Minor Problems Just Over A Year Later

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AlohaGirl
AlohaGirl Member Posts: 213
edited June 2014 in Radiation Therapy - Before, During, and After

I had a lumpectomy in the spring of 2009 and completed rads in June 2009.  Lately I keep getting a rash under my breast and in the lower armpit (the part that got zapped, not higher up) on the irradiated side.  Also, sometimes the lower part of the armpit on that side gets swollen so it is uncomfortable (though not painful).  Anyone else experience either of these effects post-rads?  (I'm pretty sure they are from the rads not the surgery.)  Any suggestions on treatment?  I don't have another follow up visit with the rad onc for several months though I have my general physical week after next and have a follow up with the med onc in a month so I can ask them but I thought I'd check in with you all in the meantime.  Neither of these is a big deal but both are annoying.  Thanks!

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  • dcchef
    dcchef Member Posts: 25
    edited July 2010

    Hi, I finished up my mammosite HDR on 6/11/10.  I have a some pink blotches (looks like a rash) in one area above my lumpectomy incision and a red patch below my incision.  I thought they were radiation burns.  I feel like you, it's not terrible, but annoying.  I have tried putting Aquafor on it, but it doesn't seem to be doing much.  I am due back to the doctor in the fall.  The oncologists did say that burns sometimes do come out after about a month.  I am sorry this wasn't more helpful, but if I learn anything new I will let you know.

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  • Marple
    Marple Member Posts: 19,143
    edited July 2010

    AlohaGirl I wonder if you have lymphedema and/or possibly an infection.  It may not be that but I'd have things checked out sooner than your scheduled visits to the either onch. 

    Good luck and gentle hugs.

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  • chrissyb
    chrissyb Member Posts: 16,818
    edited July 2010

    Hi AlohaGirl, What seems to be a rash could definitely be radiation burns and the swelling lymphedema.  I was told by my radonc that these can both occur upto six weeks after treatment.  Best suggestion...get it check out. Love n hugs. chrissyb

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  • AlohaGirl
    AlohaGirl Member Posts: 213
    edited July 2010

    Thanks for the input!  I did wonder about lymphedema, especially since I have had this problem off and on since I finished radiation.  I finished rads over a year ago so probably not radiation burns, but maybe the skin is extra sensitive there and is reacting to something the rest of my skin isn't.  I have an appointment with my primary care physician next week so I'll let you know what he says.  I suspect he may refer me back to the radiation oncologist who is doing my followup (since I think it is related to rads).  I really appreciate your help and support!  Best wishes to all of you!

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  • Marple
    Marple Member Posts: 19,143
    edited July 2010

    I don't mean to be a gloomy Gus but please mention lymphedema to your PCC.  Radiation can certainly be a contributing factor to LE.

    Gentle hugs.

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  • AlohaGirl
    AlohaGirl Member Posts: 213
    edited July 2010

    I will do that (though I suspect he will just refer me back to my rad onc).  I have been wondering about mild lymphedema with the armpit swelling.  Thanks!

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  • Marple
    Marple Member Posts: 19,143
    edited July 2010

    Sigh, and this is where you might need to be assertive and request a referral to an LE therapist.  A lot of Drs. don't know a whole lot about lymphedema.

    Hugs again.

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  • kira66715
    kira66715 Member Posts: 4,681
    edited July 2010

    Aloha Girl,

      Even though you didn't have any nodes removed, you did have radiation, and it can impact the nodes in the armpit. Unfortunately, most physicians don't know much about lymphedema--it just isn't taught in medical school or continuing education. Especially lymphedema that doesn't involve the arm tends to be misunderstood.

    After radiation, especially if someone has a SNB--which you didn't--there's a lot of breast lymphedema and it can spread to the trunk and arm.

    I'm going to put in a couple of links for you, about finding a lymphedema therapist, and trunk lymphedema. There are women who post on the lymphedema thread who swell in the armpits, and use special bras and pads to control it.

    http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

    http://www.stepup-speakout.org/breast_chest_trunckal_lymphedema.htm

    A sense of fullness in the armpit is described in the second link.

    I hope the links help. 

    Kira

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  • 3monstmama
    3monstmama Member Posts: 1,447
    edited July 2010

    do you think any of it could be related to change in season---is it hotter where you are?--or exposure to sunlight?  Also could you be more sensitive to deodorant and all?  I know we are all likely to be really careful about our sun exposure the first year but it seems to me, as we all hope to be moving on, that a year out we might be less careful.  good luck.

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  • AlohaGirl
    AlohaGirl Member Posts: 213
    edited July 2010

    Thank you all for your input and for the links!  I really appreciate it.  I have been very careful about the sun (probably more so than most people just because I live in Hawaii and am aware of strong the sun is here), but it could be that warmer weather is exacerbating the problem.  I think definitely that is the case with the rash (which comes and goes -- gone right now but I kind of hope it comes back before my doctor's appointment next week), not so much (as far as I've noticed) with the armpit swelling.  I do think lymphedema is a possibility though it isn't painful, just weird and annoying.  (For example, the other day at the gym it kept pinching between my bra and my arm when I moved it in certain ways, and I haven't gained a ton of weight or anything so that isn't the reason.)  I'm pretty sure it isn't a reaction to my deoderant since it is puffy, not rashy, but I will ask the doctor what he thinks.  I'll let you know how the doctor's appointment goes.  If I don't get satisfaction I think the next step is to try to see the oncologist(s) and/or pursue a lymphedema specialist and get to the bottom of this.  Right now it is just annoying but I want to nip it in the bud before it gets any worse if that is a possibility.  (I wish I weren't going to a new primary care physician for the first time with all of this, but what can you do?  I figure I can also talk to the oncologist(s) if he isn't helpful, and/or talk to a lymphedema specialist.)

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  • AlohaGirl
    AlohaGirl Member Posts: 213
    edited August 2010

    So, my PCC wasn't much help (seemed to think the swelling might be lymphedema but didn't say much about it).  Of course there was no rash when I went to see him so he couldn't help with that.  I met the med onc today and he thinks the rash is a fungal infection (gross, I know) and that it is just in those areas because the skin is more fragile because of radiation (hence I don't have it under the other breast, etc.).  He told me to try lotramin.  Hopefully that is all I will need.  As for the swelling, which was of course not much for the appointment but enough of that and tenderness that he could tell something is going on, he is sending me for an ultrasound to see if there is fluid buildup.  So, we'll see what I find out.  I really don't want to go for the ultrasound (worried he is really thinking they might find something else), but I will do it.  I suggested waiting and seeing how the swelling was in a couple of weeks but he thought I should get it as soon as I can get in at the hospital here, and I figure there is certainly no harm (other than a little stress).  I'll let you know what (if anything) I find out.  

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  • Binney4
    Binney4 Member Posts: 8,609
    edited August 2010

    Aloha, lymphedema is an inflammatory condition that, especially in the trunk, often shows up as redness on the skin that can either stay or come-and-go. Any doctor on your team can write a referral to a lymphedema therapist, who should be able to tell you with just a physical exam whether you're dealing with lymphedema or not. I'm glad your doctors will be checking out all the possiblilities, but do have them include an evaluation by a well-qualified lymphedema therapist. If it is lymphedema you want to get treatment promptly, because the sooner it's treated the easier it is to get control and keep it in control, and the lower your risk of serious infection in the area.

    I'm really sorry this has been such a stessful time -- bummer.Frown

    Be well!
    Binney

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  • AlohaGirl
    AlohaGirl Member Posts: 213
    edited August 2010

    Thanks, Binney!  I'm particularly interested in your comment about redness on the skin because in addition to the armpit swelling I have a red patch on my abdomen that doesn't itch and isn't sore, but has been there for a couple of months (maybe three).  My oncologist didn't know what to make of it but thought it could be related to the fungal rash under my breast.  I have a feeling it is another effect of lymphedema.  Sounds like I need to find a therapist (though looking at the sites Kira sent there doesn't appear to be one on my island).  The problem isn't a big deal now, but I don't want it to turn into something more serious.  Thanks again!

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  • hotandcold
    hotandcold Member Posts: 205
    edited August 2010

    Just had to chime in here. If you have lymphedema you don't want it to get worse.   Start calling around to the physical therapy offices and ask it they  have a lymphedema therapist.  Keep calling around and asking and also call other oncology or radiation  Dr.s offices, or go to a breast cancer support group and ask if any of them have a therapist they use.  It took me while fo find one , but it was invaluable.  When I kept trying to explain the full feeling in my armpit my first physical therapist told me to make sure I was washing good under my arms. What they heck!!!. I was so mad and insulted. My surgeon insisted that I didnt have lymphedema and finally my oncologist gave me the referal OK after I found the lymphedema therapist myself. My onco didn't know of one, but agreed to send me. My lymphedema is never painful (thankfully) but  bothersome. It comes and goes and is definitely worse in the summer. Sending you good luck thoughts.

    Corrine 

    Original Dx 08/08. Stage III,  Bi-lat Masectomy, Chemo, Finished 36 Rads 6/09 

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