R

Radial scar: a type of complex sclerosing lesion (see entry) that can sometimes harbour atypical cells, in-situ or invasive cancer.

Radiotherapy: (1) Adjuvant radiotherapy is an essential component of multimodality therapy of operable cancer treated by breast conservation surgery. After wide local excision (see entry) of the tumour, radiotherapy reduces the risk of local recurrence within the same breast, typically in most cases from 15-60% to less than 5%. This is why breast conservation where possible is the treatment of choice in early breast cancer. If the axilla has been sampled and is negative, no further treatment to the axilla is indicated. If the axilla has been formally dissected, there is no need for further radiotherapy to the axilla, even if node positive, as the surgery has formed the definitive treatment of the axilla. More recent studies have explored the use of radiotherapy after mastectomy in node positive patients. Patients who are node positive, in addition to having a higher risk of distant metastasis compared to node negative patients, also have a higher risk of local recurrence within the skin flaps of the mastectomy. Women who are node positive may be offered radiotherapy to the skin flaps even if a mastectomy has been performed. There is also evidence that radiotherapy to the supraclavicular fossa (base of the neck above the collar bone), being the next "station" of lymph nodes above the axilla, carries a survival benefit in women who have otherwise operable breast cancer. Radiotherapy to the previously dissected axilla or the supraclavicular fossa is associated with a higher risk of lymphoedema of the arm on that side. In cases of local recurrence, radiotherapy cannot be re-administered if radiotherapy formed part of the original treatment schedule. (2) Radiotherapy is effective treatment for locally advanced disease involving the breast or axilla. An example of this application is a large tumour in the breast that has ulcerated through the skin, causing an open discharging raw area. Radiotherapy may be used in conjunction with chemotherapy, surgery and endocrine therapy for this condition. (3) Palliative radiotherapy can be used to treat localised symptomatic metastatic disease. An example is in the treatment of painful bone metastasis, where treatment schedules are often short and highly effective. In weight bearing bones, fractures or potential fracture may also need to be fixed surgically, and timed in relation to radiotherapy. 

Reduction mammoplasty: An operation to reduce the size of the breasts. The indications for surgery are down to an individual woman's choice. Women may choose to have this surgery for the physical or emotional attributes of large breast size. There may also be mechanical considerations such as back pain or shoulder strain. There are a variety of techniques to achieve this. Careful consideration should be made of scars, symmetry, altered nipple sensations, wound healing, and lactation in women of childbearing age. Early post-operative complications include wound infection and hematoma (blood clot within the operated breast).