Patient pathway: Mary’s story



- She had a mammogram. Her breasts were put in between two x-ray plates and images were taken from several angles. This hurt a little as her breasts had to be flattened however it was manageable and bearable and not as bad as she had imagined it to be.
- She then had an ultrasound and a breast biopsy. The doctor took a sample of tissue from the breast and sent it away to be analysed in the laboratory.

- Her first treatment was surgery. During surgery the doctor removed the lump and some surrounding tissue (lumpectomy) to ensure that all the cancer was removed. She did not need to have her entire breast removed (known as a mastectomy).
- She was referred to a social worker who could advise her on financial matters. She was also made aware of support groups that could help her and her family.
- After surgery she received chemotherapy (known as adjuvant treatment) for several weeks before her radiation therapy began. Some chemotherapy drugs can cause hair loss and this happened in Mary’s case.
- In addition to this she also was prescribed hormone therapy and HER2 targeted drugs. These are used when a cancer is HER2 positive and hormone receptor positive.

- In this room she was asked by the radiation therapist to lie down on special equipment (breast board) to help get her into the correct position. The breast board helped hold her arms over her head.
- She found this difficult however the radiation therapists were very kind and helped her into position. She had to remove all of her top clothing before getting onto the couch, but she was given a gown to cover herself until she was on the couch.
- Once on the couch she was put into the correct position for treatment and scanned. When the scan was completed she had three permanent tattoos placed on her skin. At first she did not want these, as she was afraid that they would be painful and unsightly. However when she realised that they were not painful and only the same size as a freckle, she did not mind. The tattoos are used by the radiation therapists to position Mary daily.
- The images taken in the CT were sent to the doctor and the planners who decided exactly how much dose Mary would get. This was a plan made specifically for Mary.



During this time Mary found that her skin reaction became more pronounced than during treatment. This worried her however the radiation therapists explained that this was a normal side effect for breast radiation therapy and would get better over time. The radiation therapist gave her the unit number so she could call if she had any further worries.Radiation therapy keeps on working even if your treatment is finished: this is referred to as the cumulative effect.

- At first checkups are every three months, then six months, then annually.
In the comments section below:
Think about the story you have just heard and share your answers to the questions below in the comments section.- What is Mary thinking and feeling during the start and end of her pathway? And why?
- How would you react if you were Mary?
- How would you react if you were a friend of Mary’s?
You can download the full podcast of this story here
To download:- Right-click on “here” above and select “Open in a new tab”. The audio will begin playing in a different tab.
- Click the three dots on the right and then select “Download”. The audio file will now begin downloading.
An Introduction to Radiation Oncology: From Diagnosis to Survivorship

Our purpose is to transform access to education.
We offer a diverse selection of courses from leading universities and cultural institutions from around the world. These are delivered one step at a time, and are accessible on mobile, tablet and desktop, so you can fit learning around your life.
We believe learning should be an enjoyable, social experience, so our courses offer the opportunity to discuss what you’re learning with others as you go, helping you make fresh discoveries and form new ideas.
You can unlock new opportunities with unlimited access to hundreds of online short courses for a year by subscribing to our Unlimited package. Build your knowledge with top universities and organisations.
Learn more about how FutureLearn is transforming access to education