Education And Debate

Enraged about radiotherapy

BMJ 1994; 308 doi: (Published 15 January 1994) Cite this as: BMJ 1994;308:188
  1. K Sikora
  1. Royal Postgraduate Medical School, Hammersmith Hospital, London W12 0NN.

    The use of radiotherapy in treating breast cancer has meant that many women are able to avoid mastectomy, which is both physically and psychologically damaging. The side effects of radiotherapy, however, are given little attention. Many women have developed brachial plexus injury after radiotherapy for breast cancer, often resulting in severe pain and loss of use of the arm. There is no effective treatment for this injury and little help can be offered. In addition, many of the women did not require radiotherapy of nodal areas. A pressure group has been formed to support these women, to establish the right to compensation, and to ensure that radiotherapy regimens given to future patients will not damage the brachial plexus.

    *Radiotherapy has reduced the number of women requiring mastectomy for breast cancer

    Radiotherapy is an essential treatment for many women with breast cancer. Irradiation of the breast and surrounding draining lymph nodes after surgical removal of the primary tumour means that many women do not need the more mutilating procedure of mastectomy, which has an increased risk of local recurrence.1 Unfortunately, radiotherapy can produce long term side effects, including damage to normal structures in the volume of tissue irradiated.2

    Before 1960 some form of mastectomy was the most commonly used treatment for breast cancer, and few women received radiation as part of primary treatment. During the 1960s conservative approaches, which avoided mastectomy, were developed. These often used orthovoltage radiotherapy. The dose was limited by the tolerance of the skin which …

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