Radiation and breast appearance

tarry

I've just learned that there are clean margins with my lumpectomy. So now it is onto radation. My breast surgeon says the radiation can have a negative effect on the breast size. Does anyone know how common shrinkage is? Does the amount of shrinkage vary a lot?

bevin

Hello, I have not had any shrinkage beyond what was originally smaller due to the tissue removed during surgery. I am 1 year out from my radiation and even the slightly tanned color has faded. Good luck with your tx. You'll find you get tired about 4 weeks out. Try to take walks it helps.

GabbyCal

Tarry - Congratulations on the clean margins! I've heard that some breasts get bigger and some get smaller. I finished radiation 3 months ago and the radiated breast feels a tiny bit larger than the non-radiated breast. But it's not enough that anyone else would notice. It's a little heavier and contoured. But everyone is different. I'm sure others will be weighing in on their experiences.

I've also heard the size thing changes over time. I'm hopeful that my breast that now is a bit larger will go back to it's more normal size.

Protein is important while you're doing radiation. The May 2010 rads thread has a lot of good information on nutrition. I was told to eat and egg every day. I craved spinach (I'm thinking I needed the iron). Salmon is also good.

Best of luck. 

IllinoisNative

I'm over two months out after radiation.  Most of the color has faded...but my radiated side feels, as Gabby said, heavier.  I don't know if it's larger.  I wouldn't say radiation made it smaller.  Both my breasts look to be the same size visually...but I do have a slight indentation on the breast where they removed the lump.

tarry

Thanks for the good advice and encouraging news!

pj12

Just to add to your info... I am over two years out from radiation therapy to my left breast following lumpectomy. My rad treatments ended in July 2009.



My involved breast was fuller from swelling after surgery, thru radiation and for several months after. I had always previously been quite equal. I wore a D cup. I was not happy that the treated side was probably a half cup size larger than normal. But I, too, had worried about shrinkage so I was glad not to have that happen.


You did have a fairly large tumor and I don't know how that might affect size.


Now 2+ years after, I am pretty much back to normal. The reduction in swelling was so slow and gradual that I did not notice things getting back to the way they were before. My radiated breast is slightly less saggy than my untreated breast but not remarkably so. I hope the metamorphosis is complete!



Best wishes for a good outcome.

cbharvest

Well, I finished 24 radiation treatments in early August. I had the zingers and my fair skin burned horribly, but I'm mostly healed up. Now, two months out, my breast is tight and uncomfortable and SMALLER. It was swollen for a couple of weeks, but it shrank. I can tell it, especially in some tops, but it's not noticable to anyone else. It's not hard, but it's quite stiff when I try to raise my arm and it feels tight. I stretch as much as I can without making it sore. I am hoping this is only a stage I'm going through since it's not been too long.  

elizadevi

Dear CBHarvest and others dealing with this problem

This is probably "radiation induced fibrosis" (RIF) which first makes the breast swell from inflammation as a result of radiation damage. Then the cells shrink and become hard from scarring or fibrotic tissue inside the breast, which makes the breast seem "firm." I found out about it in the Journals of Radiation Oncology. There is one especially good, descriptive article from  Korea written in 2009.  See this article at the National Institutes for Health website. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731868/

I was blindsided when I developed this condition myself as none of the docs had ever mentioned this possibility. Even now, months later, the rad onc has not taken any responsibility or even told me what I have. I believe it is the result of too much radiation combined with a pre-existing auto-immune disease, which makes the breast tissue react with an immune response after being bombarded with radiation. I''ve made up a one page quiry to look at this theory. If you'd like a copy of it just email me at devieliza@gmail.com asking for one.

 

See also: http://www.drbaxter.com/blog/when-radiation-treatment-breast-cancer-not-breast-conserving-therapy.html

From a website in the UK

“The breast may feel hard due to a side effect called radiation fibrosis. The breast tissue becomes more fibrous and less stretchy. For many women, this is quite mild. But for some women the breast can become tender.

The breast tissue may also shrink over many years. The radiotherapy may make the breast tissue contract and this may make the breast gradually get smaller.

Swelling of the breast area

If your breast becomes swollen, see your doctor or breast care nurse. The radiotherapy may have caused problems with the natural drainage of fluid from the tissues. This is called lymphoedema (pronounced lim-fo-dee-ma) and is rare in the breast. Your doctor or nurse can refer you to a lymphoedema specialist, who can arrange for a type of massage called manual lymphatic drainage.

Small red marks on your skin

You may get small, red lines on the skin of the treated area due to tiny broken blood vessels. This is called telangiectasia (pronounced teel-an-gee-ek-tay-zee-a). This is quite a common side effect after radiotherapy. The broken blood vessels affect the look of the breast, but they don't cause any harm and are nothing to worry about.

The skin in the treated area may gradually darken in the years after your radiotherapy. It can look like a deep tan.

Some women get a swelling in the arm called lymphoedema after radiotherapy to the armpit, particularly if they have had surgery there too. These days, specialists do not recommend having both surgery and radiotherapy to the armpit because of the increased risk of lymphoedema. But surgery and radiotherapy to the armpit may both be needed if the lymph nodes there contain cancer cells.

Other more severe, but much rarer, long term side effects may occur. They are not common though, because treatment planning is very exact these days.

Rarely, you can get a continuing cough or breathlessness some years after radiotherapy to the chest. This is due to the radiotherapy causing changes in the lung tissue called radiation fibrosis. Doctors cannot predict who will get this rare side effect.

Some people who have radiotherapy to the left side of their chest may have changes in their heart many years later. But this is very rare.

Women having radiotherapy for breast cancer are often treated from more than one angle. In the past, sometimes part of the shoulder was treated twice – once from each angle. Doctors call that overlapping treatment fields. Nerves in the shoulder were sometimes badly damaged by having a high radiotherapy dose. That caused severe pain and difficulty in using the arm. These days, modern radiotherapy planning includes checks for overlapping radiation fields and so this should not happen.”