"A side effect patients might experience is lymphedema. This is an increased buildup of lymphatic fluid in the tissues, either in the breast or in the arm and hand of the affected side. It's quite problematic for women. They might feel self-conscious. It might feel uncomfortable that the arm feels like it's throbbing or heavy. Clothing may not fit quite right. So we're always on the lookout for lymphedema," Maria Fenton-Kerimian, APRN, AOCNP®, nurse practitioner at Weill Cornell Medicine in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation site-specific side effects in breast cancer.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by March 27, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to side effects experienced with radiation therapy to the breast.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Episode 368: Best Practices for Challenging Patient Conversations in Metastatic Breast Cancer
  • Episode 354: Breast Cancer Survivorship Considerations for Nurses
  • Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices
  • Episode 298: Radiation Oncology: Nursing's Essential Roles
  • Episode 194: Sex Is a Component of Patient-Centered Care
• ONS Voice articles:
  • Could High-Dose Radiation Be the Missing Link in Breast Cancer Immunotherapy?
  • Exercise Program Improves Quality of Life in Patients With Breast Cancer—and Keeps Them Moving Daily
  • Frank Conversations Enhance Sexual and Reproductive Health Support During Cancer
  • How to Handle Even the Worst Radiation Therapy Side Effects
• Clinical Journal of Oncology Nursing articles:
  • Instruments to Evaluate Self-Management of Radiation Dermatitis in Patients With Breast Cancer
  • The Effects of a Clinical Care Model on Quality Process Outcomes in Radiation Oncology
• Oncology Nursing Forum articles:
  • Feasibility of Breast Radiation Therapy Video Education Combined With Standard Radiation Therapy Education for Patients With Breast Cancer
  • ONS Guidelines™ for Cancer Treatment–Related Radiodermatitis
• ONS books:
  • Guide to Breast Care for Oncology Nurses
  • Manual for Radiation Oncology Nursing Practice and Education (fifth edition)
• ONS/ONCC® courses:
  • Radiation Oncology Conference Recordings Bundle™
  • Radiation Therapy Certificate™
• ONS Huddle Cards:
  • Altered Body Image
  • Late Effects of Cancer Treatment
  • Radiation
  • Sexuality
• ONS Guidelines™:
  • Cancer Treatment–Related Lymphedema
  • Cancer Treatment–Related Radiodermatitis
• ONS Learning Libraries:
  • Breast Cancer
  • Radiation
• American Society for Radiation Oncology (ASTRO)
• National Comprehensive Cancer Network home page

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

"The goals of radiation to the breast are typically broken out into three different rationales. Either adjuvant treatment, where the tumor is removed surgically from the breast first and then radiation is delivered to lower the likelihood of return of the cancer. And then the second way it's given is with a curative intent. That may be for tumors that couldn't be fully resected, and the hope is to eradicate the tumor that is still present in the tissue. Lastly, it can be given in a palliative fashion where you're not expecting to completely cure the person of the cancer, but you hope to shrink the tumor enough to relieve symptoms." TS 1:46

"We really try to focus on patients managing fatigue by ensuring that they're having an appropriate, balanced diet with proper macro and micronutrients and that they're having adequate protein intake. We encourage patients to get adequate sleep. There is a culture of people pushing themselves and working into late hours of the night, and this would be quite difficult if you're experiencing radiation-induced fatigue. If someone is familiar and does regular exercise, we highly encourage them to continue that. If someone has not done much exercise and has slipped into a little bit of deconditioning or they're older or more frail, we might refer them for physical therapy or strength training to rebuild some of that stamina and energy." TS 7:56

"One of the key products to use for prevention of radiation dermatitis are silicone patches, and there are many on the market that are worn during the course of radiation or when the skin reaction begins. And they could stay on for several days during treatment, even if you're gently showering around the area. There are many homeopathic creams made from calendula flower, aloe vera, or some kind of combination of these types of products. The real issue with these products is that many of them aren't covered by insurance, so patients have to buy them out of pocket, over the counter. For some of our patients who are more financially challenged, it may be a problem. So I think [it's important] to be familiar with many different products so that patients have access to something that will minimize their skin reaction." TS 14:48

"After 90 days, it may be more common to see some of the cosmetic changes that can happen in the soft tissue of the breast. One of them is radiation fibrosis, which can be like a diffused scar tissue in the breast. It can sometimes cause hardening, retraction, or asymmetry. Sometimes it can cause a tight feeling where people can't stretch their arm to the full extent. We also know that there can be slower healing if surgery is done. For people that have tissue expanders or still want to have corrective plastic surgery, we really encourage them to wait at least six months or longer before approaching any of those plastic surgery procedures." TS 19:55

"Sexual health is such a big topic, but I think that nurses in radiation oncology are in a very good position to discuss that because we see patients for repeated period of time. So, there's maybe a quicker intimacy or familiarity that happens with the nurses in radiation. Personally, I always bring it up at a follow-up visit, which we do about a month after radiation ends. And it's kind of because the dust is settling and people are getting back to their lives." TS 23:53