Lasting discomfort after radiation?


Question from Sally: I finished 33 treatments of radiation in August 2003. Is it normal to have redness, discomfort, and pain down the one side of my breast seven months after the treatment finished?
Answers - Lydia Komarnicky, M.D. This would be unusual, but, occasionally, I've had patients with tenderness in the breasts and swelling up to seven months after treatment, with still mild redness. However, make sure you ask your radiation oncologist to take a look at this for you.

I have had a number of patients continue to have tenderness even after the surgery and radiation is done for a few years, and there may always be a little tenderness in the breast. Some women have no tenderness, and some women do have tenderness and swelling.

What I tell my patients now to do, after the radiation, is to massage the breast with a nice moisturizing cream a few minutes a day to try to disperse the fluids in the breast. I think this helps decrease a little bit the swelling and some of the tenderness, but it is an ongoing process, so don't be discouraged by it.

The other thing I would recommend is that if there is tenderness and swelling of the breast, go to a larger bra or cup size. Sometimes, if the bra is too tight, this almost acts like a tourniquet around the breast, keeping the fluid in or making the breast feel engorged or heavy. So trying this is a simple way that can help reduce some of the tenderness.

When you're wearing your bra and you take it off, if you see indentations in the skin on the treatment side, this probably means that you have some fluid in the skin and the bra may be too tight for you. This can keep the breast engorged and feeling tender.
Marisa Weiss, M.D. Also, if you tend to sleep on your stomach or on the same side as you were treated, then the fluid buildup that might happen during the day doesn't get a chance to drain back into the body.

If you sleep on your back, without a bra at night, the fluid does tend to drain away from the breast during the nighttime. In the morning, you will probably notice some improvement. But by the end of the day, you'll probably notice fluid buildup along the lower part of the breast where gravity puts it.
Lydia Komarnicky, M.D. The nipple may feel a little bit hard when the breast is swollen because of the fluid in the breast. Because of the gravity, the bottom portion of the breast may feel firmer.

There are changes in the breast that go on for a year, if not two years, after the radiation therapy is complete. And even though the skin may look normal and the breast starts to feel normal, you can still see these changes ongoing in a mammogram for almost up to two years.
Marisa Weiss, M.D. Sometimes, it can feel confusing because many of the side effects from radiation go away quite quickly, like the redness. But the side effects like the diffused swelling of the breast take longer to go away.

During the first few years after radiation has been completed, the swelling does tend to very slowly improve. From day to day, it's hard to notice the difference. But Dr. Komarnicky and I can usually see improvement in between our checkups, several times a year. 

I have been quite impressed by how much the swelling can go away within the first few years. Even patients who do have a lot of swelling for, let's say, one to three years, can really have substantial improvement after that period of time.

On Wednesday, March 17, 2004, our Ask-the-Expert Online Conference was called Radiation Therapy UpdatesLydia T. Komarnicky, M.D. and Marisa Weiss, M.D. answered your questions about advances in radiation therapy: the newest and best techniques, combining radiation therapy with other treatments, ways to manage, reduce or eliminate side effects, and more.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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