External beam radiation

External beam radiation is the standard type of radiation. The customary schedule for radiation treatments is every weekday for five to six weeks. Sometimes a supplemental dose, called a "boost," is recommended at the end. The boost usually consists of another five radiation treatments. Each radiation treatment is painless and takes just a few minutes. In many treatment centers, you can set up an appointment for the same time each day so that the treatment becomes part of your daily routine.

How your doctor locates the treatment area
Before you start treatment, the radiation oncologist carefully maps your breast so that the machine delivers radiation to the precise location of where your cancer was. This mapping takes about an hour. It involves placing ink marks on your skin to provide a reference point for the technician administering the radiation.

Sometimes these marks take the form of small, permanent tattoos that look like freckles. Marks may be made with a permanent marker instead of a tattoo. If the marks can't be clearly seen, you'll have to repeat the mapping process at one or more points during your treatment.

Radiation side effects
Radiation is a cumulative process, and its side effects tend to become more of an issue as time passes. Mild to moderate fatigue is the most common complaint. It's a good idea to plan for this possibility so that you can rest whenever you feel the need.

Other side effects include skin irritation, such as itchiness, redness, shininess, soreness, peeling, blistering, swelling, and decreased or increased sensation. Many of these effects may feel similar to those you've experienced with a sunburn. They go away sometime after treatment ends.

In rare circumstances you might experience more serious problems such as swelling in the arm (lymphedema), tender ribs or inflamed lung tissue. The risk of injury to the heart from the radiation is much lower now than in the past due to improved techniques that spare the heart tissue. However, radiation to your left side, although not associated with an increased risk of cardiac death in the future, is linked to a slightly increased risk of coronary artery disease and heart attack. A small long-term risk of secondary cancers from radiation exposure also exists.

Some changes to your breast may be permanent after radiation. These include changes in skin color, feelings of heaviness in your breast, changes in the texture of your breast and even size changes.