Radiation therapy for breast cancer can have many manageable side effects, including changes to your skin, fatigue, and lymphedema. Some side effects are more common for specific types of radiation.

Radiation therapy is one of several types of breast cancer treatments. It may be used alone to treat metastatic breast cancer or often in conjunction with surgery or chemotherapy.

Side effects can vary, depending on the kind of radiation therapy you have and your response to it.

Knowing what to expect and potential side effects can help you prepare for treatment.

Skin changes are some of the main side effects of external radiation. These changes occur in the area being treated by the radiation. It’s similar to a sunburn and can include:

  • soreness
  • blisters
  • peeling
  • redness or other color changes
  • itching
  • dermatitis

These changes happen gradually throughout treatment, and in some people, they can last for years after treatment.

Some people also develop spider veins in certain areas months to years after treatment.

What to do

You can manage skin changes and side effects by:

  • keeping the area moisturized daily with A&D or Aquaphor
  • dressing in cotton, loose-fitting shirts
  • avoiding underwire bras
  • using warm water instead of hot in the shower
  • avoiding strong soaps and cleansers with fragrances

Fatigue is also common, with more than 70% of people reporting it during cancer treatment. It does not improve with rest and can affect concentration, daily activities, and speech.

Tell your doctor about your fatigue. Although no treatment is available, they might be able to provide ways to help.

What to do

You can manage fatigue with:

Some people experience lung inflammation months or years after radiation therapy to the chest. This is called radiation pneumonitis.

If the heart is significantly exposed because of radiation to the left breast, injury to the heart can occur, causing damage to the arteries or valves.

With today’s technology that uses focused radiation beams, these complications are rare.

What to do

Methods to avoid injuring the heart and lungs include prone breast radiation therapy, where you lie on your stomach instead of your back, and the breast hangs through a hole in the treatment table. This reduces exposure to your heart and lungs.

You may also try deep inspiration breath hold, which minimizes heart and lung exposure to radiation doses.

Radiation can increase the risk of lymphedema, even years after radiation therapy.

If your lymph nodes have been removed, you’re at risk for lymphedema because their removal interrupts lymph flow, leading to swelling. Radiation to lymph nodes can cause scarring and blockages.

See your doctor if you experience:

  • swelling in the hand
  • arm weakness
  • trouble moving the arm or joints

They can do an exam to confirm if you have lymphedema

During and after treatment, you can help reduce the risk of lymphedema in the following ways:

  • ask for injections and blood draws to be done on the opposite arm
  • carry your purse and heavy items with the other arm
  • use a clean razor when shaving underarms
  • do approved exercises to improve lymph flow
  • consult a massage therapist or physical therapist for manual lymphatic drainage treatment
  • eat a low sodium diet
  • avoid temperature extremes

What to do

Talk with your doctor and healthcare team about ways to reduce your risk of lymphedema and how to detect it. If it does occur, treatment typically involves exercise, bandages, and massage therapy.

You may also consider lymphovenous bypass surgery, which has been found to improve arm swelling and lymph flow in people with lymphedema.

The two main types of radiation therapy for breast cancer are:

Each type has several subtypes, mainly differing in how the radiation is delivered to the body.

External beam radiation therapy can include:

  • whole breast radiation
  • accelerated partial breast irradiation
    • intraoperative radiation therapy (IORT)
    • 3D-conformal radiotherapy (3D-CRT)
    • intensity-modulated radiotherapy (IMRT)
  • chest wall radiation
  • lymph node radiation
  • proton therapy for breast cancer
  • prone breast radiation therapy

Brachytherapy can include:

  • intracavity brachytherapy
  • interstitial brachytherapy

Your doctor will discuss the types of radiation and which may be most appropriate for you. Your larger treatment and tumor location and spread will also be considered.

While common side effects are typically from external beam radiation therapy, brachytherapy also has some. Side effects can include:

  • redness or other color changes at the treatment site
  • breast pain
  • infection
  • damage to fatty tissues
  • collection of fluid in the breast

Before starting radiation therapy, talk with your doctor about what to expect before, during, and after each therapy session. Ask them about possible side effects, how to reduce your risk of them, and best treatments.

Knowing what to expect can reduce anxiety and help you prepare.

During and after radiation therapy, tell your doctor about side effects you may have, even if you think it’s harmless. They can provide tips and tricks to cope and monitor anything that may interfere with your health.

Breast cancer treatment support groups

Support is important during treatment. Whether in-person or online, having a group that knows what you’re going through and can provide emotional support can be valuable.

Resources include:

Radiation for breast cancer is a common part of treatment plans. It will have side effects, many of which are manageable.

Talk with your doctor before starting treatment about possible side effects, how to reduce your risk of developing them, how to manage any that arise, and when to seek immediate attention for concerning side effects.

Knowing this can help you feel prepared and in control for your radiation treatment.