Orange Peel Skin After Breast Cancer Surgery: Is It Lymphedema? | MyBCTeam

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Orange Peel Skin After Breast Cancer Surgery: Is It Lymphedema?

Medically reviewed by Danielle Leonardo, M.D.
Written by Emily Brown
Posted on August 14, 2023

Have you ever thought the texture of the skin on one or both of your breasts looked strangely similar to an orange peel? If so, you’re not alone. Changes to the breast skin, including the appearance of small dimples, can be expected after breast cancer treatments.

Orange peel skin can occur as a side effect of certain breast cancer treatments, like surgery and radiation therapy. It may be more common among breast cancer surgeries where part of the breast remains. While skin changes are common, some are important to report to your treatment team.

Learn more about what orange peel skin looks like, what may be causing it, and when it’s important to contact your health care provider.

What Orange Peel Skin Looks Like

Orange peel skin — also called peau d’orange — refers to skin that looks dimpled or puckered like the outside of an orange. It may appear like thickened, pitted skin and enlarged pores. One MyBCTeam member described it as the skin being “covered with tiny dimples.”

“Orange peel skin” doesn’t refer in any way to the color of an orange — though the symptom may be accompanied by other skin changes, such as a change in color, rash, or peeling skin. “I had only two radiation treatments, but my skin on my remaining breast got very dark in color and thick and bumpy, which I think might be ‘orange peel’ texture,” one MyBCTeam member shared.

Causes of Orange Peel Skin

Changes in skin texture, such as orange peel skin, can be a symptom of breast cancer, including inflammatory breast cancer (IBC), but developing skin changes doesn’t necessarily mean a person has breast cancer. Orange peel skin is also a side effect of some breast cancer treatments, like surgery and radiation.

Orange Peel Skin After Treatment

Surgery and radiation can lead to breast edema (fluid accumulation in the breast), which can then cause changes such as swelling, sagging, and orange peel skin. Research suggests that the main cause of breast edema is breast-conserving surgery — where the cancer is removed while keeping as much of the breast as possible — followed by radiation. Types of breast-conserving surgery include lumpectomy, quadrantectomy, segmental mastectomy, and partial mastectomy.

Breast-conserving surgery may be a good treatment option for people with early-stage breast cancer or certain types of breast cancer. For example, treatment for ductal carcinoma in situ (DCIS) often involves breast-conserving surgery or a simple mastectomy. Breast-conserving surgery is generally not an option for people with IBC or those with larger, more advanced tumors.

Orange Peel Skin and Lymphedema

Orange peel skin after breast surgery may be due to lymphedema. Certain breast cancer treatments, like radiation and surgery, can disrupt the way the lymphatic system functions, due to removal of or damage to lymph nodes. This can then lead to lymph fluid buildup and swelling, resulting in lymphedema, which usually affects the arms and legs.

Lymphedema is a common side effect of breast cancer treatment — as many as 4 out of 10 women who undergo breast cancer treatments develop lymphedema, according to a study in the World Journal of Clinical Oncology. Lymphedema may show up right after having surgery or radiation — or months or years later.

In the early stages of lymphedema, you may notice swelling of the arms or legs, often on the same side as where you received treatment. For example, lymphedema in the arms may occur on the same side of your body where you had breast-conserving surgery. In the later stages, scar tissue can build up in the affected limbs, changing the skin’s texture and resulting in orange peel skin.

What Kinds of Skin Changes To Expect After Treatment

Orange peel skin after breast cancer treatment may be accompanied by other skin changes. Radiation is a common culprit of skin side effects. In addition to orange peel skin, skin changes due to radiation may include:

  • Roughness
  • Swelling
  • Itchiness
  • Redness or darkening, depending on your skin tone
  • Peeling skin, often in the underside of the breast or skin folds

Burned or peeling skin after radiation is a common experience among MyBCTeam members:

  • “Some of my skin did peel away after a few weeks, and the dark discoloration is still there after four years.”
  • “I did have burning, mostly in my armpit and under my breast.”
  • “I have had 32 treatments. My skin burned the last few weeks.”
  • “My skin did burn and peel and ooze, like a very severe sunburn.”

If you have skin changes after treatment, let your doctor know. They can usually prescribe or recommend a medication to relieve some of the discomfort, like burned or peeling skin. For example, one MyBCTeam member shared, “I had redness and peeling; they gave me Silvadene, and it healed within a week or so.”

When To Talk to Your Doctor

While skin changes are common and can be expected after surgery and radiation, it’s a good idea to get any changes checked out by your doctor so they can determine if it’s a side effect of treatment or something else.

Tell your doctor if you notice dimpled skin or orange peel skin after surgery, as this may be a sign of lymphedema. Lymphedema can also be caused by cancer cells blocking lymph nodes or lymph vessels, or it can be triggered by an infection. If you notice swelling of the affected area that gets much worse within a day or two, talk to your doctor right away. It could be a sign of an infection, cancer recurrence, or a blood clot.

In addition, because orange peel skin can be a symptom of IBC — a rare form of breast cancer — it’s important to tell your doctor about this skin change. Speaking of their experience with inflammatory breast cancer, one MyBCTeam member wrote, “My first symptom was a small hint of redness (quarter size), not always visible, and then a thickness of my breast tissue, then the orange texture. … Not everyone has the same symptoms, but please get checked.”

Keep in mind that the presence of orange peel skin does not automatically mean cancer is present. However, it’s best to let your doctor know if you notice orange peel skin so that they can look into possible causes and determine the best course of treatment.

Talk With Others Who Understand

On MyBCTeam — the social network for people with breast cancer and their loved ones — more than 64,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Have you noticed orange peel skin on one or both of your breasts after treatment? What did it look or feel like for you? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Posted on August 14, 2023
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    Danielle Leonardo, M.D. is a board-certified specialist in internal medicine and medical oncology from the Philippines and has been practicing medicine since 2014. Learn more about her here.
    Emily Brown is a freelance writer and editor, specializing in health communication and public health. Learn more about her here.

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