Side Effects of Breast Cancer Radiation

Written by Ann Pietrangelo | Published on June 26, 2014
Medically Reviewed by George T. Krucik, MD, MBA on June 26, 2014


Radiation therapy uses high-powered X-rays to kill cancer cells. It’s a type of targeted therapy often used in breast cancer treatment. The radiation may be aimed at the tumor site, the lymph nodes, or the chest wall. It attempts to stop cancer from spreading, or decrease the risk of recurrence.

External radiation treatment is typically given five times per week, for five to seven weeks. A newer approach gives larger doses of radiation over three weeks (accelerated breast irradiation). Most people tolerate radiation therapy well.

Your doctor may recommend internal radiation (brachytherapy). This is a procedure in which tiny pieces of radioactive material are placed around the tumor site. Total treatment time can range from hours to about a week. There are fewer short-term side effects with targeted therapy, and it spares healthy tissue. According to, the long-term side effects of this method are not yet known.

Short-Term Side Effects of Breast Cancer Radiation

Because it’s administered daily over many weeks, conventional external beam radiation therapy is a huge time commitment. The process can interfere with work and family responsibilities, especially if you lack transportation or don’t live close to a treatment facility.

You should plan on being there for 30 minutes to an hour, even though the actual treatment only takes about 10 minutes. Getting in position takes time and precision. The hectic daily schedule may cause you emotional upset, stress, or anxiety.

The most common side effect of radiation therapy is skin irritation in the targeted area. After the first few treatments, your skin may feel sensitive and begin to turn pink. It may eventually begin to look and feel like a sunburn, itching, peeling, or blistering. Soreness and tenderness are common. Any irritation may get worse as treatment continues. However, you can expect it to get better in the weeks following your final treatment. 

You may lose underarm hair if the radiation was targeted to your underarm area. You might also perspire less under that arm. These side effects are usually temporary.

Many women undergoing breast cancer radiation experience growing fatigue as the weeks go by. Fatigue almost always begins to clear up within a few weeks of the last treatment.

Long-Term Side Effects

Because radiation is targeted to a specific area of your body, your radiation team will spend a lot of time on “marking” prior to your first treatment. That is, they’ll take careful measurements to check and double-check that the radiation will hit the correct area and nothing else. Then they’ll make small ink marks on your skin to use as a guide for future treatments. These marks are typically tattooed onto your skin permanently.

It could take months or years for skin to return to normal color if it gets significantly darker at the site of radiation. In some cases, minor discoloration may be permanent, or skin may appear thicker or firmer. Skin sensitivity or tenderness can sometimes last for months.

Radiation can cause some nerve damage resulting in numbness and pain. Radiation therapy can limit your reconstruction options or your ability to breastfeed. These are risks you should discuss with your doctor before you begin treatment.

Rare Side Effects

If you had lymph nodes removed before getting radiation, you’re at increased risk of a blockage of the lymph system (lymphedema). This can cause swelling of the arm where the nodes were removed.

Other rare complications include:

  • fractured rib due to weakened rib cage
  • inflamed lung tissue
  • heart damage when radiation is given on the left side of the chest
  • secondary cancer caused by radiation

Tell your doctor if you’re experiencing shortness of breath, trouble swallowing, or chest pain.

Dealing with Breast Cancer Radiation Side Effects

You can’t necessarily avoid side effects of radiation therapy, but there are some things you can do to minimize them.

Wear loose-fitting clothing if you’re experiencing skin irritation. If you wear a bra, choose one without underwire.

Ask your doctor if there are special products you should use on your skin while bathing. Check with your medical team before using ointments or creams on the treated area. Try not to rub or scratch the area, and avoid ice packs and heating pads.

Fight fatigue by getting plenty of rest. Give your body the nutrition it needs to repair itself. Report any side effects to your radiation oncologist.

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