Radiotherapy

Even after the complete surgical removal of a malignant breast tumor, follow-up radiotherapy is often recommended. This is because microscopic cancer cells may still be present—cells that are invisible to the surgeon but could later cause a recurrence of the disease, either locally or in other parts of the body. Some precancerous conditions, such as ductal carcinoma in situ (DCIS)—a precursor to invasive breast cancer—can also lead to recurrence in the breast. Therefore, radiotherapy is often performed even in cases of DCIS. In certain situations, radiation of the chest wall and lymph node regions may be indicated after a mastectomy as well.

Today, radiotherapy is administered almost exclusively using a linear accelerator, which emits ionizing radiation (photons or electrons). These rays interact with the irradiated tissue and can lead to the destruction of cancer cells. One advantage of linear accelerators is the ability to deliver high-dose radiation in relatively short treatment times.

With careful planning and execution, significant side effects can usually be minimized. It’s important to distinguish between Acute side effects, such as: Skin redness, Superficial skin lesions, Breast swelling, Fatigue.
These typically disappear completely after treatment ends. And Late side effects, which may appear weeks or months after the end of treatment and may be permanent, such as: Skin changes or Breast tissue hardening. Side effects involving the ribs, lungs, or heart are rare. To minimize exposure to these organs—especially the heart—modern technologies enable three-dimensional, respiratory-gated radiotherapy. This means the radiation is only delivered during inhalation, when the heart is furthest from the radiation field. If the lymph node regions must also be irradiated, the risk of arm swelling (lymphedema) increases slightly.