Radiotherapy is associated with an increased risk of arm edema. Radiotherapy after mastectomy must be coordinated with adjuvant multiagent chemotherapy, hormone therapy, or both. Radiotherapy should not be delivered concurrently with anthracycline chemotherapy and should be delivered within the first six months after the mastectomy is performed. Side Effects Side effects of adjuvant therapy for breast cancer must be taken into account when planning therapy. Physicians communicate with their patients through decision aids and patient information materials about the medical condition or procedure, treatment side effects, probabilities associated with health outcomes and impact on quality of life.
Patients differ in the importance they place on the risks and benefits of adjuvant treatments.
The side effects of chemotherapy include nausea and vomiting, mucositis, hair loss and neutropenia. These occur in varying degrees in different chemotherapy regimens and resolve after the treatment is completed. The simultaneous combination of chemotherapy plus tamoxifen is associated with an increased risk of thromboembolism when compared with tamoxifen use alone. The most common side effects of tamoxifen are hot flushes and vaginal discharge. In addition, its use is associated with a slightly increased risk of endometrial cancer, pulmonary emboli and deep venous thrombosis, particularly in women 50 years of age or older.