Radiation therapy is one of the pillars of breast cancer management. It’s a lot like getting X-rays, except the beams used are of significantly higher energy.
The different types of radiation therapy used in the treatment of breast cancer will be the subject of future posts. For now, we’ll focus on some of the short- and long-term changes one should expect to appear on the breast skin as a result of undergoing this treatment.
Fast-multiplying cancer cells are particularly susceptible to high-energy X-rays. Because skin cells also undergo frequent division, they, too, will be affected by radiation.
Short-term Changes
The most common short-term side effects of radiation therapy are fatigue, pain and skin changes. The latter generally involve skin breakdown and loss of pigmentation.
The skin irritation that follows exposure to radiation resembles that experienced with a sunburn. Symptoms include redness, swelling, tenderness, and itchiness. Peeling and blistering can also occur. This can be more extensive in skin folds and in the underside of a breast, giving rise to what is known as a moist reaction. The latter involves significantly more discomfort.
Short-term changes tend to appear within weeks of radiation therapy. They may persist – and even worsen – for a couple of weeks once treatment ends, as the healing process takes over.
Long-term Changes
Long-term changes tend to be the result of scarring, fibrosis, and blood vessel damage.
Breast tissue can become firmer – and even shrink. Tanning and even darkening of the skin exposed to radiation is also a possibility. So is some red discoloration, especially around any surgical scars.
Lymphedema – the swelling of lymph nodes in the armpit area – can also occur.
These changes may take anywhere from months to over a year to resolve. Sometimes, they can be permanent.
Treatment Considerations
Always notify your radiation oncologist or nurse of any discomfort you might be experiencing during or as a result of radiation therapy.
For the most part, the discomfort caused by short-term changes can be easily treated. Symptoms of fatigue can persist for months, though.
Depending on the amount of breast tissue removed during lumpectomy, changes related to radiation therapy can lead to a permanent deformity. In those cases, breast reconstruction surgery should be considered.