Post Radiation Rib pain/tissue scarring

PJOTF · January 2010

Five months post radiation I started developing scarring that appears to touch and sight like a cord running down the side of my ribcage just below the skin. From about the breast level to below the ribcage to my waist area you can feel the scarring like a cord under the skin. It is very painful when pulled on like to reach up for something or bending over sideways.

Most of this tissue area that is scarring is not in the radiated area. I have been massaging the area and doing streatching exercised and the pain is getting somewhat better.

I was just wondering if others has had this type of pain?

In looking for help online I ran into this article:

http://www.uihealthcare.com/depts/respiratorycare/radiate.html

Tissue and Bone Radiation Damage

Radiation Damage of Tissues
The extent and progression over time of tissue damage following radiation depends on the amount of radiation and the fractionation schedule.

Following acute effects, chronic changes may occur which are characterized by a deterioration in the small blood vessels, cells, and fibrosis of tissue. Atrophy and ulceration of soft tissues aggravated by trauma and infection are possible further changes.

Surgery in irradiated tissue can prove to be a major problem with poor tissue healing.

Radiation injury with impaired healing can occur early after therapy but most often appears three to four years after treatment. Following radiation of the breast area it is not uncommon to see progressive chronic degeneration for 10 years or more.

I now wonder how long and how much tissue damage is going to happen when I am not even one year out? I assume that over the 10 years stated above in the article that the effects lessen over time?

PJ

Macc · January 2010

Here's another post that is similar to yours and may help answer your question.

http://community.breastcancer.org/forum/64/topic/743702

As for radiation damage...the article seems to imply that chronic changes occur when there are acute effects so hopefully if one came thro the radiation without acute effects there shouldn't be to much problem in the future. Here's hoping anyway.

Surgery in the radiated area will always be a problem as radiated skin does not heel well and I understand that the radiated breast does not increase in size if one puts weight on as an unradiated breast does.

I hope you get the cording sorted.

Regards

Macc

joycey57 · January 2010

Well I finished rads the end of Sept.09 .It's now Jan. 2010 and I am having promblems with reaching and sore rib area.I thought maybe i was going crazy because I went to see the surgeon to ask about it she sort of said nothing.It is very strange because I always excercised my whole life and lift weights,so I really didn't understand this late development.thanks for posting it.

desdemona222b · January 2010

I had my radiation therapy in 2002. I did not have chemo. I have some issues with nerve damage causing severe pectoral muscle spasms and the breast occasionally gets painful, but I have not seen a steady degradation in the area itself over a long period of time. The damage all showed up within a year of the therapy.

Alli · January 2010

Hi,

I had radiation as well. Approx one year post rads, I developed them same "cording" that you describe. It was a very tender cord from below my breast to my abdomen. You could even see it if you twisted slightly. I was told that it was Mondor's disease of the breast. A rare thrombophlebitis of a vein. Luckily it required no treatment other than motrin and time. It has not come back, but I do get soreness between my ribs at times and some areas that are tender to touch.

Alli

sherrilynne · January 2010

I finished rads in Sept. 09, and still have pain that shoots through the breast. Does anyone know if this will continue forever? Thanks

ruthbru · January 2010

My doctor said that it's the nerves growing back and that eventually it will go away. It's over two years since I finished rads (Aug. 2007), but I still occasionally get those 'zapping' pains up the side and through the breast, (feels like little electric shocks to me). I notice that it's usually after I've sat for a long time (especially on blenchers or other hard chairs/benches)

Alli · January 2010

I still get "zingers" through the breast every now and then. The scar tissue at the surgery site is still tender also. I am almost 3 yrs out of radiation.

ruthbru · January 2010

Alli, that makes me feel relieved to hear, as my whole boob is still tender/achy. It's better than it was; I finally was able to sleep on that side starting this last summer, but still annoying.

Mom_of_boys · February 2010

OK... I thought I was the only one. Finished chemo in April 2009 and rads in July 2009. Only recently, I am having very sore ribs on the radiated side. I, too, am having trouble with reaching as well. I am soooo happy I am not going crazy!

Leah_S · February 2010

Yep, finished rads Aug 09. Sore ribs. Trouble reaching - range of motion LESS than before rads/after chemo. No sore boob though - no boob.

Leah

Chutney · February 2010

whew.....thanks for all the info ladies - I too thought something really strange was going on. Feels like a horse kicked me in the ribs.

AuroraL · February 2010

I have had a cord develop from my breast over my ribs extending down toward my stomach. It has happened to me twice, both in the same area. The first time was after my second lumpectomy and before radiation. It was sore to the touch and whenever I extended my arm up over my head. I called my breast surgeon and she said it happens sometimes and not to worry about it, it should go away. I used a heating pad to ease the pain (it helped) and it went away in about 2 weeks. The second time was just a couple of weeks ago. (I completed radiation in April, 2009) It was not as severe this second time. I can feel the cord when I stretch my arm up over my head, and it feels as if there is a bruise where the cord is, especially over the rib area. Although not as sore this time, it seems to be taking longer to go away completely. I had not found an exact diagnosis--I forgot about it when I went to my check-ups and didn't ask--and I assumed it might be related to lymphedema and axillary web syndrome, because of the cording. I'm curious if it is Mondor's. In addition to this, I have had some continued soreness in my breast that I assume is from the radiation. Not too bad, though, and definitely easing over time.

blueballoon · June 2010

My ribs hurt a bit during the last couple weeks of radiaton, and then after radiation ended, they got more and more painful. And get this: When I told my radiation oncologist about the ribs hurting, she said she had never heard of that before. I regret going to a radiation oncologist who is not a breast specialist. What a mistake.

kira66715 · June 2010

I wanted to post a reference on axillary web syndrome, most cords are clotted off lymph vessels, while Mondor's is clotted veins.

Cording can come and go, and PT's can help.

Cording is a risk factor for lymphedema, but not everyone who gets cords (and many woman do) gets lymphedema.

I had acute axillary web after surgery, with many cords, including one down the side and rest in my arm, and I've had a cord recur a couple of times.

Here's the reference:

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

The initial article you posted talked about the total dose of radiation and the fraction schedule: the usual whole breast irradiation fraction is 180 cGy--the Canadian protocol delivers less radiation total, but higher fractions. I did some research for Binney, who posts on the lymphedema boards, and in the old days of cobalt machines, there was a lot of damage due to high doses and big fractions.

I do think most rad oncs (and I work for one) tend to minimize the side effects. Shortly after rads, I had a massage, and the therapist pushed on a rib, and I ended up with a chest xray, because I was certain it was broken.

Rib fractures are usually on the consent forms for breast radiation.

Kira

sjj · December 2010

I had a chord that ran down from my armpit to the bottom of my ribs immediately after surgery, lasting 2-3 weeks. It has happened several times since finishing radiation in june/09. The last time was so bad my GP sent me for a bone scan to rule out metastasis. I continue to have discomfort in my armpit and across my chest, particularly after doing heavy lifting. It is very slowly improving, but can get a bit discouraging at times. sjj

mrsnjband · December 2010

Hi PJ,

It sounds like you are having cording issues, going to a physical therapist theycan help with this. You might want to find one that is familar with lymphedema. I too had rib pain & issues stretching after radiation. (fall of 2008) I had to have wound treatment & PT for a frozen shoulder from protecting the skin burned from the radiation. I did finally get to where I could sleep on that side.

More recently, I just went to a Lymphedema (LE) therapist. She helped with swelling issues I was still having. She also gave me more streching exercises to help with my remaining range issues.

Unfortunately, I still have some pain in the rib cage area as well as my arm. Some days are better than others depending on what I do that day.

So hoping that you can find some help for you cording & pain. NJ

Spinnerpom · November 2012

I know this is an old thread, but cording is pretty common after lymph node removal, even if you only had a node or two removed. Depending on which way the channel runs, it would be possible to have it in the trunk, but more likely in the arm, traveling from the axillary area down into the wrist.

A lymphedema doc is your first stop; he/she can refer you to a lymphedema therapist. They are practiced in break up the cords, which should dramatically improve your range of motion. The cords can come back and new ones can form, but usually a few treatments will break them up and if they come back, it's usually only once.

Post Radiation Rib pain/tissue scarring

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