Breast Shrinkage 10 Years After Radiation for Breast Cancer?

Hi there. My mom is a 10 year breast cancer survivor treated with lumpectomy and radiation. She has recently noticed the treated breast has shrunk in size. She had a normal CBE and diagnostic mammogram. Is this normal for the breast to shrink in size after so many years? What can be done?

Doctor Answers 4

Breast shrinkage 10 years after radiation for breast cancer.

Hello!  It is common for the breast to undergo shrinkage from the radiation.  Depending on the deformity and asymmetry - options include an implant, but more likely mobilizing tissue to reconstruct the lumpectomy defect or simply fat grafting. 

Fat grafting has become a popular procedure to improve aesthetic outcome following breast reconstruction or for improvement of contour after lumpectomy. Much of the newest research has investigated the properties of fat, in terms of its stem cell properties and associated advantages. It has significantly ameliorated radiation damage by increasing vascularity. Also, it adds additional "fatty tissue" atop the reconstructed breast mound to further contour any concavities or deformities, while also masking implant visibility with rippling and such.

At our Breast Reconstruction Center, we have utilizing this technique almost routinely to maximize the aesthetic outcomes after lumpectomy or mastectomy. We have utilized the micro-fat grafting technique, and have been obtaining maximal fat graft survival into the breast. After harvesting of the fat from areas with excess fat, usually the belly, hips, or thighs, the fat is processed and injected back into the breast using the aforementioned techniques. Our patients have been very happy with the results as well as the areas where the liposuction was performed. Contour has been much improved using the micro-fat grafting technique, and the downtime is minimal.  Fat grafting has become a mainstay in breast reconstruction and has added another edge to breast reconstruction for aesthetics with minimal morbidity and complications.

Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Radiation effects are permanent and may cause long-lasting change.

The effects from breast radiation are permanent changes that can lead to progressive atrophy, fibrosis, and vascular compromise even years later. Contracture changes are common. It is often advised to perform  operations on the contralateral breast to achieve a symmetrical appearance rather than to operate on the radiated breast. This is due to the significantly higher rates of complications that occur in radiated breasts. If one has to operate on the radiated breast, procedures which bring in healthy, non-radiated tissue (ie a Latissimus muscle flap) produce the best results. Fat transfer has shown some promise in improving contour deformities of radiated breasts as well. A consultation with a Plastic Surgeon with experience in breast reconstruction will allow you to understand what your mom's options may be.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 25 reviews

It is very common to see sever changes post radiation treatment

The common outcome of the radiation treatment of the breast tissue is shrinkage and breast changes. The treatment options are limited to flap reconstruction. The use of implants is not recommended because of complications and unsatisfactory results.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 124 reviews

Options to treat long term effects of radiation for breast cancer

Radiation treatment for breast cancer causes permanent changes to the breast which limits the surgical options. Shrinkage after ten years is uncommon though. Sometimes the natural changes to the unaffected breast make them look more asymmetrical. Regardless, options are to reduce/lift the unaffected breast or do a muscle flap procedure to the radiated side. Implants in a radiated breast are more prone to problems such as capsular contracture.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 53 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.