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What are typical long-term side effects of radiation therapy for breast cancer that patients should watch for?
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Treatment Side Effects, Radiation Risks, Radiation, Breast Cancer Treatment Side Effects, Breast Cancer Radiation Therapy, Long Term Side Effects, Radiation Side Effects, Breast Cancer Radiation Threatment, Radiation Treatment Side Effects, Breast Cancer, Radiation Therapy Side Effects, Breast Cancer Radiation Side Effects, Side Effects, Radiation Oncology
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Treatment Side Effects
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Radiation Risks
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Radiation
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Breast Cancer Treatment Side Effects
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Breast Cancer Radiation Therapy
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Long Term Side Effects
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Radiation Side Effects
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Breast Cancer Radiation Threatment
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Radiation Treatment Side Effects
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Breast Cancer
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Radiation Therapy Side Effects
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Breast Cancer Radiation Side Effects
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Radiation Oncology
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Expert Answers
NoushinHartMD (Physician - Oncology - Radiation (Verified) ) - 05 / 15 / 2012
In general long-term side effects of radiation therapy depends on several factors:
- the area irriadiated: the larger the area, the more likely to develop side effects
- the age of the patient: the younger the patient, the more likely to develop side effects
- the radiation dose: the higher the dose, the more likely to develop side effects
- the technology used for radiation, the older the technology, the more likely to develop side effects
- the baseline risk for developing side effects: the higher the baseline risk, the more likely to develop side effects
1. Lymphedema:
Sentinel lymph node biopsy has significantly reduced risk of lymphedema but it has not eliminated it. Especially because the practice of completion axillary dissection in patients who have a positive sentinel lymph node biopsy continues. Even before receiving radiation therapy a women who has undergone sentinel lymph node biopsy and/or axillary lymph node dissection has already have a certain risk for lymphedema. Addition of radiation therapy would certainly increase this risk. The most important factor in preventing lymphedema is preventing infection in the affected arm. Any minor cut during cooking, gardening, manicure, etc. must be immediately disinfected and covered. Lifting heavy weight with that arm should be avoided. Repetitive movements of the arm would also have a negative impact on lymphedema. Whether flying is detrimental or not is controversial but most advise wearing a compression garment while flying.
2. Secondary Cancers:
Even though the annual risk is very small (0.5% per year) , the risk over 10 to 20 years after radiation would build up to a reasonable amount. The most common secondary cancer is skin cancer. It is important to remember that these secondary cancers would develop in the irradiated tissues and therefore within the radiation field. In treatment of breast cancer, radiation fields are either limited to the breast itself or may extend to include the lymph nodes above clavicle (aka supraclavicular lymph nodes). In this case, part of thyroid gland might receive some radiation. Thyroid gland is a very sensitive organ to radiation and would be at risk of developing cancer. Other tissues at risk of developing cancer would be soft tissues in the field. These tissues might be at risk of developing soft tissue sarcoma. Obviously risk of developing a second breast cancer is also there not only because of radiation but also because anyone who develops breast cancer, inherently is at higher risk of developing another one.
3. Radiation Pneumonitis
Even though your radiation oncologist would make every effort to minimize the volume and dose of radiation to your lung, it is impossible to irradiate the breast or chest wall without giving any radiation to the lung. Radiation Pneumonitis is a condition mimicking a pneumonia presenting with persistent cough, shortness of breath, fever and chest pain which can occur any time between 3 months to 3 years after completion of radiation. Because of its similarity to pneumonia, it would be treated like a pneumonia but would not respond to antibiotics. Imaging studies would be helpful and would reveal Interstitial Pneumonitis. Treatment of choice would be steroids.
- the area irriadiated: the larger the area, the more likely to develop side effects
- the age of the patient: the younger the patient, the more likely to develop side effects
- the radiation dose: the higher the dose, the more likely to develop side effects
- the technology used for radiation, the older the technology, the more likely to develop side effects
- the baseline risk for developing side effects: the higher the baseline risk, the more likely to develop side effects
1. Lymphedema:
Sentinel lymph node biopsy has significantly reduced risk of lymphedema but it has not eliminated it. Especially because the practice of completion axillary dissection in patients who have a positive sentinel lymph node biopsy continues. Even before receiving radiation therapy a women who has undergone sentinel lymph node biopsy and/or axillary lymph node dissection has already have a certain risk for lymphedema. Addition of radiation therapy would certainly increase this risk. The most important factor in preventing lymphedema is preventing infection in the affected arm. Any minor cut during cooking, gardening, manicure, etc. must be immediately disinfected and covered. Lifting heavy weight with that arm should be avoided. Repetitive movements of the arm would also have a negative impact on lymphedema. Whether flying is detrimental or not is controversial but most advise wearing a compression garment while flying.
2. Secondary Cancers:
Even though the annual risk is very small (0.5% per year) , the risk over 10 to 20 years after radiation would build up to a reasonable amount. The most common secondary cancer is skin cancer. It is important to remember that these secondary cancers would develop in the irradiated tissues and therefore within the radiation field. In treatment of breast cancer, radiation fields are either limited to the breast itself or may extend to include the lymph nodes above clavicle (aka supraclavicular lymph nodes). In this case, part of thyroid gland might receive some radiation. Thyroid gland is a very sensitive organ to radiation and would be at risk of developing cancer. Other tissues at risk of developing cancer would be soft tissues in the field. These tissues might be at risk of developing soft tissue sarcoma. Obviously risk of developing a second breast cancer is also there not only because of radiation but also because anyone who develops breast cancer, inherently is at higher risk of developing another one.
3. Radiation Pneumonitis
Even though your radiation oncologist would make every effort to minimize the volume and dose of radiation to your lung, it is impossible to irradiate the breast or chest wall without giving any radiation to the lung. Radiation Pneumonitis is a condition mimicking a pneumonia presenting with persistent cough, shortness of breath, fever and chest pain which can occur any time between 3 months to 3 years after completion of radiation. Because of its similarity to pneumonia, it would be treated like a pneumonia but would not respond to antibiotics. Imaging studies would be helpful and would reveal Interstitial Pneumonitis. Treatment of choice would be steroids.
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