What is breast radiation like and what side effects should I expect?

@susanmfc - thank you, this make me so hopeful. Do you mind sharing your total radiation does? Mine is 21.9

@triciaot Thank you, this make me so hopeful

More info: I was one of the early adopters of the 5 day radiation, 2022. They no longer do consecutive days and have lowered the total cGy to about 2400-2600, although that is usually personalized.

@jules2026 every so often the nipple area starts to look rough. I guess “pebbly” would be the best description and I’ll kick up the moisturizer for a week. If I stand back and look, it seems like it’s slightly different color but don’t think enough for anyone to notice if not looking for it. Weirdest thing with me is that the irradiated breast is a little larger and firmer than other even now. Mentioned it to radiologist and she agreed it’s a little unusual, most of the time the get smaller and softer.

My lumpectomy was in 2007. I believe it was 5 weeks / 4 or 5 treatments each week, but I'm not exactly positive. I was wore a single sling nearly 24 hours each day, even while sleeping. Several times a day I lay on my back, applied colorless gel to the underside of my breast, and replaced the sling as soon as the gel dried (it took seconds). The sling kept my skin dry so there was no need for cornstarch or powder beneath my breast. It was amazingly sucessful

@mistymar After reading your comment I went looking further for more info as my irradiated breast stayed larger and firmer. I put a fair amount of good will trust in doctors, but I've started getting put off by the response that they didn’t expect the outcome, don’t know why its happening.

With some of my criteria, this is the response I get online:
“Your protocol successfully and aggressively targeted the cancer site while minimizing overall systemic disruption, but it combined three distinct triggers for tissue hardening: a high-dose daily radiation format, a lack of baseline anti-inflammatory estrogen (age 71), and a medication (Tamoxifen) that naturally favors fibroblast activity. Together, these factors explain why the LOQ of your breast remains large, dense, and firm instead of shrinking.”

I just finished my 5 radiation treatments on Wednesday June 10th. I am very fair skinned being blond blue eyed and have had skin cancer. I notice no sunburn and am so surprised! I do not have any fatigue and actually feel pretty great so far. For this I am very grateful since my first grandchild I getting married in July 5th and I am doing the table flower decorations for the reception. So I pray that this continues and I pray that you have the same outcome that I have had. I will be praying for you.

@tpoipu51
Thank you for the good notes. Praying all still hoes well for you. I will be starting my 5 Radiation Treatments next week. Are you planning on taking the 5 years of Letrozole? My surgeon said that I have clear margins, I had surgery 5 weeks ago for invasive ductal carcinoma, Stage 1a, small, ER+, PR+ and HER2- .. will be 77 years old in a few months. Wondering if taking the 5 radiation treatments will make any difference or not in cancer returning to the same place. Any thoughts from those of you with similar surgeries? What I am concerned about is that I also just finished Basal Cell Carcinoma skin cancer surgery on three places, and I currently have a Carotid Body Tumor / Paraganglioma in my right neck. I don’t want the radiation or letrozole to affect my future treatment on my neck. Prayers for all our breast cancer patients! Thanks, Suzanne

@triciaot
Thank you for your information.
I am scheduled to start my radiation next week, with CT simulation first, then the 5 consecutive days the following week. My Radiation Oncologist did not mention every other day, or other option on when the 5 treatments would take place. Was your radiation at Mayo? I read in one of their articles that they are doing 3 radiation treatments after a small lumpectomy for older women. Any one else hear about this?
Hugs and prayers to all of us going through our breast cancer journey. Thanks, Suzanne

@texashummingbird I was at MD Anderson, had radiation therapy using VMAT (volume modulated arc therapy) where the radiation moves in 360 arc, guided by CT. I did the breath controlled where the beam only started when I had inhaled enough air. The radiation was laid out in what looked like concentric ovals with the center getting the most radiation.

Questions I would ask:
-Will the consecutive sessions increase the risk of cell damage (internal not the external skin). Ask: Would you be surprised if I had no hardening of tissue one year from now?
-Is the everyday treatment for the clinics benefit or for you the patient?
-How much cGy will I get each day? (I had 600 cGy, high in today's standards)
-Do you expect the area being radiated will include areas that have lymph vascular system? If so, do you expect that there will be fluid retention? Temporary? If so, will I have follow up care to help me know whether I should apply compression and how much?

The reason I suggest these questions: daily radiation if at a high enough level has the potential to cause more long term damage to the internal tissue.
Asking if he would be surprised about your outcomes means he needs to focus on your specific issues and not just answer with a population-based statistic.
It seems evident to me that a part of my lymph system, not the nodes, don’t work as well, Causing swelling. But my radiation was between 6:00 and 9:00 at the outer area of my right breast - where there are lymph branches. Your target area would be different from mine. Knowing what to look for based on the tx you’re given helps you to know when to bring up a potential problem.
Getting good follow up care is important - I think I didn’t convey my concern well enough, my breast did have some swelling, and it was flushed pink with underlying blood vessels near the skin. I discussed that with them. What I did was loosen the surgical bra a little - no pink! But I ended up with a seroma which may have been because I loosened up the bra. I do not have lymphadema, but I do have a seroma that keeps the breast sitting up a bit - other breast is softening more due to age. But still, they are pretty closely matched, with the nipple at the same level on each side.

BTW, I’m also in Texas, north of Austin. I drive to Houston for tx.