cancer on the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) website. It is written for researchers and specialists so is not in plain English.

Overall, for women with early breast cancer the cure rate is the same whether they have lumpectomy followed by radiotherapy or have a mastectomy. Usually radiotherapy is given to the whole of the remaining breast tissue after lumpectomy (known as whole breast radiotherapy). But some trials are looking at giving radiotherapy just to the area where the breast cancer was removed using intensity modulated radiotherapy (IMRT). There is more about this on our  breast cancer treatment research page.

 

How and where you have treatment

You have to travel to hospital for radiotherapy treatment. You have your treatment in the radiotherapy outpatient department. Radiotherapy is split into a course of small treatments. If you were to have the total dose in one go, it would be too harmful to normal body tissues. So the dose is split into smaller doses that you have each day (or on alternate days) over a number of weeks. Each dose is known as a 'fraction'.

You may have treatment once a day for 3 weeks, from Monday to Friday, with a rest at the weekend. This means you will have to travel to the hospital every weekday for that time. Or you may have treatment on alternate weekdays for 5 weeks. The length of your course of treatment will vary, depending on your needs and the hospital where you are treated. The total dose of radiotherapy you get is usually about the same with each of these schedules. One trial has looked at giving a slightly lower overall radiotherapy dose - it is called the FAST trial and we are waiting for the results.

 

Planning your treatment

Radiotherapy is specialist treatment and your doctor will plan it very carefully and individually for you. At your first visit you may lie under a large machine called a CT simulator (as in the picture below) or have CT scans. The doctor uses the CT simulator or CT scans to plan exactly where to give the treatment.

Image of a patient lying under a CT simulator

During planning you will have a pinprick tattoo made on your skin. The radiographers use this to line up the radiotherapy machine accurately every time you have treatment. You may also have marks drawn on your body with a felt tip pen. Try not to wash them off. They will fade, though. So tell your radiographer if they do and they'll ink them in again. Don't draw them in again yourself!

 

Having your treatment

Each treatment only takes a few minutes. The radiographers will help position you on the couch and make sure you are comfortable.

Image of a patient lying under a CT simulator with two radiographers by their side

You will be left alone for the minute or two the machine is switched on. But the staff will be able to hear you through an intercom or video link, so you can call if you need them. The treatment does not hurt. You will not be able to feel it at all. You must lie very still for the few minutes it takes to treat you.

Having external radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

 

Internal radiotherapy

In July 2008, NICE (National Institute for Health and Clinical Excellence) issued guidance that internal radiotherapy (a 'radiotherapy implant' or 'breast brachytherapy') could be used to give radiation treatment after surgery, if it is used as part of a clinical trial. This is a way of giving radiation directly to the area where the cancer was removed.

You will have a general or a local anaesthetic. Thin hollow tubes or an inflatable 'balloon' are put into your breast. Later, radioactive wires are passed through the middle of the tubes or a small radioactive metal source is put into the balloon.

Diagram showing how you have internal radiotherapy for breast cancer

The radioactive wires may be left in place for a few days, or just inserted for a few minutes. If you are having high dose treatment, you will have the treatment for a few minutes over several days. Balloon brachytherapy is always given in short daily sessions. If the wires are left in place for a few days, then you will stay in hospital, in a single room. Your friends and family will only be allowed to visit for a short time each day. This is so they won't be exposed to radiation. Children and pregnant women will not be allowed to visit you at all.

The radioactivity is in the wires. So the radioactivity goes when the doctor takes the wires out. Then it is completely safe for you to be with other people including children.

There is more information about treatment with radioactive wires in the main radiotherapy section and in our breast cancer research section.

 

Where to find out more about radiotherapy

There is much more information about radiotherapy in our main radiotherapy section. You can find information about