A person with breast cancer may receive radiation therapy as a sole treatment, or as a part of a treatment program. As the radiation passes through the skin to reach the cancer cells, it can damage healthy skin cells. This can cause skin changes that appear as burns.
Oncologists may prescribe this treatment for people with breast cancer, sometimes as a sole treatment, and sometimes as part of a treatment program including surgery, chemotherapy, hormone therapy, immunotherapy, or targeted therapy. The type of treatment will depend on the stage and type of breast cancer.
Radiation therapy kills cancer cells or stops them from growing by using different types of radiation or high-energy x-rays.
While the treatment is painless, it can result in side effects, including skin changes, which may appear as burns similar to mild or severe sunburn.
This article discusses what radiation burns are and why they happen. It also discusses their appearance, other symptoms, and how a person can manage them.
In addition, this article also looks at where to find support.
According to Breastcancer.org, the side effects of radiation depend on the location and type of cancer, the person’s general health, and the dose of radiation.
Some people will experience few or no side effects, while others will experience many.
When people receive radiation treatment daily, or almost daily, their skin cells do not have enough time to regrow between treatments.
This can cause changes to the skin, which can appear as moderate to severe burns.
There are two types of radiation therapy:
External radiation therapy
This is the type doctors use most often to treat breast cancer.
The doctors use a large machine to aim a beam of high-energy x-ray radiation at the affected area of the breast, or the entire breast.
The high-energy x-ray radiation from external radiation therapy kills healthy skin cells in the treatment area, as the radiation passes through the skin to reach the cancer.
Internal radiation therapy
This is a form of treatment in which a source of radiation is put inside a person’s body, near the cancer. This can come in the form of a capsule, seed, or ribbon.
According to the National Cancer Institute, people may experience skin changes over the course of radiation treatment, including:
- Redness or darkening of the skin: The skin may become red on white skin, and darken on darker skin. It can also be painful.
- Dry, peeling, or blistered skin: A person’s skin in the treatment area may become extremely dry and peel. If the skin peels faster than it is able to heal, a person may develop blistered sores.
- Swollen skin: The skin in the treatment area can swell and appear puffy.
- Excessive itching: The skin in the treatment area can itch intensely. It is important that people avoid scratching, which can lead to skin breakdown and infection.
- Moist reaction: The skin in the treated area can become sore, wet, and infected. This most often occurs under the breasts, where there are skin folds.
Skin changes happen gradually during the course of radiation treatment, and may only occur in certain areas.
Breastcancer.org notes that people are more likely to experience them on parts of the body where skin touches, such as under the breast or the armpit. It can also occur in places that have had more sun exposure, such as the upper chest.
Some people experience a change in skin color that lasts for years after treatment.
Not every person who undergoes radiation therapy will experience burns, and different people will experience them in different degrees of severity.
A person may not be able to prevent radiation burns entirely. However, they can take steps to help the skin to be less sensitive during radiation treatment, and help the skin heal after treatment has ended.
From the start of the treatment, a person should moisturize after each treatment and at night with a moisture-rich ointment.
If their skin becomes dry and flaky during the course of the treatment, people should gently cleanse and moisturize more frequently.
Being careful when showering or bathing
A person should use warm rather than hot water, and avoid letting the spray from the showerhead directly hit the treatment area.
The National Cancer Institute notes that a person can shower daily. However, if they prefer bathing, they should do this every other day and avoid soaking for long periods of time.
They should avoid strong or fragranced soaps, and opt for gentle, fragrance-free, moisturizing soaps specifically for sensitive skin.
People should cleanse gently, and avoid scrubbing with loofahs or wash cloths, then, when done, use a soft towel to pat themselves dry..
Avoiding skin-to-skin contact
Skin-to-skin contact can cause friction, pressure, heat, and moisture.
This most often occurs:
- in the armpit
- under the breast
- between the breasts
If a person is not wearing a bra, it may be beneficial to place soft material under the breast.
To help reduce moisture, a person can use cornstarch or baby powder that does not contain talc. To do this, a person can apply it with a clean makeup brush. Another method is to place the cornstarch into a thin sock and gently tap it against the skin.
A healthcare professional may recommend using creams. If this is the case, a person should apply those before the cornstarch.
Before using cornstarch, a person should discuss this with a healthcare professional.
Avoiding picking at blisters or peeling skin
A person should allow the skin to grow back and avoid disturbing the area.
The exposed area may be weepy and painful. A person should inform their doctor of open sores and take steps to stop the area from becoming infected.
They should keep the area clean and dry, and apply a non-adherent dressing.
A person may take over-the-counter (OTC) medication to alleviate pain, or a doctor may prescribe pain medication or antibiotics.
If the problem persists, a doctor may suggest a short break in treatment to allow recovery.
Additionally, a person can:
- Dress comfortably: Wear soft, loose-fitting clothing, and avoid wearing tight or underwire bras.
- Use skin-soothing products: Apply soothing creams and salves for mild irritation, burning, and itching, such as an aloe vera preparation or an OTC hydrocortisone cream. Apply these up to three times a day, but stop at least 1 hour prior to treatment.
- Protect the skin from the sun: Treatment areas will be more sensitive to sun damage; keep them covered and use sunscreen with an SPF 30 or higher.
Skin changes may start a few weeks after a person begins radiation therapy. Many of these changes disappear a few weeks after treatment is over, but some may remain for years, or even permanently.
For some people, skin in the treatment area may always appear darker and blotchy. The skin may also feel thicker and drier than before. Skin in the treatment area will remain permanently sensitive to the sun.
Common side effects of radiation therapy include:
- changes in skin sensation
- swelling in the breast
- discomfort in the armpit
A person may also develop spider veins, or telangiectasias.
Less common side effects include:
People looking for support regarding radiation burns and breast cancer can connect with other survivors at the American Cancer Society’s free Reach for Recovery program. Here, a person can talk online or over the phone with a trained volunteer who has survived breast cancer.
The program offers support for treatment, side effects, talking to family and friends, working during treatment, and more.
Organizations that provide support include:
- The Male Breast Cancer Coalition
- The National LGBT Cancer Project
- Living Beyond Breast Cancer
There are several breast cancer organizations that provide support specifically for people of color. These include:
- African American Breast Cancer Alliance
- Sisters by Choice
- Sisters Network
- Black Women’s Health Imperative
Organizations based in the United Kingdom include:
Doctors often treat breast cancer using radiation. This may lead to changes in the skin which appear as burns. This occurs because the radiation kills healthy skin cells during the process of killing or stopping the growth of cancer cells.
Radiation burns may make the skin appear reddened or darkened, blistered, swollen and dry. The skin can also become painful and severely itchy.
To help manage the side effects, people can moisturize frequently, gently cleanse, avoid irritating blistered or broken skin, protect their skin from the sun, and wear comfortable clothing. A doctor may prescribe pain medication or antibiotics, or may halt treatment for a short while to allow the skin to heal.
The damage may heal in a few weeks after treatment. However, some people will experience discoloration and thicker skin in the treatment area for years, or permanently.