Skin Changes in the Treatment Field

Normal changes post radiation:

  • Hyper pigmentation in the treated area
  • Small broken blood vessels called telangiectasia can appear (even years later)
  • Thickened skin with increased density of the breast tissue for patients with lumpectomy
  • Adherence of skin to the underlying fascia for patients with mastectomy
  • Defined thickening around the scar can be present initially and gradually subsides over time as surgical changes resolve
  • Some patients may have persistent seromas
  • Axillary cording may develop and be observed as a thick visible cord stretching from the anterior axilla to the upper arm or even distally beyond the elbow    

Abnormal changes:

  • New lumps in the breast tissue, scar, axilla or neck nodes
  • New erythema
  • New pain
  • New nipple retraction or dimpling


  • Please refer the patient for imaging and to a surgeon for assessment / biopsy
  • If unsure about thickening of skin, please refer to the surgeon