Long-term radiation sequelae after radiotherapy for breast cancer

Long term radiation complications following radiotherapy for breast cancer are reviewed and preventive methods are discussed. Potential complications associated with radiotherapy are pneumonitis and pulmonary fibrosis, cardiac toxicity, skin and subcutaneous complications, lymphedema, brachial plexopathy, rib fracture and radiation induced cancer. Almost all of the late sequelae after radiotherapy are irreversible, so we should keep in mind to reduce the extent and dose of organ at risk in the fields as much as possible. In view of consistency and extent of the survival benefit for radiotherapy a slight increase in second cancer incidence should not be overestimated. (author)