Breast Fibrosis From Radiation Therapy for Breast Cancer

Fibrosis of the breast after radiation therapy refers to a thickening and stiffening of tissues of the chest wall and breast that often occurs after radiation therapy is finished.

Radiation fibrosis is simply fibrosis—scar tissue—which forms as a result of damage caused by radiation therapy. Fibrosis often begins with inflammation during radiation therapy, with fibrosis that can occur up to 10 years after radiation therapy is completed (but most commonly in the first two years.)

Breast cancer radiation can affect other areas, including:

• The lungs: Radiation can cause radiation pneumonitis in the lungs and inflammation of the tissues of the lungs which can lead, if untreated, to pulmonary fibrosis (fibrosis of the lungs).
• The bones: Radiation can also cause damage resulting in fibrosis to the ribs. On rare occasions, breast cancer survivors may experience rib fractures due to this side effect.

Unfortunately, radiation therapy affects normal cells located near cancer. The DNA of these healthy cells is damaged, as well as small blood vessels in the area which may become damaged or sealed off. When the blood supply to the normal tissue is cut off, the tissue no longer gets the nourishment it needs to function properly. Damage to cells combined with an inadequate blood supply may then scar.

Fibrosis can begin with tenderness and redness which later becomes firm. Fibrosis of the breast can be very frightening as the scar tissue may feel firm like a mass. Many people become anxious about fibrosis, believing that the scar tissue mass is a recurrence of cancer.

There is no specific treatment for breast fibrosis, as fibrosis is by definition a permanent change in the breast tissue—a scar if you will. Treatment is aimed at preventing further fibrosis if your symptoms occur early on during or after radiation therapy, and preserving function after fibrosis has occurred.

Researchers are looking at methods of preventing radiation fibrosis in the breast, both during radiation therapy and during the first two years after radiation therapy when much of this scar tissue forms. In the past, it was thought that fibrosis was completely irreversible—but that thought is changing with methods of modifying fibrosis in those first two years an area of active research. Therapies that have been tried in clinical trials include vitamin E and pentoxifylline among others. Talk to your doctor during and after radiation therapy about these methods, as well as others which are being studied.

Since fibrosis is irreversible, methods to best cope with this symptom are the mainstay of treatment and coping. Some physical therapists, especially those certified in the STAR program for cancer rehabilitation, may work on breaking down some of this scar tissue and increasing mobility in nearby regions of muscle and soft tissues.

For women (and men) who develop radiation fibrosis of the lungs, pulmonary rehabilitation has been helpful for some people.