Breast Cancer Treatment Q & A with Sri Gorty, MD, Radiation Oncologist & President of the Medical Staff

Q: Why do some women receive radiation therapy treatment for breast cancer and not others?

A: Every woman’s treatment is different. In most cases, women who have had a mastectomy don’t require radiation therapy, unless they have high-risk features such as cancer that has spread into the lymph nodes, a tumor that was bigger than five centimeters or cancer that was not completely removed. Most women who have lumpectomies will need radiation, although there is a small population that will not require it. It depends on each woman’s individual circumstances, including her overall health, age, the stage of her cancer and other factors.

Q: Is radiation therapy ever used as a stand-alone treatment for breast cancer?

A: Rarely. The standard of care includes surgery and/or chemotherapy in addition to radiation. Radiation therapy may be used as a palliative treatment to relieve pain and other symptoms in breast cancer patients who are not candidates for surgery or chemotherapy because of their health or age. In these cases, we can shrink their cancer, and sometimes eliminate it.

Q: How does radiation therapy work to help kill cancer cells after surgery?

A: There’s a 20–30 percent chance that breast cancer will come back after surgery, because of cancer cells that may still present but which we can’t see – even if margins are negative. We use radiation therapy to sterilize those cells. Cancer is like the palm of our hand. What we can see, and what they remove during surgery, is the palm of the hand. What we’re trying to remove during radiation therapy are the finger-like extensions of the cancer. Radiation attacks the DNA of cancer cells, so the cells can no longer divide.

Q: Can radiation therapy be used on all stages of breast cancer?

A: Yes, we use radiation therapy on all stages of breast cancer. It’s almost always used after lumpectomy, and occasionally after mastectomy.

Q: Does radiation therapy make you lose your hair?

A: Not the hair on your head, unless you’re receiving radiation therapy to the head. Radiation therapy for breast cancer will cause you to lose your armpit hair, which most women welcome!

Q: Are there some women who should not get radiation therapy as part of their breast cancer treatment?

A: Women who have advanced metastatic breast cancer, which means the cancer has spread widely, may not benefit from radiation therapy to the breast. And women with some medical conditions, including lupus, are at higher risk for complications when receiving radiation therapy. So we have to monitor them more closely. These complications may include more pronounced fatigue and more severe skin reactions that can look like a bad sunburn.

Q: What are the possible side effects to radiation therapy treatment for breast cancer?

A: There’s a range of side effects; most women fall somewhere in the middle. The main short-term side effects are breast swelling, mild to moderate fatigue and skin changes in the area being treated, such as peeling or darkening of the skin.

Q: What is the biggest misconception women have about radiation therapy treatment for breast cancer?

A: One of the biggest misconceptions is that they’re not safe to be around their family. They think they can’t be around their kids or someone who’s pregnant. That’s not true. When we give radiation for breast cancer, the treatment only affects the patient, they’re at no risk to anybody else.

Q: What else should women know?

A: Breast cancer is one of the most common cancers in women, but don’t take it lightly. If you have a breast mass that you feel, see a doctor as soon as possible. And if you feel something but the mammogram is negative, push for further diagnostic tests like ultrasound or MRI. If you feel something, and feel that it’s growing, there may be something in the breast even if the mammogram shows nothing.

To learn more about diagnosis and treatment of breast cancer at The Robert & Beverly Lewis Family Cancer Care Center, visit: