Side effects of breast cancer treatment often go away once treatment is over, but some can be long term. Side effect management might include home remedies and prescription medications.

Breast cancer treatment options vary widely from person to person. Most people undergo some kind of surgery, but many also receive other treatments, such as chemotherapy, radiation, hormone therapy, targeted therapy, or immunotherapy.

All these therapies may cause side effects, which can vary depending on the type of treatment or the specific drug within each category.

It can be overwhelming to think about what you might experience during breast cancer treatment. But knowing about some of the possible side effects may help you communicate with healthcare professionals so that your treatment is as safe and effective as it can be. And there are ways to manage each set of side effects.

Breast cancer treatment often includes surgery. The goal of surgery may be to remove the cancer or to see whether cancer is also present in your lymph nodes. After breast cancer treatment, you might have breast reconstruction surgery. There are also surgical options for advanced cancer.

Types of breast cancer surgery include:

  • mastectomy or breast-conserving surgery
  • sentinel lymph node biopsy
  • axillary lymph node dissection
  • breast reconstruction

Possible side effects of breast cancer surgery can include:

  • bleeding
  • infection
  • blood clots
  • pneumonia
  • tissue damage
  • drug reactions
  • organ damage
  • pain
  • slow recovery of bowels
  • reduced energy

Most of these side effects are potential risks of surgery, so surgical teams take steps to prevent them.

The surgical team will monitor you closely during surgery to minimize the chance of a drug reaction, and your surgeon will maneuver around blood vessels during the procedure.

Leg pumps, which move your muscles during surgery, can also reduce your chance of developing blood clots.

Managing side effects

Before breast cancer surgery, you might have to wash with a special soap to help prevent infection. After the procedure, you’ll want to sit up and stand as soon as possible to reduce your chance of blood clots.

Moving in this way can also help restore your bowel function and energy levels. To manage pain, a doctor might recommend acetaminophen or a prescription pain reliever.

Chemotherapy is a regimen of drugs that fight cancer. Chemo drugs may be given intravenously (into a vein), by mouth, or directly into your spinal fluid if you have cancer in that area. You might receive chemo to shrink cancer before surgery or to kill any remaining cancer cells after surgery. Chemo is also one treatment for metastatic cancer.

Chemo has many possible side effects, including bruising, bleeding, fatigue, and an increased risk of infection, all due to chemo’s impact on your bone marrow. Chemotherapy can also cause side effects that affect your appearance and the way you feel, such as:

  • hair loss
  • changes to your nails
  • sores inside your mouth
  • nausea, vomiting, or diarrhea
  • appetite loss
  • weight changes
  • menstrual changes
  • fertility changes
  • nerve damage
  • difficulty concentrating (“chemo brain”)

Chemotherapy can sometimes cause infertility, early menopause, or changes to your menstrual cycle. If you enter menopause, you might experience vaginal dryness and hot flashes.

Some people develop neuropathy, or nerve damage, in their extremities. You might have numbness, burning, tingling, or temperature sensitivity. Some chemo drugs also cause hand-foot syndrome, which involves swelling or blistering of your hands or feet.

Managing side effects

A doctor might recommend medication to help with nausea and vomiting. You might also find it helpful to eat foods that are gentle on your stomach, such as bland foods and pudding. Drinking more fluids can help prevent dehydration.

You might receive radiation therapy if your cancer has spread. It’s also an option after a mastectomy or breast-conserving surgery. Radiation uses high energy particles to kill cancer cells.

There are two main types of radiation therapy:

The possible side effects of external beam radiation include breast swelling, fatigue, and skin changes at the site of the radiation. Your skin might darken, develop redness or other color changes, or peel as if you have a sunburn.

The possible side effects of brachytherapy are similar to those of external beam radiation but can also include breast pain, infection, seroma (fluid buildup in your breast), or damage to the fatty tissue in your breast. In rare cases, brachytherapy might cause rib weakness and fracture.

Managing side effects

Because of radiation’s impact on your skin, it can be easy to irritate the area. You might want to try not wearing a bra or choosing a soft cotton bra. Sometimes shoulder stiffness can develop. A doctor or physical therapist might be able to teach you exercises to relieve this stiffness.

Hormone therapy is an option for treating hormone receptor-positive breast cancer. There are several types of hormone therapy that either reduce your estrogen levels or stop estrogen from supporting cancer cell growth.

Types of hormone therapy include:

All these therapies can cause hot flashes, and all but SERDs can cause vaginal dryness. SERMs can also cause menstrual cycle changes and, in rare cases, tumor flares that lead to bone pain and possibly high calcium levels.

Like other types of ovarian suppression therapy, LHRH agonists can cause early menopause symptoms such as mood changes and night sweats.

Other possible side effects of SERDs include:

  • nausea
  • fatigue
  • headache
  • appetite loss
  • pain in muscles, joints, or bones or at the injection site
  • higher cholesterol (a side effect of the SERD elacestrant only)

AIs can also cause muscle, joint, or bone pain.

Men who take the SERM tamoxifen can experience erectile dysfunction and loss of libido.

Managing side effects

If you experience muscle, joint, and bone pain when taking an AI medication, you might choose to switch to a different AI to try to avoid this side effect.

Other options are the medication duloxetine (Cymbalta) and regular exercise combined with nonsteroidal anti-inflammatory drugs (NSAIDs). If these don’t work, you might choose a different hormonal therapy, such as the SERM tamoxifen.

Targeted drugs work by attaching to proteins on breast cancer cells and either slowing the growth of these cells or destroying them. There are many types of targeted therapy, and each has unique side effects. Common side effects of these drugs include:

  • skin changes such as light sensitivity, a sunburn-like feeling, an acne-like rash, dryness, itching, sore cuticles, hand-foot syndrome, and darkening of skin
  • hair changes such as bald patches or faster or slower growth of facial hair
  • eye changes such as burning, dryness, redness, tenderness, or swelling
  • high blood pressure
  • swelling, especially in your feet, hands, or legs or around your eyes
  • nausea or vomiting
  • diarrhea
  • mouth sores
  • shortness of breath
  • fatigue
  • headache
  • increased infection risk
  • organ damage

Less common side effects of targeted therapy include:

  • problems with bleeding or blood clotting
  • slow wound healing
  • heart damage
  • autoimmune reactions

If you’re receiving targeted therapy, your doctor or healthcare team should monitor your symptoms and side effects. It’s a good idea to tell your doctor about all the symptoms you experience, even ones that seem minor. If necessary, your doctor can change your treatment or provide additional support.

Managing side effects

It’s a good idea to tell your healthcare team if you experience any skin changes. If left untreated, these can worsen and increase your risk of infection.

You can manage these changes by using mild soaps and irritant-free laundry detergents. Oatmeal baths can also help soothe your skin. Additionally, the American Cancer Society (ACS) recommends that you stay out of the sun as much as possible.

Acne medication will not work on this kind of rash, even if the rash looks like acne, so the ACS does not recommend trying it.

Your doctor might recommend taking a diuretic (a water pill) to help reduce swelling. They can also monitor your blood pressure and might recommend medication if your blood pressure is high.

Immunotherapy drugs work by improving your body’s ability to fight cancer cells.

Immune checkpoint inhibitors are one type of immunotherapy drug. They prevent breast cancer cells from working on certain proteins in immune system cells. By working on these proteins, breast cancer cells would stop your immune system from fighting the cancer. The immunotherapy drug restores your immune system’s ability to fight.

The common side effects of immunotherapy are similar to those of other breast cancer treatments. They include:

  • tiredness
  • nausea
  • skin rash
  • lack of appetite
  • diarrhea or constipation
  • cough

Two less common but serious possible side effects of immunotherapy are infusion reactions, which you might experience while receiving the drug, and autoimmune reactions, which can occur over time.

Fever, flushing, chills, dizziness, and trouble breathing are symptoms of an infusion reaction. Let a doctor or nurse know right away if you experience any of these symptoms.

Immune reactions happen when your immune system attacks healthy cells and organs, such as your lungs, your kidneys, or your glands, which make hormones. Because of the seriousness of these side effects, you should talk with a doctor about all the symptoms you experience while receiving immunotherapy.

Managing side effects

Physical activity is one possible strategy for managing fatigue. You can start slowly, doing as much as you’re comfortable with, and gradually increase your movement. Prioritizing important tasks during times when you have energy can allow you to rest when you need to.

Many breast cancer treatments can have long-term side effects. For some treatments, the long-term effects are unknown.

While many of the side effects of chemotherapy go away once you’re finished treatment, others — such as early menopause — can become permanent.

If you plan to become pregnant, you can discuss your fertility options with a doctor. The ACS does not recommend using hormonal birth control if you have hormone receptor-positive breast cancer. Fertility and contraception planning should form part of your breast cancer treatment discussion.

External beam radiation can cause long-term changes to the treated area. Your breast might become smaller and your skin firmer. You might find that you’re unable to breastfeed from the affected breast.

Radiation to your breast can sometimes cause nerve damage called brachial plexopathy. And treating your lymph nodes with radiation might lead to lymphedema, a type of pain and swelling due to lymphatic system dysfunction.

One type of hormonal therapy, the SERM tamoxifen, can cause bone thinning in women who have not yet been through menopause. It might also lead to cataracts. AIs can also cause bone thinning, which can lead to complications such as osteoporosis.

Most targeted therapy drugs are new medications, so the long-term effects are largely unknown.

According to a 2021 research review, people with breast cancer may experience mental health concerns such as anxiety, distress, depression, and post-traumatic stress disorder. The effects of treatment can disrupt daily life. Some people also have difficulties with body image as a result of the physical changes that treatment can bring.

To manage distress during breast cancer treatment, you might consider keeping a journal in which you can express your emotions. You might also find it helpful to work with a doctor who is open to hearing all your questions and concerns. Joining a support group for people with cancer and engaging in a spiritual practice can be beneficial as well.

The range of treatment options for breast cancer can seem overwhelming. One way to feel more at ease when having conversations about treatment is to think of some questions to ask your doctor. You can bring these questions to your next appointment.

The ACS has worksheets for tracking radiation side effects and chemotherapy side effects. You can also create your own sheets for tracking the side effects of other breast cancer therapies.

Your healthcare team might be able to help you find support groups in your area. The ACS also has free resources you can use to find support.

Living through breast cancer treatment often means understanding the potential side effects of each therapy. You can often take steps to manage these effects at home.

A doctor might be able to change your treatment plan or recommend an additional treatment in response to a side effect. You can reach out for help from a doctor or look for support groups for people with cancer.