This handout is for women receiving three to six weeks of radiation to the breast. It describes
how your treatments are given. It also describes how to take care of yourself.
What to Expect at Your First Treatment
Each day, right before your treatment, you will be asked to get into position on a treatment table.
The radiation therapists will help you get into the correct position. Often, this position is laying
on your back with your arms over your head. Some women are treated laying on their stomachs
(called “prone” breast radiation). The first treatment often takes the longest. Tiny tattoos done at
your CT appointment are used to help get you positioned for treatment. Imaging is then done
(i.e. X-ray, CT scan, or MRI scan) and checked by a doctor before your first treatment is given.
You will not feel anything as the radiation is delivered. It takes about 1-15 minutes to deliver a
radiation treatment. 1-2 more tattoos or other skin marks may be made right after your first
treatment is given.
What to Expect as Treatment Continues
Many people getting radiation are concerned about side effects. Common side effects from
radiation to the breast include skin irritation and fatigue. Some women have tenderness and
swelling in the nipple and breast. Side effects usually increase slowly during treatment. They are
different from person to person.
During treatment, you will see radiation therapists every day. Your doctor will see you once a
week, or more often if needed. You may also see a radiotherapy nurse during treatment. Please
tell us if you have questions or concerns about anything. Other ways to reach us with questions
are through MyChart, or by calling the Radiation Oncology Clinic at (608) 263-8500.
Nutrition During Breast Radiation
There is no special diet that you need to follow during breast radiation. Try to eat a well-balanced
diet that includes enough protein. Drink enough fluid—8-12 glasses per day. It is fine to take a
multivitamin or calcium supplement daily. Try to avoid taking high-dose antioxidant
supplements (i.e. vitamin C, vitamin E, vitamin A, melatonin). These may work against the
Radiation Skin Reaction
Skin in treatment sites can become red and irritated. It can also become dry and itchy.
Sometimes, the skin will peel and become moist. This happens most often in skin folds and
Please use skin care products as directed, and report any changes you notice. As your skin
reaction develops, we will watch it closely. We may ask you to change the way you care for your
skin. Some skin reactions can be painful. Tylenol or ibuprofen can be used for pain. If you
need something stronger, let us know.
In order to protect your skin during treatment, please follow the guidelines listed below. You
will need to follow these guidelines during your treatment and afterwards, until your skin has
1. Apply a mild, unscented lotion gently to the skin in the treatment area 2-4 times per day.
Your skin will most likely feel softer and more comfortable with the use of creams and
lotions. Using creams and lotions will not reduce how severe your skin reaction
becomes. Try to avoid using lotion for 1-2 hours prior to your treatment. Some well known
types of skin care products are listed below:
Calendula cream (available at natural food stores)
Vaseline Intensive Care lotion
2. You may continue using your usual deodorant.
3. Bathe or shower using lukewarm or warm water. If you need soap, use one that is meant for
dry or sensitive skin. Rinse well and gently pat dry. Do not rub the skin in your treatment
4. Avoid extreme heat -- heating pads, very hot water in the bath or shower, and hot water
5. Avoid extreme cold. Do not allow the skin to become chilled from exposure to ice or very
cold water or air. You may cool the treatment area gently. For example, you may try using
an ice pack wrapped in a towel.
6. Avoid sunlight or sunlamps on the skin in treatment site. When outside, keep the area
covered with clothing. If clothing does not completely cover the area, use sunscreen with
SPF 30 or higher.
7. Avoid “rough” clothing or clothing that rubs back and forth over treated skin. If possible,
wear a soft, cotton bra without an underwire. Some women are most comfortable without a
bra toward the end of treatment. Others feel most comfortable wearing their usual bra.
8. Avoid using tape on the skin in treatment areas.
9. People who smoke or who use excessive amounts of alcohol may have a more severe
reaction. Quitting smoking is hard. Please let us know if you are interested in quitting.
We can help.
10. If you swim regularly and the chlorine or saline water does not irritate your skin, you may
continue this activity. Please stop swimming if you start to notice that the water is bothering
your skin, or if you develop areas of skin peeling.
Remember: Your skin needs to be clean and dry before each treatment. Lotions and creams can
be applied 2-4 times per day to help your skin feel better. You should not apply lotions or
creams in the 1-2 hour period before your treatment. If your treatment is late in the day, you may
apply a skin care product before your treatment if it will be fully absorbed by the time your
treatment is given.
Sometimes the treated breast becomes swollen and tender during the course of treatment. You
may feel sharp twinges of pain once in a while. The nipple may become swollen or tender.
These side effects lessen when treatments finish. They can last up to 6 months.
To help relieve tenderness: 1) Take two tablets of acetaminophen (Tylenol ) or ibuprofen every
four hours as needed. 2) Lie down and rest with a cool (not icy cold) compress over the breast.
The radiation therapy nurse may have more suggestions for this symptom.
Fatigue (feeling tired) during radiation is common. The severity of fatigue varies from person to
person. Some people feel no fatigue and are able to keep up with their normal routines. Others
feel the need to take a daily nap. Still others change their routines, working only part time, for
example. Some people don’t do anything that requires a large amount of energy. Fatigue can
begin right away, or it can develop after 1-2 weeks of treatment. It can go on for several weeks
to months after treatment has ended. Rarely, it can last for up to a year.
Here are a few tips that may help with feeling tired.
1. Listen to your body and rest when you need to. A short nap during the day or sleeping a
little longer during the night may help.
2. Exercise regularly – daily walks, riding an exercise bike, yoga, or anything else you enjoy.
Go at your own pace. Listen to your body and decrease the intensity and/or frequency of
your exercise if needed.
3. Eat well and drink plenty of water.
4. Try to stop smoking or cut back on cigarette use, and do not drink alcohol to excess.
5. If you work, you may want to keep working. Some people are able to maintain a full-time
job. Others find it helpful to work fewer hours. Many employers understand and will agree
to part-time work. We can schedule your treatment times to fit in with your work schedule.
6. Take advantage of emotional outlets. Pent up emotions can add to fatigue. Talk about your
feelings with family or friends. You may benefit from speaking with a cancer
psychologist or participating in support activities through Gilda’s Club or elsewhere.
7. Make time for activities you enjoy. Take a walk in the fresh air, visit with a friend, or
pursue a hobby during the times you feel most energetic. Do things that help you feel good.
9. If you need help with your basic daily needs, ask your nurse or the social worker to help
you contact your local resources. You may be able to receive help with meals,
housekeeping, personal care, transportation, support groups, and respite care.
10. Accept offers of help from family and friends. If friends ask if they can help, accept it! If
they ask if you “need anything,” they may need specific ideas to be helpful. Often, people
want to help, but don’t know what things you need the most help doing. Things like
mowing the lawn, making a dinner, or watching the kids after school for an hour or two can
help both you and your friends to feel good.
11. Visits from family and friends can be nice, but also tiring. You do not need to be the
perfect host or hostess. Let your family and friends fix dinner, and get the drinks and
snacks for you!
Arm Swelling (Lymphedema)
Swelling in the arm or hand (lymphedema) sometimes forms on the side treated for breast cancer.
This can happen before, during, or after radiation. The risk for lymphedema depends on how
much treatment is needed to the lymph nodes from the armpit area (axilla). Most women have
lymph nodes from the armpit area removed during surgery. This can lead to a blockage of the
normal flow of lymph fluid from the arm to the body. Some women also need radiation therapy
to lymph nodes in the axilla and near the collarbone. After radiation to lymph node areas,
changes to the tissues can also cause lymphedema. If you have questions or concerns about your
risk for lymphedema, please ask your doctor. We may send you to see an occupational
therapist to check for swelling and teach you more about how to prevent it.
What Can I Expect After My Last Treatment?
Usually, the side effects of radiation are at their worst at the time that radiation is finishing. The
skin can continue to look and feel worse for up to 1-2 weeks after your last treatment. Continue
to take good care of your skin and contact the radiation oncology clinic if you have questions or
concerns (608-263-8500). Sometimes, we suggest that you come back to clinic about 1 week
after your last treatment to have a nurse check your skin. Within 1-2 weeks after your last
treatment, you will notice your skin starting to heal. You will also start to notice that your
fatigue is starting to improve. You will have a follow-up visit about 1 month after your last
A diagnosis of cancer brings concerns other than the need to manage the side effects of
treatment. Often, it affects many other areas of your life. Patients feel its impact on their
emotions, marriage, family, jobs, finances, thoughts and feelings about the future, and many
other important areas of life. The doctors, nurses and social workers can help you cope with
these issues. They can suggest support services and resources. Feel free to speak them at any
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©3/2016. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4502