After surgery and/or reconstruction, some women go straight to chemotherapy; they will sometimes have breast radiation therapy after their chemo. Others will have radiation after surgery. Women can also choose to participate in an adjuvant (post-surgery) clinical trial before radiation therapy.
Radiation therapy is almost always recommended if the surgical choice is lumpectomy, since research has shown this reduces the risk of recurrence within the breast if you have an invasive breast cancer. If lymph nodes are involved, then radiation may be recommended after mastectomy or if the tumor is larger than 5cm or the tumor is at or close to margins.
Radiation may be optional in those with a diagnosis of DCIS or intraductal cancer. With this diagnosis, it is important to explore whether the risk of local recurrence is high enough to warrant radiation.
Different types of radiation for breast cancer include: intraoperative radiation (radiation given during breast surgery), internal radiation (where small pieces of radioactive material, are placed in the area that had cancer; this therapy is currently still under study), and external radiation, the most common type.
There are side effects of radiation for breast cancer, including breast pain, skin soreness, redness, or peeling, fatigue, and nausea. There can be long term side effects of radiation for breast cancer too, including lymphedema, or severe swelling, in the arm, hands, fingers, or chest. The risk of lymphedema from radiation therapy is greater in women who have also had many axillary nodes removed during their surgery, and/or who are overweight.