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Radiation therapy for breast cancer - shorter courses, gentler on the heart.

Whole-breast, chest-wall, nodal or partial-breast - planned by a breast-specialist clinical oncologist, delivered with 5-fraction FAST-Forward where suitable and deep-inspiration breath hold for left-sided disease.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private breast radiotherapy costs in the UK.

Indicative ranges across our partner radiotherapy centres.

In short

£8,000–£13,000, done in one week.

Schedule Indicative range
Whole-breast VMAT, 5-fraction FAST-Forward £8,000–£13,000
Whole-breast VMAT, 15-fraction (START-B) schedule £10,000–£16,000
Whole-breast plus tumour-bed boost £12,000–£18,000
Post-mastectomy chest wall RT (± nodes) £12,000–£20,000
Whole-breast + regional nodal irradiation £14,000–£22,000
Partial-breast irradiation (IMPORT LOW) £7,000–£12,000
DIBH set-up and surface guidance surcharge Usually included

Prices vary by centre, by schedule (5-fraction FAST-Forward, 15-fraction START-B, 20-fraction with boost), by whether nodal fields are added and by whether DIBH and surface guidance are used. Boost and DIBH set-up are usually included in the headline fee.

The problem

The right schedule, the right technique, and the heart looked after.

Breast radiotherapy is where private oncology can quietly stick to old habits - 25 fractions where 5 would do, no breath hold where the heart needs it. We fix all three before you consent.

  • 5 fractions where FAST-Forward supports it

    For most whole-breast cases, 26 Gy in 5 fractions matches longer courses on control and toxicity. If you are being offered 20-plus without a clear reason, ask why.

  • DIBH by default for left-sided disease

    Deep-inspiration breath hold typically drops mean heart dose to 1–2 Gy - a lifetime cardiac benefit that costs nothing but a few minutes of coaching.

  • Reconstruction discussed with plastics first

    If chest wall RT is likely, we get the plastic surgeon and oncologist in the same room before the mastectomy - not after, when options are narrower.

When it helps

When breast radiotherapy is the right step.

The situations we see most, plus the one red flag that means MDT-first with neoadjuvant chemotherapy - not straight-to-radiotherapy planning.

  • After breast-conserving surgery (lumpectomy)

    Whole-breast radiotherapy after lumpectomy cuts 10-year local recurrence roughly in half and, for many, improves breast cancer survival.

  • Post-mastectomy chest wall RT

    Recommended for pT3–T4 tumours, positive nodes (usually four or more, and often for one to three) and close or positive margins after mastectomy.

  • Tumour-bed boost

    An extra dose to the lumpectomy cavity for women under 50 or high-grade disease - further reduces local recurrence at the cost of some cosmesis and fibrosis.

  • Regional nodal irradiation

    Supraclavicular, axillary and internal mammary chain fields for node-positive disease - improves disease-free and, in selected patients, overall survival.

  • Partial-breast irradiation

    For selected postmenopausal women with small, low-risk tumours (IMPORT LOW criteria) - a smaller volume treated, better cosmesis, fewer side effects.

  • Local recurrence and re-irradiation

    Isolated in-breast or chest wall recurrence - sometimes retreatable with SBRT, brachytherapy or partial re-irradiation in specialist centres.

  • DCIS after conservation

    Whole-breast radiotherapy after wide local excision of ductal carcinoma in situ roughly halves 10-year ipsilateral recurrence.

  • Red flag: inflammatory or locally advanced disease

    Peau d’orange, rapidly enlarging or fixed tumour needs urgent MDT for neoadjuvant chemotherapy first - not straight-to-radiotherapy planning.

Technique options

Volume, schedule and technique are chosen together.

What each option involves - the volume treated (whole-breast, chest wall, boost, nodes, partial-breast) and the schedule delivered.

  • Whole-breast VMAT / IMRT

    Volumetric arc or intensity-modulated photon therapy across the whole breast - the modern standard. Better dose homogeneity and skin cosmesis than 2D tangents.

  • FAST-Forward (5 fractions)

    26 Gy in 5 fractions over one week - non-inferior to 15-fraction START-B in tumour control and normal tissue effects at five years. Now UK standard for many patients.

  • START-B (15 fractions)

    40 Gy in 15 fractions over three weeks - the established UK moderate hypofractionation, still used where FAST-Forward is not appropriate.

  • Post-mastectomy chest wall RT

    VMAT or 3D-CRT to the chest wall (bolus in selected cases to bring skin dose up) with or without regional nodes. Consider tissue expander position in reconstruction.

  • Tumour-bed boost

    An extra 10–16 Gy to the surgical bed after whole-breast RT. Delivered as sequential photon or electron boost, or as a simultaneous integrated boost (SIB) within a VMAT plan.

  • Partial-breast irradiation (PBI)

    Only the tumour bed with a margin is treated - external beam PBI (IMPORT LOW schedule) or intraoperative RT with TARGIT for selected postmenopausal, low-risk cases.

  • Regional nodal irradiation

    Supraclavicular fossa and axillary levels I–III (with internal mammary chain in selected cases) - important for node-positive disease.

  • Proton beam therapy for breast

    A niche option for young patients with left-sided disease, extensive internal mammary chain involvement or unfavourable anatomy. UK access is limited and evidence still evolving.

Safety and recovery

What to expect during and after - honestly.

Breast radiotherapy is well tolerated by most women. The main things to plan for are skin changes and fatigue in the short term, and - for left-sided disease - protecting the heart with breath hold.

  • Acute skin changes

    Redness, dryness and - in higher-dose areas like the inframammary fold and axilla - moist desquamation from around week 2–3. Peaks 1–2 weeks after the last fraction and settles over 4–6 weeks.

  • Fatigue

    Common by week two of a three-week schedule and for 4–8 weeks afterwards. FAST-Forward 5-fraction schedules generally produce less cumulative fatigue.

  • Long-term breast changes

    Fibrosis, mild volume loss, altered shape and telangiectasia can develop over months to years. Cosmetic outcomes are typically good with modern VMAT and hypofractionation.

  • Cardiac risk (left-sided disease)

    Every gray of mean heart dose adds a small long-term ischaemic risk. Deep-inspiration breath hold pushes the heart away from the chest wall and cuts mean heart dose to typically 1–2 Gy - a real, cumulative gain over a lifetime.

  • Lung dose and pneumonitis

    Small volume of lung receives high dose. Symptomatic radiation pneumonitis is uncommon (under 2 percent) with modern plans, higher when nodal fields are added or with concurrent taxane chemotherapy.

  • Lymphoedema

    Arm swelling risk rises with axillary node clearance and axillary radiotherapy combined. Physiotherapy referral, arm care and early recognition are part of the follow-up plan.

  • Reconstruction outcomes

    Post-mastectomy RT increases capsular contracture and complications after implant-based reconstruction. Autologous reconstruction is generally more radiation-tolerant. Timing (immediate vs delayed) is planned with the plastic surgeon.

  • Second cancers

    A small excess risk (roughly 1 in 200 to 1 in 500 over a lifetime) of contralateral breast, lung and - very rarely - angiosarcoma. Modern IMRT and DIBH keep these risks minimised.

  • Red flags after treatment

    Fever above 38 °C, spreading redness, wound breakdown, new breathlessness or unexplained chest pain need the on-call oncology team or A&E - not a routine appointment.

Reading your radiotherapy summary

Your treatment summary in four parts. Read the last one first.

Whichever schedule you had - 5, 15 or 20-plus fractions with or without a boost - the summary sent to you and your GP keeps to the same shape.

A UK breast clinical oncologist reviewing a patient’s radiotherapy plan

A quiet reminder

Radiotherapy language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the prescription, cardiac dose and follow-up plan before your review, just ask.

  1. 01 Prescription

    Total dose, fractions and schedule

    Total dose in gray, fractions delivered, boost dose if given, and the schedule used (26 Gy in 5, 40 Gy in 15, etc.). This defines what you actually received.

  2. 02 Target

    Whole breast, boost and nodal volumes

    The clinical target volume - whole breast, chest wall, tumour bed, supraclavicular fossa, axillary levels, internal mammary chain - and the planning margin around each.

  3. 03 Constraints

    Heart, lung and contralateral breast dose

    Mean heart dose (goal typically under 4 Gy, ideally under 2 Gy for left-sided with DIBH), ipsilateral lung V20, contralateral breast dose - measured against modern constraints.

  4. 04 Assessment

    Response, acute toxicity and surveillance

    Read this first: skin and fatigue grade, cosmetic outcome, surveillance mammography schedule and any recommended systemic or endocrine therapy continuation.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Breast radiotherapy is usually covered under a cancer benefit when medically indicated. Boost, DIBH and nodal fields are typically included in the RT episode of care.

Frequently asked

Everything we get asked about breast radiotherapy.

Quick answers on 5-fraction schedules, breath hold, mastectomy RT, reconstruction and cost.

  • Why is my radiotherapy only 5 sessions when my friend had 25?

    The FAST-Forward trial showed that 26 Gy in 5 fractions over one week gives the same tumour control and normal-tissue outcomes at five years as older 3-week schedules for many whole-breast cases. UK guidance now supports the 5-fraction schedule as standard for suitable patients. Longer courses are still used where nodal fields, boost, or specific tumour factors mean the 5-fraction schedule is not appropriate.

  • What is deep-inspiration breath hold and do I need it?

    DIBH means you take a comfortable breath in and hold it for 15–25 seconds while the beam is on. Filling the lungs pushes the heart away from the chest wall and typically cuts mean heart dose to 1–2 Gy for left-sided treatment. It is now standard for most left-sided breast radiotherapy and worth insisting on if it is not offered.

  • Do I still need radiotherapy if I had a mastectomy?

    Not always. Post-mastectomy radiotherapy is recommended for pT3–T4 disease, positive margins, and four or more positive lymph nodes - and often for one to three positive nodes based on tumour biology and patient factors. If the tumour was small, node-negative and margins were clear, mastectomy alone is often enough.

  • Will radiotherapy affect my breast reconstruction?

    Yes, meaningfully. Radiotherapy after implant-based reconstruction increases capsular contracture, revision surgery and reconstruction failure. Autologous (own-tissue) reconstruction generally tolerates radiotherapy better. If chest-wall RT is likely, we discuss immediate vs delayed reconstruction with the plastic surgeon and the oncologist together, before the mastectomy where possible.

  • How much does private breast radiotherapy cost in the UK?

    Roughly £8,000–£13,000 for whole-breast 5-fraction VMAT, £10,000–£16,000 for a 15-fraction course, £12,000–£20,000 for post-mastectomy chest wall RT, £14,000–£22,000 with regional nodal irradiation, and £7,000–£12,000 for partial-breast irradiation. Boost, DIBH set-up and imaging are usually included.

  • Am I radioactive after treatment?

    No. External beam breast radiotherapy leaves no radiation behind. You are safe to be near children, pregnant partners and pets straight after each fraction. The only exception is intraoperative radiotherapy with a permanent implant (rare in breast practice), which the team walks you through separately.

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