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Internal radiotherapy and radiotherapy during surgery for breast cancer

These types of radiotherapy are not standard treatments in the UK. You might have them as part of a clinical trial.

Internal radiotherapy to the breast is called brachytherapy. You have a radioactive source placed in the area where the cancer was removed. This usually takes place over a few days. 

Radiotherapy during surgery is called intrabeam. You have a dose of radiotherapy to the breast tissue during your operation. 

Internal radiotherapy

Doctors are still collecting information about this type of radiotherapy. They want to know how well it works and more about the long term side effects. So the National Institute for Health and Care Excellence (NICE) recommends that people should only have it as part of a clinical trial.

Your doctor will give you more information if you have this treatment. 

What happens?

You have a general or a local anaesthetic. The doctor puts thin hollow tubes or an inflatable balloon into your breast. These are called applicators.

Diagram showing how you have internal radiotherapy for breast cancer

The applicators can stay in your breast for several days. During this time you need to stay in hospital.

You have treatment once or twice a day. You go to a special room in the radiotherapy department each time you have treatment. You can have painkillers beforehand if you need them. Your treatment team will make sure that you are as comfortable as possible. 

The radiographer connects a machine to the applicators. Then they leave the room and watch you from the next room on a CCTV screen. 

A small radioactive pellet travels into the applicators. Once the pellet is inside the applicator, it gives off a radiation dose. This is not painful and you won't feel anything during the treatment.

This treatment doesn't make you radioactive. You can have visitors while you are in hospital.

After treatment

Your doctor or nurse gently removes the applicators after the last treatment. They can give you painkillers beforehand if you would like them.

You can go home afterwards. The treatment team will tell you how to look after the treatment area. And they will let you know about further check up appointments.

Your skin might go red or darker in the treatment area. The red or darker areas can also feel sore. Your nurse or doctors can give you painkillers to reduce the soreness. They can also give you creams to soothe the skin. The soreness usually goes away within 2 to 4 weeks of ending the treatment.

Radiotherapy during surgery

Radiotherapy during breast surgery is also called intrabeam or intra operative radiotherapy. 

You have one single treatment of radiotherapy during your breast conserving surgery. It’s given directly to the area where the cancer has been removed. 

You might have a course of external beam radiotherapy after having intrabeam radiotherapy.

This type of radiotherapy is still being researched and is only available in a few hospitals in the UK. You should only have this type of radiotherapy in hospitals where doctors have had specialist training and after they have discussed the pros and cons of the treatment with you. You might have it as part of a clinical trial.