Radiation Therapy

See the current version of the SEER Program Coding Manual under Reporting Guidelines, Section VII: First course of therapy, for complete coding instructions for the radiation data items.

Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Breast cancer is sometimes treated with external beam radiation therapy. This type of radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. Radiation therapy may be given alone or with other types of treatment, such as chemotherapy.

Radiation therapy is regularly used after breast conserving surgery (excisional biopsy, lumpectomy). Radiation therapy is also indicated for high-risk postmastectomy patients. The main goal of adjuvant therapy is to eradicate residual disease, reducing local recurrence. Breast Cancer Treatment (PDQ®) - NCI.

Postoperative radiation therapy is used for early/localized/operable breast cancers when the patient has

  • Axillary node-negative breast cancer (postmastectomy)
  • Axillary node-positive breast cancer (postmastectomy)
    • For one to three nodes, the role of regional radiation therapy to the infra/supraclavicular nodes, internal mammary nodes, axillary nodes, and chest wall is unclear.
    • For four or more nodes or extranodal involvement, regional radiation therapy is advised.

For breast cancer, radiation therapy also has a major role in the palliation of localized symptomatic metastases. Indications for external-beam radiation therapy include the following.

  • Painful bony metastases
    • Strontium chloride Sr 89, a systematically administered radionuclide, can be given for palliation of diffuse bony metastases.
  • Unresectable central nervous system metastases (i.e., brain, meninges, and spinal cord)
  • Bronchial obstruction
  • Fungating/painful breast or chest wall lesions
  • After surgery for decompression of intracranial or spinal cord metastases
  • After fixation of pathological fractures

Document radiation details in NAACCR Item #’s

  • 2620: Text-Dx Proc-Radiation (Beam)
  • 2630: Text-Dx Proc-Radiation Other

See Additional resources for Breast cancer treatment for more information.

Updated: January 10, 2025