Background:Chemotherapy and radiation playa very crucial role in the treatment of breast cancers but also associated with risk for development of second primaries. Hence, the present study was conducted to assess the risk of second malignancies following radiotherapy in patients of breast carcinoma at a tertiary care hospital. Materials &Methods:A total of 50 patients of locally advanced breast cancer (LABC) or metastatic cases(MBC)were taken. LABC were treated with neoadjuvant chemotherapy followed by radical surgery followed by radiation to loco-regional area with or without hormonal treatment and targeted therapy. Ovarian ablation therapywas also considered when required. MBC were treated with palliative radiation as per requirement to site either painful or prone to fracture and also with systemic chemotherapy alone or hormonal therapy alone depending on tumor burden. All patients were followed with a median time of 23 months. Complete demographic and clinical details of all the patients were recorded. Follow-up for second malignancies was mainly conducted through direct contact with the patients at regular visits at out-patient clinics. Follow-up was done and occurrence of second malignancies was recorded. Results: A total of 50 patients were evaluated. The mean age of the patients was 51.5 years. Out of them 31 were locally advanced breast cancer (LABC)while 19 were metastatic cases(MBC). radiotherapy along was done in all 31 of the LABC patients and 16 patients of MBC, while chemotherapy received by all 46 patients at any part of treatment and hormonal therapy alone was done in4 patients. The median follow up post treatment was approximately 23 months. On follow up 5 cases in LABC category and one case in MBC category developed second primary malignancy. Amongst sites of second malignancies 4 have developed in contralateral breast and 2 in lung as large solitary mass. Conclusion:The advancement of newer imaging techniques and facilities had led to early detection of breast cancer. And adjuvant therapy had increased the number of breast cancer survivors. However, further studies are recommended for better exploration of results. Although the absolute risk of development of second malignancies is low, we should consider that the benefits of breast cancer treatment significantly outweigh the risk of adverse effects.