What do you use for pain from radiation fat necrosis or calcification?

Posted by Rubyslippers @triciaot, Dec 28, 2023

I’m 14 months post radiation and started having a different pain in my breast where the radiation was focused. Because my lesion was in the lower outer quadrant the pain also is along the suture line and then up into the breast about 2 in.
My guess is that it is either radiation induced fat necrosis changes or calcifications from the radiation. I’ve read that capsaicin might be best for this type of pain. I don’t have any, so I put a 4% lidocaine patch on the area - waiting to see if it works.
I wake up with pain in the middle of the night and in the morning. Then sometimes in the middle of the day the pain increases and I have to stop what I’m doing for a moment. It does seem to pass or becomes so minor I ignore it.
Any help you can give me for the best pain relieve would be great! Thanks!

Interested in more discussions like this? Go to the Breast Cancer Support Group.

Colleen Young, Connect Director | @colleenyoung | Jan 7 2:07pm

Using the search function of the Breast Cancer support group, I found related discussions in these search results:
- fat necrosis https://connect.mayoclinic.org/group/breast-cancer/?search=fat+necrosis#discussion-listview
- radition and pain https://connect.mayoclinic.org/group/breast-cancer/?search=radiation+and+pain&index=discussions
.
@triciaot, how is your pain? Has it subsided?

hollyng | @hollyng | Jan 7 2:54pm

What does your radiation oncologist say about this?

Rubyslippers | @triciaot | Jan 7 5:27pm

In reply to @colleenyoung "Using the search function of the Breast Cancer support group, I found related discussions in these..." + (show)

Thank you for the links to discussions. I usually look through the various topics, but obviously haven’t used the search function! It’s nice to know these topics can more easily be found than just by reading through so many posts!
The pain has subsided. I understand how cut nerve endings can hurt and may heal on varying timelines. But this was different, and it’s pretty much gone now. I will contact the survivorship NP if it comes back. Although I think it falls in the normal range, and recommendations would most likely be “wait and see”. They might write a prescription pain reliever, but I’d only take something like gabapentin if the nerve pain was really bad.
Thanks for responding! It is always nice to see the comments you post!

Rubyslippers | @triciaot | Jan 7 5:49pm

In reply to @hollyng "What does your radiation oncologist say about this?" + (show)

I was debating on contacting the oncologist - although at my cancer center messages and conversations usually go through survivorship first. They will bring in the oncologist if needed. I’m also 3 1/2 hours from the center so I hesitate to get into a situation that would involve the 7 hr round trip, unless I really wanted the doctor to address the issue. I have sent photos and used telehealth - and I’m comfortable using this, but this type of pain means they need to palpate the area. Gotta be hands on.
It was right around the holidays when this started and I knew I wanted to avoid a day or two trip to Houston if I could.
The pain has subsided into just tender to the touch. But if it returns I will contact the doctor.
I really want a better “orientation” to my “new breasts”. (I had a breast reduction along with the lumpectomy.) I’d like a lump by lump map of my breast, like, here’s where the DCIS was removed and a lymph node probably was cut out along with it, here’s where we removed lots of tissue to reduce the size - and and you can feel the different sections that were fit together, this is where the nipple pedicle was run and may cause raw nerve endings, yada yada yada
Maybe it’s an unusual request, but I’d just like to know which of the lumps and valleys are expected to meld together, and which ones may continue to have extra lymph fluid waiting to be absorbed. I do ask questions and come in with a list of concerns, but by gosh, it’s a day after my visit when I realize I’m missing some info I really wanted.

jlgc | @jlgc | Jan 8 5:09pm

Try physical therapy massage to the area. About 3 months post radiation to my left breast (post lumpectomy) I developed increasing pain along the trunk to bottom of ribs up to the axilla. I was sent to PT by one team because I was wondering if I had some radiation associated lymphedema. Never really decided if it was lymphedema but the Physical therapist felt the tissue was crunchy, tight (and sooo painful) and probably due to radiation. However A surgical NP denied that could be the cause. Yet the PT continued with deep massage of the area “releasing” the tightened areas, for several weeks with much relief. I can now lift my arm completely 100% with out pain. Patients should be made aware of the potential side effects from XRT before therapy begins, what to look for how to report it and obtain follow up. Radiologists are not known for their people skills they need encouragement.