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Radiotherapy is a part of multidisciplinary treatment for breast cancer, but it is not well recognized and is sometimes misrepresented. This study aimed to clarify the recognition and impression of radiotherapy among Japanese breast cancer patients.

A web-based questionnaire survey was conducted to assess the impressions of radiotherapy before and after treatment and the recognition of the knowledge and the source and timing of information about radiotherapy. For a recognition survey, we selected four topics regarding radiotherapy: 1) adjuvant radiotherapy after breast-conserving surgery, 2) the effect of adjuvant radiotherapy, 3) PMRT, and 4) hypo-fractionated radiotherapy. The target population was female breast cancer patients aged 20-79 years diagnosed with breast cancer between 1 and 5 years ago. The first screening survey was conducted among the general population to find the targets. Breast cancer patients with Stage IV disease at diagnosis and no surgery were excluded from the recognition survey.

The survey was conducted in May 2021. We obtained the answers from 309 breast cancer patients who met the eligibility criteria. The median age was 52 years (27-77). There were 46 patients in stage 0, 122 patients in stage II, 31 patients in stage III, 9 patients in stage IV, and 11 patients in the unknown stage without distant metastasis. 46% had a breast-conserving surgery, and 50% had a total mastectomy. 4% had no surgery. 58% of patients were anxious before the treatment. 83% of patients thought radiotherapy was very hard or somehow hard before the treatment, whereas the proportion of patients who thought that decreased to 61% after the radiotherapy. A higher percentage of patients (41%) answered, “treatment was easier than they expected” on radiotherapy compared to surgery and chemotherapy. The percentage of patients who were informed of radiotherapy when deciding on the type of surgery was 88% in breast-conserving surgery patients and 51% in total mastectomy patients. Most patients (94%) who had breast-conserving surgery knew that “adjuvant radiotherapy is a standard treatment after breast-conserving surgery,” but fewer patients (80%) knew the effect of adjuvant radiotherapy. 28 percent of patients who had total mastectomy did not know that “PMRT may be required after total mastectomy.” Few patients (39%) knew that “hypo-fractionated radiotherapy” even after the treatment. Most patients receive this information from diagnosis to surgery, and few know before the diagnosis. The breast surgeon was the primary source of information. Seven percent of patients answered that they might select another treatment if they knew the radiotherapy.

Most people got information about radiation therapy after the diagnosis and expected radiotherapy to be harder than it was. More than half of the patients felt anxious about the treatment.