What You Should Know About Radiation Therapy For Breast Cancer Treatment
Radiation therapy is a treatment that can be used for many different types of cancer to target cancer cells and minimize tumor growth. Radiation therapy works by using high-energy beams or particles to damage the DNA of cancer cells, which prevents them from dividing, and results in the death of the cell.
Radiation therapy is often used for breast cancer patients to make sure any remaining cancer cells are killed after surgery or if cancer has spread to other areas of the body. Read on to learn more about the types of radiation therapy, when radiation therapy is used to treat breast cancer, what to expect at a radiation oncology appointment, and the side effects of radiation therapy.
Skin Rash On The Breasts
You may not associate breast cancer with redness or a skin rash, but in the case of inflammatory breast cancer , a rash is an early symptom. This is an aggressive form of breast cancer that affects the skin and lymph vessels of the breast.
Unlike other types of breast cancer, IBC doesnt usually cause lumps. However, your breasts may become swollen, warm, and appear red. The rash may resemble clusters of insect bites, and its not unusual to have itchiness.
If Cancer Is Found Tests Are Done To Study The Cancer Cells
- how quickly the cancer may grow.
- how likely it is that the cancer will spread through the body.
- how well certain treatments might work.
- how likely the cancer is to .
Tests include the following:
Based on these tests, breast cancer is described as one of the following types:
- HER2/neu positive or .
This information helps the doctor decide which treatments will work best for your cancer.
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Skin And Hair Reactions
Your skin and hair in the treatment area will change during your radiation therapy. This is normal.
- Your skin may turn pink, red, tanned, or look like it has sunburn. The skin in the folds under your arm and breast, over your collar bone, and in other parts of the treatment area that have been in the sun may blister and peel.
- Your skin may become very sensitive and itchy.
- You may get a rash, especially in any area where your skin has been in the sun. Tell a member of your radiation therapy team if you get a rash at any time during your radiation therapy. Rashes are sometimes a sign of an infection.
- You may lose some or all of your hair under your arm on the treated side. It usually grows back in 2 to 4 months after you finish radiation therapy.
If your skin becomes open, wet, and oozing, contact your radiation team. They may prescribe a cream called Silvadene® . Your radiation oncologist may also stop your radiation therapy until your skin heals, although this is rarely needed.
Skin reactions from radiation therapy are usually strongest 1 or 2 weeks after you finish radiation therapy and then start to heal. It often takes 3 to 4 weeks for skin reactions to heal. If you have any questions or concerns, dont hesitate to contact your radiation oncologist or nurse.
Skin care guidelines
Follow these guidelines care for your skin during treatment. Keep following them until your skin gets better. These guidelines refer only to the skin in the treatment area.
Breast Exam By Your Doctor
The same guidelines for self-exams provided above are true for breast exams done by your doctor or other healthcare professional. They wont hurt you, and your doctor may do a breast exam during your annual visit.
If youre having symptoms that concern you, its a good idea to have your doctor do a breast exam. During the exam, your doctor will check both of your breasts for abnormal spots or signs of breast cancer.
Your doctor may also check other parts of your body to see if the symptoms youre having could be related to another condition.
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Risk Factors For Breast Cancer
There are several risk factors that increase your chances of getting breast cancer. However, having any of these doesnt mean you will definitely develop the disease.
Some risk factors cant be avoided, such as family history. You can change other risk factors, such as smoking. Risk factors for breast cancer include:
- Age. Your risk of developing breast cancer increases as you age. Most invasive breast cancers are found in women over 55 years old.
- Drinking alcohol. Alcohol use disorder raises your risk.
- Having dense breast tissue. Dense breast tissue makes mammograms hard to read. It also increases your risk of breast cancer.
- Gender. According to the
While there are risk factors you cant control, following a healthy lifestyle, getting regular screenings, and taking any preventive measures your doctor recommends can help lower your risk of developing breast cancer.
Are There Different Types Of Breast Cancer
The breasts are made of fat, glands, and connective tissue. The breast has several lobes, which split into lobules that end in the milk glands. Tiny ducts run from the many tiny glands, connect together, and end in the nipple.
- These ducts are where 80% of breast cancers occur. Ductal cancer is breast cancer that arises in the ducts.
- Cancer developing in the lobules is termed lobular cancer. About 10%-15% of breast cancers are of this type.
- Other less common types of breast cancer include inflammatory breast cancer, medullary cancer, phyllodes tumor, angiosarcoma, mucinous carcinoma, mixed tumors, and a type of cancer involving the nipple termed Paget’s disease.
Precancerous changes, called in situ changes, are common.
- In situ is Latin for “in place” or “in site” and means that the changes haven’t spread from where they started .
- Ductal carcinoma in situ is the medical term for in situ changes that occur in the ducts. Routine mammography may identify DCIS.
- Lobular carcinoma in situ refers to abnormal-appearing cells in the milk-producing lobules of the breast. This is considered a non-cancerous condition that increases a woman’s risk for breast cancer.
When cancers spread into the surrounding tissues, they are termed infiltrating cancers. Cancers spreading from the ducts into adjacent spaces are termed infiltrating ductal carcinomas. Cancers spreading from the lobules are infiltrating lobular carcinomas.
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Nerve Damage Around The Treatment Area
Scaring from radiotherapy may cause nerve damage in the arm on the treated side. This can develop many years after your treatment. Symptoms include tingling, numbness, pain, and weakness. In some people, it may cause some loss of movement in the arm and shoulder.
Speak to your doctor if you notice any of these symptoms.
Types Of Breast Cancer
There are several types of breast cancer, and theyre broken into two main categories: invasive and noninvasive. Noninvasive breast cancer is also known as breast cancer in situ.
While invasive cancer has spread from the breast ducts or glands to other parts of the breast, noninvasive cancer has not spread from the original tissue.
These two categories are used to describe the most common types of breast cancer, which include:
- Ductal carcinoma in situ. Ductal carcinoma in situ is a noninvasive condition. With DCIS, the cancer cells are confined to the ducts in your breast and havent invaded the surrounding breast tissue.
- Lobular carcinoma in situ. Lobular carcinoma in situ is cancer that grows in the milk-producing glands of your breast. Like DCIS, the cancer cells havent invaded the surrounding tissue.
- Invasive ductal carcinoma. Invasive ductal carcinoma is the most common type of breast cancer. This type of breast cancer begins in your breasts milk ducts and then invades nearby tissue in the breast. Once the breast cancer has spread to the tissue outside your milk ducts, it can begin to spread to other nearby organs and tissue.
- Invasive lobular carcinoma.Invasive lobular carcinoma first develops in your breasts lobules and has invaded nearby tissue.
Other, less common types of breast cancer include:
The type of cancer you have helps guide your treatment options and long-term outcome.
of people with breast cancer, according to the American Cancer Society .
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Radiation Therapy And Risk Of A Second Cancer
In rare cases, radiation therapy to the breast can cause a second cancer.
The most common cancers linked to radiation therapy are sarcomas . For women who are long-term smokers, radiation therapy may also increase the risk of lung cancer .
The risk of a second cancer is small. If your radiation oncologist recommends radiation therapy, the benefits of radiation therapy outweigh this risk.
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Biomarker Testing Is Used To Find Out Whether Breast Cancer Cells Have Certain Receptors
Healthy breast cells, and some breast cancer cells, have that attach to the and . These hormones are needed for healthy cells, and some breast cancer cells, to grow and divide. To check for these biomarkers, samples of tissue containing breast cancer cells are removed during a biopsy or surgery. The samples are tested in a laboratory to see whether the breast cancer cells have or .
Another type of receptor that is found on the surface of all breast cancer cells is called HER2. HER2 receptors are needed for the breast cancer cells to grow and divide.
For breast cancer, biomarker testing includes the following:
- Estrogen receptor . If the breast cancer cells have estrogen receptors, the cancer cells are called . If the breast cancer cells do not have estrogen receptors, the cancer cells are called .
- Progesterone receptor . If the breast cancer cells have progesterone receptors, the cancer cells are called . If the breast cancer cells do not have progesterone receptors, the cancer cells are called .
- Human epidermal growth factor type 2 receptor . If the breast cancer cells have larger than normal amounts of HER2 receptors on their surface, the cancer cells are called . If the breast cancer cells have a normal amount of HER2 on their surface, the cancer cells are called . HER2+ breast cancer is more likely to grow and divide faster than HER2- breast cancer.
Sometimes the breast cancer cells will be described as or .
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The Tnm System The Grading System And Biomarker Status Are Combined To Find Out The Breast Cancer Stage
Here are 3 examples that combine the TNM system, the grading system, and the biomarker status to find out the Pathological Prognostic breast cancer stage for a woman whose first treatment was surgery:
If the tumor size is 30 millimeters , has not spread to nearby lymph nodes , has not spread to distant parts of the body , and is:
The cancer is stage IV .
Savi Brachytherapy For Early
A Specialized Procedure Used for Short-Course Radiation Therapy
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
Strut-adjusted volume implant brachytherapy uses an implanted device that delivers radiation internally. Brachytherapy is also known as internal radiation therapy.
SAVI is often used after a lumpectomy in those diagnosed with early-stage breast cancer. This type of brachytherapy is different from external beam radiation, which applies radiation from outside the body and can cause damage to underlying tissues of the breast, lung, and ribcage.
SAVI reduces the length of therapy from up to seven weeks for traditional whole-breast irradiation to just one week or less. This short-course approach is known as accelerated partial breast irradiation .
In studies, ABPI was shown to improve cosmetic outcomes while remaining an effective treatment method and being generally well-tolerated by patients. People undergoing ABPI typically report fewer side effects than those who receive whole-breast irradiation.
This article will explain when SAVI is used, how it works, and what to expect from the procedure.
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Breast Discomfort Or Swelling
You may have some tenderness in your breast on your affected side, especially at your nipple. You may also develop extra fluid in your breast that may cause sharp, stabbing sensations. Your breast or chest may feel heavy or swollen. Your shoulder on your affected side may also feel stiff.
These sensations can start within the first few days of your radiation therapy. They can go on for many months after you finish radiation therapy. Below are suggestions to help you reduce this discomfort.
- If you wear bras, you may want to choose soft, loose bras without an underwire. Sports bras or cotton bras are good choices. You may even find it more comfortable to not wear a bra at all.
- Take pain medications such as nonsteroidal anti-inflammatory drugs as needed. Some examples of NSAIDs are ibuprofen and naproxen . If you cant take an NSAID, you can take acetaminophen instead.
The Grading System Is Used To Describe How Quickly A Breast Tumor Is Likely To Grow And Spread
The system describes a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. cancer cells look more like normal cells and tend to grow and spread more slowly than cancer cells. To describe how abnormal the cancer cells and tissue are, the pathologist will assess the following three features:
- How much of the tumor tissue has normal breast ducts.
- The size and shape of the in the tumor cells.
- How many dividing cells are present, which is a measure of how fast the tumor cells are growing and dividing.
For each feature, the pathologist assigns a score of 1 to 3 a score of 1 means the cells and tumor tissue look the most like normal cells and tissue, and a score of 3 means the cells and tissue look the most abnormal. The scores for each feature are added together to get a total score between 3 and 9.
Three grades are possible:
- Total score of 3 to 5: G1 .
- Total score of 6 to 7: G2 .
- Total score of 8 to 9: G3 .
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When Should Someone Seek Medical Care For Breast Cancer
Breast cancer develops over months or years. Once identified, however, a certain sense of urgency is felt about the treatment because breast cancer is much more difficult to treat as it spreads. You should see your health care provider if you experience any of the following:
- Finding a breast lump
- Finding a lump in your armpit or above your collarbone that does not go away in two weeks or so
- Developing nipple discharge
- Noticing new nipple inversion or skin changes over the breast
Redness or swelling in the breast may suggest an infection of the breast.
- You should see your health care provider within the next 24 hours to begin treatment.
- If you have redness, swelling, or severe pain in the breast and are unable to reach your health care provider, this warrants a trip to the nearest emergency department.
If your mammogram spots an abnormality, you should see your health care provider right away to make a plan for further evaluation.
Problems Moving Your Arm And Shoulder
Radiotherapy might make it harder to move your arm and shoulder. This can affect your activities and work. It usually improves when the treatment finishes. Your nurse or physiotherapist can give you exercises to help.
Its important to continue the arm exercise you were shown after your surgery. This will make it easier for you to lift your arm to the correct position during radiotherapy. It can also help stop your arm and shoulder from becoming stiff.
- There is help available ask the hospital for support
- Talk to your friends and family about how you are feeling
- Ask about local support groups
- Your GP or hospital can provide counselling
- You can get help and support online through forums
If you’re experiencing a side effect that hasn’t been covered in this video, you can find more information on the Cancer Research UK website.
On screen text: For more information go to: cruk.org/radiotherapy/side-effects
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Inflammatory Breast Cancer Pictures And Symptoms
The symptoms of IBC include a breast that:
- Quickly changes appearance
- Looks larger, thicker or heavier
- Feels very warm
- Has skin that looks dimpled or ridged like an orange
- Is tender, aches or feels painful
- Has larger lymph nodes under the arm or around the collarbone
- Has a flatter nipple or one that is turned inward
Unlike other forms of breast cancer, there is no lump formation with IBC.
Inflammatory Breast Cancer Pictures of Different Symptoms
Below are some of the pictures of IBC for reference only, you may not experience them at all. If you find anything abnormal with your breast and are concerned, do not hesitate to visit your doctor.
As these inflammatory breast cancer picture shows, the texture of the breast may change and appear to look dimpled or ridged, like an orange peel. This is referred to as peau dorange, which is French for orange skin and it is caused by cancer cells blocking the lymph vessels beneath the skin, which have formed into ridges or tiny lumps.
One of the first symptoms women experience is the breast appearing to be red, pink or purple. The discoloration may look like bruising that covers one-third or more of the breast. It may also feel warm or be tender.
With IBC, the skin may appear to be splotchy or irritated and there may be bumps present.
Inflammatory breast cancer pictures show the discoloration that can appear.