Radiotherapy leaflets

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Radiotherapy
Colchester Hospital
01206 745 055

Side effects from radiotherapy to the breast/chest wall

As with any kind of treatment there is a risk of side effects from radiotherapy. Many people are only affected in a minor way or not at all but there may be side effects during or after the treatment. Some side effects may be long term.

Possible early or short term side effects

These side effects may occur during or shortly after completing radiotherapy and usually resolve within two to six months of finishing treatment.

Expected early side effects (50-100%)

• Tiredness – You may feel more tired than usual
• Temporary hair loss in treatment area

Common early side effects (10 to 50%)

• Skin soreness, skin darkening (similar to sun burn), and skin itching in the treatment area. The skin in the treatment area may become progressively pinker and darker

Less common early side effects (less than 10%)

• Breast/chest wall discomfort – you may find that the treated breast tissue is more tender than normal
• Breast swelling – Radiotherapy can inflame the breast/chest wall. This can result in the area becoming swollen and uncomfortable
• Change in breast size
• Change in breast texture (i.e. the breast may feel firmer)

Rare early side effects (less than 1%)

• Sore throat
• Skin blistering – occasionally areas of skin may break down and leak fluid
• Pneumonitis (temporary inflammation of the lung leading to cough/breathlessness)
• Oesophagitis – for some patients part of the oesophagus (gullet) may be included in the treatment area.  This may cause oesophagitis which may lead to some discomfort when swallowing food

Possible late or long term side effects

Common late side effects (10 to 50%)

• Skin colour change in the treatment area – lighter, darker or pinker
• Subtle changes to breast appearance – change to breast size, shape and texture. The treatment may affect the feeling of the skin in the treated area, giving a leathery feel with loss of elasticity.  The breast may also feel firmer.  Over months or years the treated breast may shrink slightly in size.  If you are unhappy with the size or shape of the breast then please discuss this with your consultant
• Breast/chest wall discomfort including aching and shooting pains, usually mild and intermittent and may occur for some time after radiotherapy
• Worsened cosmetic outcome after reconstruction surgery. For patients who have had a breast reconstruction, fibrous tissue can build up around the reconstruction.  Occasionally the contracture is severe enough to make the breast feel hard and look misshapen.  In these cases the implant may need to be surgically removed with our without replacement of the implant

Less common late side effects (less than 10%)

• Marked changes to breast appearance including changes to breast size, shape and texture
• Breast swelling
• Shoulder stiffness. As a result of radiotherapy some scarring can occur around the shoulder. This can make the shoulder feel stiff and may limit the amount of movement you have.  Exercises can help this
• Lymphoedema of the arm. If the lymph nodes within the shoulder/armpit area are in the treatment area, the radiotherapy can cause damage, which can inhibit the flow of lymphatic fluid through the lymph nodes. This can cause swelling of the arm on the treated side.  Surgery to the lymph nodes can also cause this to happen.  The symptoms can be relieved by exercises or you may be given a special bandage to wear.

Rare late side effects (less than 1%)

• Rib fracture. As well as the lung being included in the treatment area, the ribs will also be treated. The radiotherapy can damage them, making them more brittle and increasing the risk of a fracture
• Increased risk of heart disease in later life. If radiotherapy is given to the left breast/chest wall then it is possible that a small amount of the heart will be in the treatment area. Radiotherapy can cause damage to the heart, which might increase the risk of heart disease later in life, although this is extremely rare
• Fibrosis (scarring) of the underlying lung which can cause breathlessness, cough or changes on X-ray
• Telangiectasia in the treatment area – small visible blood vessels which can be seen on the skin surface.
• Brachial plexopathy.  Nerve damage which may cause pain, numbness or tingling affecting the shoulder and arm
• A different cancer in the treatment area. Radiotherapy can cause cancer, and, a small number of people will develop a second cancer because of the treatment they’ve had. However, the chance of a second cancer developing is so small that the risks of having radiotherapy are far outweighed by the benefits

Contact numbers

Macmillan Advanced Radiotherapy Practitioners
Monday to Friday, 8.30am to 4.30pm
Tel: 01206 745 025

Radiotherapy Reception 
Tel: 01206 745 055

Macmillan Cancer Support (Opens in a new window)
Freephone 0808 808 0000

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