Both surgery and radiotherapy for breast cancer can cause changes to the appearance of the breast. Sometimes these changes can continue or develop after treatment finishes. These are called late effects.

Changes to the breast after treatment

Surgery and radiotherapy treatment for breast cancer can cause changes to the appearance, size and shape of the breast. If these continue or develop after treatment, they are called late effects.

Changes caused by surgery

Surgery for breast cancer can cause changes to the appearance of the breast.

Scars

After any type of breast cancer surgery there will be a scar. The amount of scarring will depend on the type of surgery you have and how well it heals. Most scars fade with time and become less obvious.

Stretching and massaging the scar area every day during the first year after surgery can help to reduce scarring. Ask your cancer doctor or specialist nurse for more advice.

Breast reconstruction

Breast reconstruction is surgery to make a new breast shape after a mastectomy. It is also sometimes used to improve the shape of the breast after a wide local excision.

After breast reconstruction, there are sometimes dents or irregularities in the outline (contour) of the new breast. It may be possible to fill in these dents using fat cells removed from the tummy area (abdomen) or thighs. This technique is called lipomodelling. The fat cells are removed using gentle liposuction. The whole fat cells are then separated and injected into the breast.

Changes caused by radiotherapy

Usually, radiotherapy side effects slowly get better after treatment ends. Some side effects can develop months or years after the end of radiotherapy. If you notice changes to the appearance or feel of your breast, it is best to have them checked by your doctor or specialist nurse.

Colour

After radiotherapy, the skin of the breast may change colour. It may become darker with a blue or black tinge. It may also be more sensitive. It is important to protect the area from strong sunlight by covering up with clothes or using a sun cream with a high sun protection factor (SPF).

Blood vessels

Sometimes blood vessels under the skin can become dilated. This is called telangiectasia. It can cause lots of thin red lines. This changes how the breast looks, but it should not cause any other problems. Rarely, prominent blood vessels in the skin of the breast or chest can be a sign of more serious conditions. Always talk to your doctor about any changes.

Appearance and size

Sometimes after radiotherapy, the breast may be red and swollen. This usually goes back to normal over a few weeks or months.

Some women develop a hardening or thickening of the breast tissue after radiotherapy. This is called fibrosis. The breast may also shrink slightly over time. This can cause the breast to become harder and smaller than it was. Breast shrinkage is worse in women who smoke. Your doctor may strongly advise you to give up smoking.

Breasts often get bigger with age or weight gain. But if you have had radiotherapy, the treated breast will not always grow to match the other breast. Keeping to a healthy weight can help the breasts stay more the same size.

If the breasts are very different sizes, some people choose to have surgery to reduce the size of the larger breast. The size of the treated breast can also be increased, using fat injections. Your cancer doctor or specialist nurse can tell you more about this.

Breast prosthesis

Some people choose to use a partial breast prosthesis (shell) to help make the breasts look more even under clothing. A breast prosthesis is an artificial silicone insert. It fits over the smaller breast and can be worn inside one side of a bra. Breast Cancer Now has information on different kinds of prostheses.

We have more information on how your breast looks after surgery.

Coping with changes in the appearance of the breast

Women who have a breast removed (mastectomy) may find it hard to accept the change in their appearance. It may change how you feel about yourself (your body image) and affect your sex life. It may also result in problems with depression. Some women choose to have breast reconstruction. You may need support adjusting to the changes.

Having only a small part of the breast removed (wide local excision) will cause fewer changes in the appearance of the breast. This may be easier to adjust to.