It is rare for patients to need any medication for this. The most common side effect needing attention is skin reaction. Most patients develop reddening, dryness and itching of the skin after a few weeks. Some patients develop substantial irritation.

FRONT VIEW A bright yellow indicates breast being treated B light yellow part of the beam, beam in air, not touching woman C opening of the linear accelerator D arm holder supports woman's right arm

SIDE VIEW A bright yellow indicates breast being treated B light yellow part of the beam, beam in air, not touching woman C opening of the linear accelerator D arm holder

CROSS-SECTION A middle radiation beam B side radiation beam C bright yellow area indicates place where radiation is given to the breast D rib cage/chest wall E heart F lungs G backbone H sternum/breast bone

Some patients develop a sunburn-like reaction with blistering and peeling of the skin, called "moist desquamation." This usually occurs in the fold under the breast or in the fold between the breast and the arm, or sometimes in the area given a radiation boost. Most people with a limited area of moist desquamation can continue treatment without interruption. When treatment must be interrupted, the skin usually heals enough to allow radiation to be resumed in five to seven days. Skin reactions usually heal completely within a few weeks of completing radiotherapy.

What are some of the possible risks or complications?

Minor complications include:

• Slight swelling of the breast during radiotherapy. This usually goes away within six to 12 months.
• The skin becomes darker during the course of radiotherapy, similar to tanning from the sun. In most cases, this also fades gradually over six to 12 months.
• Most women will have aches or pains from time to time in the treated breast or the muscles surrounding the breast, even years after treatment. The reason why this happens is not clear; however, these pains are harmless, although annoying. They are NOT a sign that the cancer is reappearing.
• Rarely, patients may develop a rib fracture years following treatment. This occurs in less than 1 percent of patients treated by modern approaches. These heal slowly by themselves.

More serious complications include:

• Very rarely, patients develop a breakdown of the skin, fractures of the sternum (breastbone) or such severe pain in the breast that surgery is needed for treatment.
• Radiation therapy given to the axillary lymph nodes can increase the risk of patients developing arm swelling ("lymphedema") following axillary (armpit) dissection. Radiation to this area can cause numbness, tingling or even pain and loss of strength in the hand and arm years after treatment. Fortunately, both these treatment effects are very rare.
• Some patients develop "radiation pneumonitis," a lung reaction that causes a cough, shortness of breath and fevers three to nine months after completing treatment. Fortunately, it is usually mild enough that no specific treatment is needed and it goes away within two to four weeks with no long-term complications.
• Radiotherapy may damage the heart. Fortunately, radiation techniques used now treat much less of the heart than those used in the past. Current studies have found no increased risk of serious heart disease in patients treated with modern techniques even 10 to 20 years after radiotherapy treatment was given. However, there is still some uncertainty about the risks of radiation causing heart disease for individuals who smoke or have pre-existing heart disease, or for those who receive certain chemotherapy drugs. It is likely that such risks will also be found to be very small.
• Women age 45 or younger at the time of treatment may have a slightly increased risk (by a few percent at most) of developing cancer of the other breast with time, compared with the risk they would have if they did not undergo radiation. There is a very small risk (perhaps one in 1,000 individuals) that cancers may develop five, 10, 20 or more years later in the skin, muscle, bone or lung directly in the area of treatment.

For a detailed information on breast cancer treatment through radiation therapy, click here.

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