Breast Cancer

, Volume 24, Issue 1, pp 52–62 | Cite as

Overview on cardiac, pulmonary and cutaneous toxicity in patients treated with adjuvant radiotherapy for breast cancer

  • Icro MeattiniEmail author
  • Marina Guenzi
  • Alessandra Fozza
  • Cristiana Vidali
  • Paolo Rovea
  • Fiammetta Meacci
  • Lorenzo Livi
Review Article


Conservative management of breast cancer represents the standard treatment for early disease. Breast conserving surgery associated with radiotherapy for stage I-II has been proven to be as equally effective as mastectomy in term of local control, distant disease, and overall survival. The growing minimal invasive surgical approach on the axillary region, and the new breast reconstructive techniques, will probably lead to a significant decrease of the rate of side-effects related to mastectomy. Therefore, the adverse events caused by adjuvant radiation still remain a challenge. Cutaneous, pulmonary and cardiac toxicity represent the main toxicities of adjuvant radiotherapy for breast cancer. Safety profile of radiation is strongly dependent on the multidisciplinary management of the single case (systemic treatment, endocrine therapy, surgery), individual characteristics (i.e., co-morbidities, age, habits), and radiation-related aspects. Radiation techniques development, and facilities implementation concerning organs-at-risk sparing systems (i.e., image-guided radiotherapy, tracking systems, respiratory gating), represent brand new tools for the clinical oncologist, that would certainly minimize toxicity profile in the next future. However, data reported from published literature will greatly help physicians, to give to the patients appropriate counseling regarding the efficacy and potential adverse events of treatments, thus optimizing the informed decision-making process.


Cardiac toxicity Pulmonary toxicity Cutaneous toxicity Radiotherapy Breast cancer 



This review work got inspired from the Breast Working Party Workshop “Radiotherapy related-toxicity in early breast cancer” presented by the authors during the 23rd National Congress of the “Italian Association of Radiation Oncology” (AIRO), Taormina, October 2013. We also like to thank Ilaria Francesca Furfaro, Tatiana Masoni, and Cinzia Ciabatti (Radiation Oncology Unit, University of Florence, Florence, Italy), involved in the initial paper’s structuring.

Compliance with ethical standards

Conflict of interest

The Authors declare that there are no conflicts of interest.


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Copyright information

© The Japanese Breast Cancer Society 2016

Authors and Affiliations

  1. 1.Radiation Oncology Unit, Azienda Ospedaliero-Universitaria CareggiUniversity of FlorenceFlorenceItaly
  2. 2.UOC Oncologia RadioterapicaIRCC Azienda Ospedaliero-Universitaria San Martino ISTGenoaItaly
  3. 3.Unità di RadioterapiaULSS 12 VenezianaMestreItaly
  4. 4.Radiation Oncology DepartmentUniversity Hospital of TriesteTriesteItaly
  5. 5.Radiotherapy UnitAzienda Ospedaliero-Universitaria Città della Salute e della ScienzaTurinItaly

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