Whole breast radiation therapy
Whole breast radiation therapy (WBRT) uses high-powered x-rays to kill breast cancer cells.
Cancer cells multiply faster than normal cells in the body. Because radiation is most harmful to quickly growing cells, radiation therapy damages cancer cells more than normal cells. This prevents the cancer cells from growing and dividing, and leads to cell death.
Breast cancer - radiation therapy; Carcinoma of the breast - radiation therapy; External beam radiation - breast; Intensity-modulated radiation therapy - breast cancer; Radiation - whole breast; WBRT
This type of radiation is delivered by an x-ray machine that targets radiation either to the whole breast, or the chest wall (if done after mastectomy). Sometimes, radiation will also target the lymph nodes in the armpit or neck area or under the breast bone.
You may receive radiation treatment either in a hospital or in a private outpatient radiation center. You will go home after each treatment. A typical course of treatment is given 5 days a week for 3 to 6 weeks. Each treatment is scheduled the same time each day for your convenience.
Before you have any radiation treatment, you will meet with the radiation oncologist. This is a doctor who specializes in radiation therapy.
- The doctor or staff may put small marks, or tiny dots on your skin. These marks ensure that you are correctly positioned during your treatments.
- These marks will either be ink marks or a permanent tattoo. Do not wash ink marks off until your treatment is finished. They will fade over time.
During each treatment session:
- You will lie on a special table, either on your back or your stomach.
- The technicians will position you so the radiation targets the treatment area.
- You may be asked to hold your breath while the radiation is being delivered. This helps limit how much radiation your heart receives.
- Most often, you will receive radiation treatment for between 1 and 5 minutes. Each day you will be in and out of the treatment center in less than 20 minutes on average.
Why the Procedure Is Performed
Radiation is used to prevent breast cancer from coming back in the breast, chest wall, or lymph nodes in the neck or the armpit area. When radiation is delivered after surgery is performed, it is called adjuvant (additional) treatment.
Whole breast radiation therapy may be given:
- For ductal carcinoma (DCIS)
- For stage I or II breast cancer, after lumpectomy or partial mastectomy (breast-conserving surgery)
- For more advanced breast cancer, sometimes even after full mastectomy
- For cancer that has spread to local lymph nodes (in the neck or armpit)
- For widespread breast cancer, as a palliative treatment to relieve symptoms
Before the Procedure
Tell your health care provider what medicines you are taking.
Wear loose-fitting clothes to the treatments.
You are not radioactive after radiation treatments. It is safe to be around others, including babies or children. As soon as the machine stops, there is no more radiation in the room.
After the Procedure
Radiation therapy, like any cancer therapy, can also damage or kill healthy cells. The death of healthy cells can lead to side effects. These side effects depend on the dose of radiation and how often you have the therapy.
Side effects can develop early during treatment (within a few weeks) and be short-lived, or they may be more lasting long-term side effects. Late side effects can happen months or years later.
Early side effects one to three weeks after your first treatment may include:
- You may develop some breast swelling, tenderness, and sensitivity.
- Your skin over the treated area may turn red or darker in color, peel, or itch (much like a sunburn).
Most of these changes should go away about 4 to 6 weeks after the radiation treatment is over.
Your health care provider will explain care at home during and after radiation treatment.
Late (long-term) side effects may include:
- Decreased breast size
- Increased firmness of breast
- Skin redness and discoloration
- Swelling in the arm (lymphedema) in women who have had nearby lymph nodes removed
- In rare cases, rib fractures, heart problems (more likely for left breast radiation)
- Development of a second cancer
WBRT following breast-conserving surgery reduces the risk of cancer coming back and of death from breast cancer.
National Cancer Institute. Breast cancer treatment (PDQ). cancer.gov Web site. Updated August 11, 2016. www.cancer.gov/types/breast/hp/breast-treatment-pdq. Accessed September 13, 2016.
National Cancer Institute. Radiation therapy and you: support for people who have cancer. cancer.gov Web site.www.cancer.gov/publications/patient-education/radiation-therapy-and-you. Accessed September 13, 2016.
Reviewed By: David Herold, MD, MBA, radiation oncologist, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.